As state laws put limits on gender-affirming care, ACP argues that widely accepted guidelines support providing this care for those with gender dysphoria
May 19, 2023 (ACP) — A growing number of states seek to ban or restrict gender-affirming care, and the American College of Physicians is stepping up its advocacy efforts to protect the rights of individuals with gender dysphoria and the physicians who are treating them.
“ACP firmly believes that gender-affirming care is an important component of comprehensive health care services for transgender and nonbinary patients,” said Joshua Serchen, ACP associate for health policy. “The College has long had policy affirming that public and private health benefit plans include comprehensive transgender health care services and provide all covered services to transgender persons as they would all other beneficiaries, including gender-affirming care.”
As such, ACP opposes efforts to restrict access to such evidence-based care and to prohibit public payers, such as state Medicaid programs, from covering this care. ACP has joined several amicus briefs, including two last month in Florida, and rallied against laws restricting gender-affirming care in Kentucky and Mississippi.
For individuals with gender dysphoria, gender-affirming care seeks to support them in exploring and living their life in a way that aligns with their gender identity, Serchen explained. “It includes medical interventions that facilitate the alignment of one's physiology with their gender identity, such as the use of puberty blockers and other forms of hormone therapy, combined with other social, psychological and behavioral interventions,” he said.
This is widely accepted as the standard of care for gender dysphoria to reduce the physical and mental harms associated with gender dysphoria and is considered safe, effective and necessary by numerous professional medical organizations, Serchen noted.
ACP has primarily been involved in advocacy in the judicial realm. “In the amicus briefs, ACP and other allied organizations argue that widely accepted guidelines support the provision of gender-affirming care for treating individuals experiencing gender dysphoria, that these guidelines were developed under a rigorous and transparent process based on scientific evidence and that prohibiting the gender-affirming care would cause irreparable harm to impacted patients experiencing gender dysphoria,” Serchen said.
Many state laws impose criminal and professional penalties on physicians who provide gender-affirming care, including the risk for imprisonment and loss of medical license, which sets a concerning precedent and can have a chilling effect on the practice of medicine, Serchen explained.
In Kentucky, a law enacted in March bans gender-affirming care for minors and forces detransition for any minors who are already receiving that care. In Mississippi, a new law, also passed in March, will ban gender-affirming care for patients younger than 18 and also threatens the medical license of any physician or other health care professional who violates the ban.
“ACP is strongly opposed to unnecessary government interference in the patient-physician relationship that prevents physicians from providing their patients with evidence-based, medical services,” Dr. Ryan D. Mire, ACP past president, said in a statement on the Mississippi law. He added: “Physicians should not face civil or licensure penalties for providing medical care that is in accordance with the recommendations of ACP and other medical organizations. Instead of policies that block access to health care and harm the patient-physician relationship, we need to seek ways to better support these families, improve access to care for these services and reduce social stigma.”
ACP policy on this issue stems from a 2015 position paper on lesbian, gay, bisexual and transgender health disparities, published in the Annals of Internal Medicine.
Every member can do something to call attention to these issues, Serchen said, as laws surrounding access to gender-affirming care are largely being debated at the state level. “Individual members can advocate for their state legislators to oppose efforts to restrict access to gender-affirming care or to introduce legislation to protect and expand access to care,” he said. “ACP expects this issue to continue to be a priority for many state legislatures throughout the country in 2023.”
Information on ACP Advocacy in the Courts is available on the ACP website.