News for Gay, Lesbian, Bisexual and Transgender Physicians

WHO considers incorporating gender identity diagnoses in ICD-11

As the World Health Organization (WHO) prepares to publish its revised International Statistical Classification of Diseases and Related Health Problems (ICD) by 2015, one particularly challenging issue has been the treatment of sexuality and gender identity. The task of working out this issue has been charged to the Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH), which has evaluated clinical and research data to inform the revision of these diagnostic categories that are currently included in the mental and behavioral disorders chapter of the ICD.

The WGSDSH's challenge was to find a balance between concerns related to the stigmatization of mental disorders and the need for diagnostic categories that facilitate access to health care. While transgender individuals need access to appropriate treatment, the stigma of a "mental disorder" diagnosis may do more harm than good.

In a major development in transgender health, the WGSDSH recently released their initial report in the International Review of Psychiatry.  The group believes that "it is now appropriate to abandon a psychopathological model of transgender people based on 1940s conceptualizations of sexual deviance and to move towards a model that is (1) more reflective of current scientific evidence and best practices; (2) more responsive to the needs, experience, and human rights of this vulnerable population; and (3) more supportive of the provision of accessible and high-quality healthcare services."

The AMA supports equal access to health care for transgender patients, including public and private health insurance coverage for treatment of gender identity disorder as recommended by the patient's physician.

Adopted children get crucial care from doctors specializing in their needs

Adopted children need more than just a loving home; they also need physicians trained to identify and care for their unique health needs, reports American Medical News. This specialization in the health needs of adoptees has become the primary focus of 65 physicians in 31 states, many of whom are trained as primary care doctors or specialize in infectious diseases or developmental-behavioral pediatrics.

Jane Aronson, MD, an infectious diseases specialist who has treated adopted children for about 25 years, explains that "most pediatricians and family doctors are not aware of the issues of adopted children." These include not only medical but also mental, behavioral and developmental challenges—especially for children adopted from abroad.

These challenges can begin even before the child is born, as their biological mother likely did not get appropriate prenatal care or used drugs or alcohol while pregnant. These are important considerations for the care of the nearly 65,500 adoptees living with gay, lesbian or bisexual parents—children likely to be foreign born and young.

Adoption specialists advise that initial evaluations of these children should be exceptionally thorough, as many issues facing foreign adoptees are not ones pediatricians normally think about. Other advice for physicians treating adoptees include being aware of local support groups and resources for adoptive parents and using vocabulary that reflects respect and permanency about adopted children and their families.