AMA Strengthens Policy on Protecting Access to Gender-affirming Care

The American Medical Association (AMA) House of Delegates today passed the Endocrine Society’s resolution to protect access to evidence-based gender-affirming care for transgender and gender-diverse individuals.

The Endocrine Society partnered with the American Association of Clinical Endocrinology (AACE), the American Society for Reproductive Medicine (ASRM), and the Medical Student Section of the AMA House of Delegates to develop and advocate for this resolution.

As political attacks on gender-affirming care escalate, it is the responsibility of the medical community to speak out in support of evidence-based care. Medical decisions should be made by patients, their relatives and health care providers, not politicians.

In the resolution, the AMA committed to opposing any criminal and legal penalties against patients seeking gender-affirming care, family members or guardians who support them in seeking medical care, and healthcare facilities and clinicians who provide gender-affirming care. The AMA will work at the federal and state level with legislators and regulators to oppose such policies and collaborate with other organizations to educate the Federation of State Medical Boards about the importance of gender-affirming care.

The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Urological Association, the American College of Physicians, and GLMA: Health Professionals Advancing LGBTQ+ Equality, also co-sponsored the Society’s resolution.

Approximately nine in ten transgender adults who wanted puberty-delaying treatment, but did not receive it, reported lifetime suicidal ideation.

Due to widespread misinformation about medical care for transgender and gender-diverse teens, 18 states have passed laws or instituted policies banning gender-affirming care. More than 30% of the nation’s transgender and gender-diverse youth now live in states with gender-affirming care bans, according to the Human Rights Campaign. Some policies are even restricting transgender and gender-diverse adults’ access to care.

These policies do not reflect the research landscape. More than 2,000 scientific studies have examined aspects of gender-affirming care since 1975, including more than 260 studies cited in the Endocrine Society’s Clinical Practice Guideline.

Pediatric gender-affirming care is designed to take a conservative approach. When young children experience feelings that their gender identity does not match the sex recorded at birth, the first course of action is to support the child in exploring their gender identity and to provide mental health support, as needed.

Medical intervention is reserved for older adolescents and adults, with treatment plans tailored to the individual and designed to maximize the time teenagers and their families have to make decisions about their transitions. Major medical organizations also agree on waiting until an individual has turned 18 or reached the age of majority in their country to undergo gender-affirming genital surgery.

Gender-affirming care can be life saving for a population with high suicide rates. For example, a 2020 study analyzed survey data from 89 transgender adults who had access to puberty-delaying medication while adolescents and data from more than 3,400 transgender adults who did not. The study found that those who received puberty-delaying hormone treatment had lower likelihood of lifetime suicidal ideation than those who wanted puberty-delaying treatment but did not receive it, even after adjusting for demographic variables and level of family support. Approximately nine in ten transgender adults who wanted puberty-delaying treatment, but did not receive it, reported lifetime suicidal ideation.

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