Population Care

Why anti-transgender bills are a dangerous intrusion on medicine

Kevin B. O'Reilly , Senior News Editor

What’s the news: The AMA is sending a strong message to America’s governors to stop interfering in the medical care of transgender minors.

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Legislation pending in several states aims to prohibit medically necessary gender transition-related care for minor patients. AMA Executive Vice President and CEO James L. Madara, MD, wrote to Bill McBride, executive director of the National Governors Association warning that these measures would “insert the government into clinical decision-making and force physicians to disregard clinical guidelines.” Such legislation was enacted in Arkansas last month after legislators overrode a veto by Republican Gov. Asa Hutchinson.

“Decisions about medical care belong within the sanctity of the patient-physician relationship,” he added. “We believe it is inappropriate and harmful for any state to legislatively dictate that certain transition-related services are never appropriate and limit the range of options physicians and families may consider when making decisions for pediatric patients.”

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Why it’s important: “Forgoing gender-affirming care can have tragic consequences,” Dr. Madara wrote, noting that transgender patients are up to three times likelier than other patients to have a mental health disorder. “The increased prevalence of these mental health conditions is widely thought to be a consequence of minority stress, the chronic stress from coping with societal stigma, and discrimination because of one’s gender identity and expression. Because of this stress, transgender minors also face a significantly heightened risk of suicide.”

Treatment for gender dysphoria can include counseling, social transition, hormone therapy or surgery. The “clinical guidelines established by professional medical organizations for the care of minors promote these supportive interventions based on the current evidence and that enable young people to explore and live the gender that they choose,” Dr. Madara wrote. “Every major medical association in the United States recognizes the medical necessity of transition-related care for improving the physical and mental health of transgender people.”

Find out how the new president is showing strong signs on LGBTQ+ inclusion and health.

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Learn more: Another concerning trend are bills—introduced in a majority of states this year—to bar transgender women and girls from participating in school athletics consistent with their gender identity. In some states, a physician or other health professional would need to verify a student’s sex.

Last year, Idaho became the first state to enact a ban on transgender minors’ participation in youth athletics. The law was challenged and blocked by a federal court last summer. The AMA, along with the American Academy of Pediatrics and other health care organizations, submitted a friend-of-the-court brief (PDF) with the 9th U.S. Circuit Court of Appeals noting that the law undermines the accepted approach for treating gender dysphoria.

Find out more about the AMA Advisory Committee on LGBTQ Issues, as well as an AMA Foundation fellowship program that offers a chance to transform the nation’s LGBTQ+ care.