The American Medical Association supports everyone’s access to quality evidence-based health care regardless of gender or sexual orientation. To ensure that LGBTQ patients are not discriminated against in seeking the care they need, nor forced into medically un-sound programs, the AMA works diligently at the state and federal levels to expand access to medical services, reduce stigma in treating patients with unique needs and break down discriminatory barriers to necessary care.
LGBTQ “conversion therapy”
“Conversion therapy” refers to any form of interventions which attempt to change an individual’s sexual orientation, sexual behaviors or gender identity. Underlying these ‘therapies’ is the assumption that homosexuality and gender nonconformity are mental disorders and that sexual orientation and gender identity can be changed. This assumption is not based on medical or scientific evidence. Professional consensus rejects pathologizing homosexuality and gender nonconformity and evidence does not support the efficacy of changing sexual orientation.
“Conversion therapy” often includes unethical techniques including electric shock, deprivation of food and liquid, chemically induced nausea and masturbation reconditioning. These practices may increase suicidal behaviors and cause significant psychological distress, anxiety, lowered self-esteem, internalized homophobia, self-blame, intrusive imagery and sexual dysfunction.
The AMA opposes the use of “conversion therapy” for sexual orientation or gender identity.
Coverage for gender-affirming care
Transgender patients often face discriminatory hurdles in accessing medically necessary health care services that affirm gender or treat gender dysphoria. As a population, transgender individuals are less likely to be insured than both the lesbian, gay, bisexual and general population. Among those that are insured, a national survey found that 25 percent of transgender individuals who sought coverage for hormones in the past year were denied and 55 percent of those who sought coverage for transition-related surgery in the past year were denied.
Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population. Receipt of gender-affirming care has been linked to dramatically reduced rates of suicide attempts, decreased rates of depression and anxiety, decreased substance use, improved HIV medication adherence and reduced rates of harmful self-prescribed hormone use.
The AMA supports public and private health insurance coverage for treatment of gender dysphoria and opposes the denial of health insurance based on sexual orientation or gender identity.
Transgender individuals’ access to public facilities
For many transgender individuals, social transition is a critically important part of medically necessary treatment. Social transition involves living one’s life fully in accordance with one’s gender identity and typically includes publicly identifying oneself as that gender, adopting a new name, using different pronouns, grooming and dressing in a manner typically associated with one’s gender identity and using restroom and other single-sex facilities consistent with that identity. Policies excluding transgender individuals from restrooms and other facilities undermine well-established treatment protocols for gender dysphoria, expose individuals to stigma and discrimination as well as potential harassment and abuse and impair their social and emotional development, leading to poorer health outcomes throughout life.
Transgender individuals face a greater risk of violence when using a public facility that does not correspond with their gender identity, including being verbally harassed, physically assaulted, or sexually assaulted when accessing a restroom. In addition, prolonged avoidance of the restroom can cause physical harm including dehydration, continence issues, kidney issues and urinary tract infections.
The AMA opposes policies preventing transgender individuals from accessing basic human services and public facilities consistent with gender identity, including the use of restrooms.