Medical Organization Statements
Leading medical groups recognize the medical necessity of treatments for gender dysphoria and endorse such treatments. Most of these groups have also explicitly rejected insurance exclusions for transgender-related care.
American Academy of Child and Adolescent Psychiatry
About the organization:
The mission of the 9,600-member American Academy of Child and Adolescent Psychiatry is to promote the healthy development of children, adolescents, and families through advocacy, education, and research, and to meet the professional needs of child and adolescent psychiatrists throughout their careers.
Statements:
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Florida’s “Don’t Say Gay or Trans” Law Stigmatizes LGBTQ+ Youth and Families
“Harmful legislation like the ‘Don’t Say Gay or Trans’ bill not only endangers the LGBTQ+ community, but it also jeopardizes their ability to reach their full potential. This action sends a dangerous message that certain voices don’t deserve to be heard. Additionally, this bill is a big step backwards for all marginalized communities, their families, and for the appreciation and understanding of diversity.”
“AACAP opposes policies that stigmatize normal and healthy expressions of sexual and gender identity… This bill exacerbates the stigma that many LGBTQ+ youth already experience and paves the way for other groups to similarly be targeted… This law grossly undermines the basic tenets of education policy by denying students access to and support from some of the most important and influential adults in their lives. This regressive approach to education and development will have devastating consequences for all, especially for LGBTQ+ youth and families.”
Date: March 18, 2022
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“The American Academy of Child and Adolescent Psychiatry (AACAP) supports the healthy development of all children, adolescents, and their families, including transgender and gender-diverse youth and families. Recent state attacks on gender-affirming support and care for transgender and gender-diverse youth endanger the welfare of many young people across the country. These attacks undermine the right of parents and caregivers to access evidence-based and developmentally appropriate treatment”
Date: March 1, 2022
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"The American Academy of Child and Adolescent Psychiatry (AACAP) supports the use of current evidence-based clinical care with minors. AACAP strongly opposes any efforts – legal, legislative, and otherwise – to block access to these recognized interventions. Blocking access to timely care has been shown to increase youths’ risk for suicidal ideation and other negative mental health outcomes. Consistent with AACAP’s policy against conversion therapy (2), AACAP recommends that youth and their families formulate an individualized treatment plan with their clinician that addresses the youth’s unique mental health needs under the premise that all gender identities and expressions are not inherently pathological."
Date: November 8, 2019
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Stewart L. Adelson & American Academy of Child and Adolescent Psychiatry Committee on Quality Issues, Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents, 51 J. Am. Acad. of Child & Adolesc. Psychiatry 957 (2012).
"Children and adolescents who are growing up gay, lesbian, bisexual, gender nonconforming, or gender discordant experience unique developmental challenges. They are at risk for certain mental health problems, many of which are significantly correlated with stigma and prejudice. Mental health professionals have an important role to play in fostering healthy development in this population. Influences on sexual orientation, gender nonconformity, and gender discordance, and their developmental relationships to each other, are reviewed. Practice principles and related issues of cultural competence, research needs, and ethics are discussed."
Date: Sept. 1, 2012
American Academy of Dermatology
About the organization:
The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 20,500 physicians worldwide, the AAD is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair, and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair, and nails.
Statements:
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The American Academy of Dermatology
- Strongly opposes recent efforts by state legislatures to restrict physicians’ ability to provide care to transgender youths.
- Recognizes the dignity and identity of transgender individuals and advocates for dermatologists’ ability to provide therapy and procedures that help the mental and physical well-being of these and all patients.
“Evidence has shown that transgender individuals who are forced to forgo gender-affirming care face an increased risk of mental health disorders including substance abuse disorders, and have higher rates of suicide. Transgender and gender-diverse individuals can benefit greatly from medical and surgical gender-affirming treatments. Treatments are often medically necessary for the health and well-being of these patients and are not to be considered as cosmetic or elective."
Date: June 1, 2021
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Position Statement on Sexual and Gender Minority Health in Dermatology
The American Academy of Dermatology
- "Recognizes that transgender and gender diverse individuals can benefit greatly from medical and surgical gender-affirming treatments.
- Supports evidence-based coverage of all gender-affirming therapy and procedures which help the mental and physical well-being of gender diverse individuals.
- Recognizes that gender-affirming procedures and treatments are not “cosmetic” or “elective” or for the mere convenience of the patient. These procedures are not optional in any meaningful sense, but are understood to be medically necessary for the health and well-being of the individual.
- Advocates for removal of barriers to care and supports both public and private health insurance coverage of gender transition treatment."
Date: March 4, 2019
American Academy of Family Physicians
About the organization:
Founded in 1947, the American Academy of Family Physicians represents 136,700 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.
Statements:
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NCCL Delegates Concern for Anti-Transgender Legislation
"The reference committee heard strong support for a resolution to oppose state legislation banning adolescent transgender care and to offer an advocacy toolkit on the subject, which delegates adopted.
Member testimony noted the sharp increase in anti-transgender legislation across the states and discussed how these bills are a direct interference in evidence-based care, and the denial of gender-affirming care is linked to adverse outcomes,” the committee reported. Members expressed particular concern that some of the bills “seek to penalize and criminalize physicians for medically necessary care.”
Date: 2021
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Frontline Physicians Oppose Legislation That Interferes in or Penalizes Patient Care
AAFP joined the American Academy of Pediatrics, The American College of Obstetricians and Gynecologists, the American College of Physicians, the American Osteopathic Association, and the American Psychiatric Association in opposing legislation that interferes in or penalizes patient care for transgender individuals.
"Our organizations, which represent nearly 600,000 physicians and medical students, oppose any laws and regulations that discriminate against transgender and gender-diverse individuals or interfere in the confidential relationship between a patient and their physician. That confidentiality is critical to allow patients to trust physicians to properly counsel, diagnose and treat.
Our organizations are strongly opposed to any legislation or regulation that would interfere with the provision of evidence-based patient care for any patient, affirming our commitment to patient safety. We recognize health as a basic human right for every person, regardless of gender identity or sexual orientation. For gender-diverse individuals, including children and adolescents, this means access to gender-affirming care that is part of comprehensive primary care.
Further, we strongly oppose any effort to criminalize or penalize physicians for providing necessary care for their patients. Physicians must be able to practice medicine that is informed by their years of medical education, training, experience, and the available evidence, freely and without threat of punishment. Patients and their physicians, not policymakers, should be the ones to make decisions together about what care is best for them."
Date: April 2, 2021
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Policy: Discrimination, Patient
"The AAFP opposes all discrimination in any form, including but not limited to, on the basis of actual or perceived race, color, religion, gender, sexual orientation, gender identity, ethnic affiliation, health, age, disability, economic status, body habitus or national origin."
Date: 2020
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Coverage Equity for Drugs, Testing, Procedure, Preventive Services, and Reproductive Technologies
"Employers and health plans should not discriminate by the patient's birth gender, sexual orientation, or marital status in the provision of health care benefits including a) prescription drugs and devices, b) elective sterilization procedures, c) diagnostic testing, d) medically indicated surgical procedures, and e) assisted reproductive technologies. These benefits should be covered under the same terms and conditions as other prescription drugs, devices, elective surgeries, diagnostic testing, and medically indicated surgical procedures.
Coverage should include medically appropriate services for individuals requiring transition or transgender care as determined by best practice standards, the patient, and the attending physician. Further, this coverage should extend to the medically-appropriate, sex-specific recommended preventive services determined appropriate by the patient's primary care physician."
Date: 2018
American Academy of Nursing
About the organization:
The American Academy of Nursing serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The Academy's more than 2,800 fellows are nursing's most accomplished leaders in policy, research, administration, practice, and academia.
Statements:
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Health Care Services for Transgender Individuals: Position Statement
Carol A. Sedlak & Carol J. Boyd, Health Care Services for Transgender Individuals: Position Statement, 64 Nursing Outlook 510-12 (Sept./Oct. 2016).
"The American Academy of Nursing supports initiatives to address the health needs of transgender individuals (TI) and supports policy initiatives that reduce the heath care barriers that most TI encounter. There is a great need for the development of strategies and policies to eliminate the health care disparities of approximately 700,000 TI in the United States."
Date: 2016
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AAN Comments HHS Sec 1557 Nondiscrimination Proposed Rule
The AAN opposed the repeal of transgender-specific protections under Section 1557 of the Affordable Care Act noting: "The proposed rule would eliminate the definition of sex discrimination from the Section 1557 regulation, inviting insurers to deny treatment to transgender and gender nonconforming patients, including the denial of treatments such as hormone therapy, counseling and surgery that are essential to transgender patients, as they see fit. ... Since the implementation of Section 1557, 18 states have implemented affirmative coverage protocols in their respective Medicaid programs to ensure coverage of medically necessary transition-related care. These coverage improvements and any future progress will be in jeopardy if this rule is finalized as proposed."
Date: 2019
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AAN joined an amicus brief in Fulcher v. Secretary of Veterans Affairs, which challenged the U.S. Department of Veterans Affairs' refusal to engage in rulemaking to reconsider its ban on providing transgender-related surgery to veterans.
Date: 2017
American Academy of Pediatrics
About the organization:
The American Academy of Pediatrics (AAP), a non-profit professional organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents, and young adults,
Statements:
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AAP SAHM Comments on Nondiscrimination in Health and Health Education Programs or Activities
The AAP opposed the repeal of transgender-specific protections under Section 1557 of the Affordable Care Act noting: "The proposal would also eliminate the provision that prohibits a health plan from categorically or automatically excluding or limiting coverage for health services related to gender transition. The rollback of these protections could have a devastating impact on access to medically necessary services for youth who identify as TGD and adversely affect self-esteem and contribute to the perception that they are undervalued by society and the health care system. Furthermore, insurance denials can reinforce a socioeconomic divide between those who can finance the high costs of uncovered care and those who cannot."
Date: 2019
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Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents
Jason Rafferty et al., Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents, 142 Pediatrics e20182162 (2018).
The AAP works toward all children and adolescents, regardless of gender identity or expression, receiving care to promote optimal physical, mental, and social well-being. Any discrimination based on gender identity or expression, real or perceived, is damaging to the socioemotional health of children, families, and society.
The AAP recommends that youth who identify as transgender and gender diverse have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space and that insurance plans offer coverage for health care that is specific to the needs of youth who identify as transgender and gender diverse, including coverage for medical, psychological, and, when indicated, surgical gender-affirming interventions.
Date: 2018
American Academy of Physician Assistants
About the organization:
Founded in 1968, the American Academy of Physician Assistants is the national professional society for PAs. It represents a profession of more than 140,000 PAs across all medical and surgical specialties in all 50 states, the District of Columbia, U.S. territories, and the uniformed services.
Statements:
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Letter Opposing Changes to Section 1557 Regulation
All the undersigned associations have adopted policies or otherwise support addressing the specific health concerns of LGBTQ people, including opposition to discrimination in health care and insurance coverage based on an individual’s sexual orientation or gender identity. As part of that commitment, our organizations support public and private health insurance coverage for treatment of gender dysphoria when medically necessary.
Date: 2019
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Guidelines for Ethical Conduct for the PA Profession
PAs should not discriminate against classes or categories of patients in the delivery of needed healthcare. Such classes and categories include gender, color, creed, race, religion, age, ethnic or national origin, political beliefs, nature of illness, disability, socioeconomic status, physical stature, body size, gender identity, marital status, or sexual orientation.
Date: 2018
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The Lesbian Bisexual Gay & Transgender PA (LBGT PA) Caucus joined an amicus brief in Fulcher v. Secretary of Veterans Affairs, which challenged the U.S. Department of Veterans Affairs' refusal to engage in rulemaking to reconsider its ban on providing transgender-related surgery to veterans.
Date: 2017
American College Health Association
About the organization:
Since 1920, the American College Health Association (ACHA) has served as the voice for student health and wellness. Through advocacy, research and education, ACHA stands at the forefront of issues that impact the health and wellness of our college students. ACHA represents over 1,100 institutions of higher education, representing the collective health and wellness needs of 10 million college students. ACHA serves nearly 3,000 individual college health and wellness professionals and leaders of all disciplines united together to advance the health and wellness of college students.
Statements:
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Statement on Legislation Affecting Medically Necessary Services for Transgender Patients
"As a society, we have made significant strides in removing barriers and improving health care and outcomes for transgender and gender diverse patients. Individuals feel more comfortable disclosing their authentic gender and are doing so at younger ages. Health care services should be made universal to all and should not discriminate in any way, whether this be on age; race/ethnicity, sex; sexual orientation; gender (including gender identity); marital status; physical size; religious, spiritual or cultural identity; psychological/physical/learning disability; socioeconomic status; or veteran status. This is consistent with the long held values of cultural inclusion, respect, equality, and equity that ACHA has advocated for.
Therefore, ACHA opposes any legislation, both state or federal, that would restrict or limit access to gender-related medically necessary services for transgender youth and adults."
Date: 2020
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ACHA rejects all forms of discriminatory conduct with respect to: age; race/ethnicity; sex; sexual orientation; gender, including gender identity and expression; marital status; physical size; psychological/physical/learning ability; religious, spiritual or cultural identity; socioeconomic status; or veteran status.
Date: 2019
American College of Nurse-Midwives
About the organization:
The American College of Nurse-Midwives (ACNM) is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States.
Statements:
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"The American College of Nurse-Midwives (ACNM) strongly opposes the U.S. Department of Health and Human Services’ (HHS) recent decision to finalize a rule removing non-discrimination protections established under the Affordable Care Act for LGBTQ people when it comes to health care providers and health insurance coverage. ACNM champions access to comprehensive sexual and reproductive health care services for every person, and as midwives we believe everyone has the right to make choices that meet their individual needs. Every person has the right to safe, supportive, and affirming health care in which providers demonstrate respect for human dignity."
Date: June 19, 2020
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Health Care for Transgender and Gender Non-Binary People
It is the position of ACNM that midwives should:
● Respect transgender and gender non-binary (TGNB) people. This includes becoming familiar with terminology related to gender identities and expression and endeavoring to use correct names, pronouns, and preferred anatomical language.
● Understand TGNB identity as a normal human variation rather than pathology.
● Be knowledgeable about the health care needs of TGNB people, including the individual and systematic barriers to care, as well as the options and benefits of gender-affirming treatment within a framework of shared decision-making and harm reduction.
● Provide or identify appropriate referral for reproductive and sexual health and primary care, including gender-affirming hormone therapy. Match treatment approaches to the specific needs of TGNB people, particularly their goals for gender affirmation and expression.
● Provide resources and referrals to support and advocate for patients within their families and communities (eg, schools, workplaces, and other settings).
● Advocate for, and work to create welcoming and inclusive health care settings for TGNB people (eg, gender-neutral bathrooms and gender inclusive forms, signage, education materials, and electronic health records).
Date: 2021
American College of Obstetricians and Gynecologists
About the organization:
The American College of Obstetricians and Gynecologists is the nation's leading group of professionals providing health care for women.
Statements:
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Committee Opinion No. 512: Health Care for Transgender Individuals, 118 Obstet Gynecol 1454 (2011).
"Within the medical community, transgender individuals face significant barriers to health care. This includes the failure of most health insurance plans to cover the cost of mental health services, cross-sex hormone therapy, or gender affirmation surgery. This barrier exists despite evidence that such treatments are safe and effective and that cross-gender behavior and gender identity issues are not an issue of choice for the individual and cannot be reversed with psychiatric treatment."
"The American College of Obstetricians and Gynecologists, therefore, urges public and private health insurance plans to cover the treatment of gender identity disorder."
Date: 2011
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Committee Opinion No. 685: Care for Transgender Adolescents
American College of Obstetricians and Gynecologists, Committee Opinion No. 685: Care for transgender adolescents, 129 Obstet Gynecol e11 (2017).
Date: 2017
American College of Physicians
About the organization:
The American College of Physicians recommends 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.
Statements:
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Hilary Daniel & Renee Butkus, for the Health and Public Policy Committee of the American College of Physicians, Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians, 163 Annals of Internal Medicine 135 (2015).
Date: 2015
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ACP joined an amicus brief in Fulcher v. Secretary of Veterans Affairs, which challenged the U.S. Department of Veterans Affairs' refusal to engage in rulemaking to reconsider its ban on providing transgender-related surgery to veterans.
Date: 2017
American Counseling Association
About the organization:
The American Counseling Association is a not-for-profit, professional and educational organization that is dedicated to the growth and enhancement of the counseling profession. Founded in 1952, ACA is the world's largest association exclusively representing professional counselors in various practice settings.
Statements:
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Competencies for Counseling Transgender Clients
The American Counseling Association's Association of Lesbian, Gay, Bisexual, and Transgender Issues in Counseling has issued competencies for counseling transgender clients that include "affirm[ing] transgender mental and medical health care (e.g., hormone therapies, sexual reassignment surgery, safe and trans-positive general medical services) through the entire lifespan."
Date: Nov. 7, 2011
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Nondiscrimination: Position Statement
The American Counseling Association is committed to nondiscrimination and to the prevention of harassment in all forms—verbal, physical, sexual, emotional, and psychological—including protections for transgender, gender non-conforming, and LGBTQ+ individuals.
Date: Undated
American Heart Association
About the organization:
The American Heart Association (AHA) is a nonprofit and nonpartisan organization that represents more than 100 million patients with cardiovascular disease (CVD) and includes more than 33 million volunteers and supporters committed to our goal of improving the cardiovascular health of all human beings. As the nation’s oldest and largest voluntary organization dedicated to building healthier lives free from cardiovascular disease and stroke, the AHA has long advocated for health equity, access to quality health insurance coverage, and evidence-based medical services and treatment for all individuals.
Statements:
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The AHA opposed the repeal of transgender-specific protections under Section 1557 of the Affordable Care Act noting: "Transgender people also face a high degree of insurance discrimination. Historically, many plans have used transgender-specific exclusions to deny transgender people coverage for medically necessary care—including hormone therapy, mental health counseling, and surgeries—even though the same services are routinely covered for non-transgender individuals. While the 2016 rule resulted in the elimination of transgender-specific exclusions from many private health insurance policies, transgender people continue to face a high number of denials for transition-related care. ...
This discrimination is not limited to transition-related care and, rather, affects all health care access for transgender people. ... These experiences of health care and health insurance discrimination contribute to significant health disparities. The LGBTQI community faces higher rates of substance use, including tobacco; higher rates of mental health issues; a higher risk of HIV and other sexually transmitted diseases; and a higher risk of certain types of cancer (due in part to reduced access to cancer screening). Relative to heterosexual people, lesbian, gay, and bisexual individuals are more likely to rate their overall and cardiovascular health as poor, have more chronic health conditions, have higher prevalence and earlier onset of disabilities, and have a heightened risk for CVD."
Date: 2019
American Medical Association
About the organization:
The American Medical Association, the largest association of physicians and medical students in the United States, articulates in H-185.950 that an "established body of medical research" shows both the medical effectiveness and necessity of "mental health care, hormone therapy, and sex reassignment surgery" in treating gender dysphoria. The AMA has resolved "[t]hat our American Medical Association support public and private health insurance coverage for treatment of gender identity disorder as recommended by the patient’s physician."
Statements:
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Clarification of Evidence-Based Gender-Affirming Care
The AMA:
- Recognizes that treatments for gender dysphoria and gender incongruence are medically necessary
- Will work with stakeholders to advocate for laws and policies that protect access to care, oppose laws and policies that impede the provision of care, support protections against liability for physicians and institutions who provide care and patients who seek it, and communicate about the importance of gender-affirming care
- Will advocate for coverage of gender-affirming care by public and private health insurer
Date: 2023
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AMA opposes effort to allow discrimination against patients
"This proposal marks the rare occasion in which a federal agency seeks to remove civil rights protections. It legitimizes unequal treatment of patients by not only providers, health care organizations, and insurers, but also by the government itself—and it will harm patients. Such policy should not be permitted by the U.S. government, let alone proposed by it.”
Date: June 12, 2020
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AMA statement on U.S. Supreme Court’s ruling on Title VII cases
“As physicians, and as leaders in medicine, we believe that LGBTQ+ individuals must be protected from workplace discrimination in order to prevent negative health outcomes. The AMA supports everyone’s access to quality, evidence-based health care regardless of gender or sexual orientation, and will continue to work 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 care.”
Date: June 15, 2020
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Transgender prisoners have fundamental right to appropriate care
"Prisoners have a fundamental right to access necessary and effective medical care, and that includes the full range of treatments for gender dysphoria. So argues a strongly worded friend-of-the-court brief filed by the AMA and other medical and mental health professional organizations."
Date: May 2019
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Health Insurance Coverage for Gender-Affirming Care of Transgender Patients
"The AMA opposes any discrimination based on an individual’s sex, sexual orientation or gender identity, opposes the denial of health insurance on the basis of sexual orientation or gender identity, and supports public and private health insurance coverage for treatment of gender dysphoria as recommended by the patient’s physician."
Date: 2019
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Removing Financial Barriers to Care for Transgender Patients H-185.950
"Our AMA supports public and private health insurance coverage for treatment of gender dysphoria as recommended by the patient's physician."
Date: 2016
American Medical Student Association
About the organization:
The American Medical Student Association is the oldest and largest independent association of physicians-in-training in the United States. Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing the concerns of physicians-in-training.
Statements:
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"AMSA adamantly opposes treatment policies that discriminate against patients based on their sexual orientation and gender identity, or that inhibit their access to quality care. Health care for transgender people should be individualized, holistic, and comprehensive – including, but not limited to surgical treatment– and transgender persons in the military should be allowed to openly undergo gender transition and be eligible for the equitable benefits and rights afforded to cisgendered service personnel, including health care."
Date: 2017
American Nurses Association
About the organization:
"The American Nurses Association (ANA) is the premier organization representing the interests of the nation's 4 million registered nurses. ANA is at the forefront of improving the quality of health care for all. Founded in 1896, and with members in all 50 states and U.S. territories, ANA is the strongest voice for the profession."
Statements:
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ANA Comment Letter to HHS on 1557 Revisions
The ANA opposed the repeal of transgender-specific protections under Section 1557 of the Affordable Care Act noting: "The proposed rule would substantially alter HHS’ current approach to discrimination in health care, removing a number of safeguards built into the 2016 regulations. Among the significant revisions proposed, HHS seeks to eliminate provisions clarifying the health care rights of LGBTQ+ individuals. If finalized, the rule’s definition of sex discrimination under Section 1557 would no longer include discrimination based on gender identity or sex-stereotyping. Additionally, there would be no prohibition to insurance plans denying or limiting health care coverage based on gender identity. Without these protections, providers and payers can deny care to transgender persons and to other LGBTQ+ patients based on sex-stereotyping."
Date: 2019
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Nursing Advocacy for LGBTQ+ Populations
"ANA is committed to the elimination of health disparities and discrimination based on sexual orientation, gender identity, and/or expression within health care. LGBTQ+ populations face significant obstacles accessing care such as stigma, discrimination, inequity in health insurance, and denial of care because of an individual’s sexual orientation or gender identity. ...
ANA condemns any discrimination based on sexual orientation, gender identity, and/or gender expression in access to or provision of health care."
Date: 2018
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ANA joined an amicus brief in Fulcher v. Secretary of Veterans Affairs, which challenged the U.S. Department of Veterans Affairs' refusal to engage in rulemaking to reconsider its ban on providing transgender-related surgery to veterans.
Date: 2017
American Osteopathic Association
About the organization:
The American Osteopathic Association represents more than 137,000 osteopathic physicians and medical students, promotes public health and serves as the primary certifying body for DOs.
Statements:
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American Osteopathic Association policy compendium H445-A/15 Gender Identity Non-Discrimination
"The American Osteopathic Association supports the provision of adequate and medically necessary treatment for transgender and gender-variant people and opposes discrimination on the basis of gender identity."
Date: 2015
American Psychiatric Association
About the organization:
The American Psychiatric Association is the world’s largest psychiatric organization and publisher of the Diagnostic and Statistical Manual.
Statements:
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Jack Drescher, M.D., Ellen Haller, M.D., APA Caucus of Lesbian, Gay and Bisexual Psychiatrists. Revised 2017 Eric Yarbrough, M.D., APA Caucus of LGBTQ Psychiatrists and the Council on Minority Mental Health and Health Disparities, APA Official Actions: Position Statement on Access to Care for Transgender and Gender Variant Individuals (2018).
“Significant and long-standing medical and psychiatric literature exists that demonstrates clear benefits of medical and surgical interventions to assist gender variant individuals seeking transition. … Access to medical care (both medical and surgical) positively impacts the mental health of transgender and gender variant individuals," and states the following:
- Recognizes that appropriately evaluated transgender and gender variant individuals can benefit greatly from medical and surgical gender transition treatments.
- Advocates for removal of barriers to care and supports both public and private health insurance coverage for gender transition treatment.
- Opposes categorical exclusions of coverage for such medically necessary treatment when prescribed by a physician.
- Supports evidence-based coverage of all gender-affirming procedures which would help the mental well-being of gender diverse individuals"
Date: 2018
American Psychological Association
About the organization:
The American Psychological Association is the largest association of psychologists worldwide.
Statements:
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“This policy statement affirms APA’s support for unobstructed access to healthcare and evidence-based clinical care for transgender, gender-diverse, and nonbinary children, adolescents, and adults.
Furthermore, this policy statement addresses the spread of misleading and unfounded narratives that mischaracterize gender dysphoria and affirming care, likely resulting in further stigmatization, marginalization, and lack of access to psychological and medical supports for transgender, gender-diverse, and nonbinary individuals.”
Date: February 2024
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APA adopts resolution opposing biased or coercive efforts to change individuals’ gender identity
"The American Psychological Association has adopted a resolution opposing efforts to change people’s gender identity, citing scientific research showing that such actions may be harmful.
The resolution, adopted by APA’s governing Council of Representatives on Feb. 26, aligns with the association’s stance against similar efforts aimed at changing people’s sexual orientation.
“There is a growing body of research that shows that transgender or nonbinary gender identities are normal variations in human expression of gender,” said APA President Jennifer F. Kelly, PhD. “Attempts to force people to conform with rigid gender identities can be harmful to their mental health and well-being.”
The Resolution on Gender Identity Change Efforts (PDF, 105KB) emphasizes that “individuals who have experienced pressure or coercion to conform to their sex assigned at birth or therapy that was biased toward conformity to one’s assigned sex at birth have reported harm resulting from these experiences, such as emotional distress, loss of relationships, and low self-worth.”
At the same meeting, the council also adopted an updated Resolution on Sexual Orientation Change Efforts (PDF, 222KB), which reiterates APA’s opposition to using nonscientific explanations to frame same-gender and multiple-gender orientations as unhealthy. APA adopted its first resolution discouraging efforts to change people’s sexual orientation in 1997 and a second in 2009, when it also issued a task force report with a systematic review of research on the topic. The new resolution now specifically opposes those efforts."
Date: March 2021
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APA RESOLUTION on Gender Identity Change Efforts
"WHEREAS APA opposes discrimination on the basis of gender identity, gender expression, and transgender and gender nonbinary identities, and actively opposes the adoption of discriminatory legislation (APA, 2008) .... BE IT FURTHER RESOLVED that the APA opposes the dissemination of inaccurate information about gender identity, gender expression, and the efficacy of GICE, including the claim that gender identity can be changed through treatment, the characterization of transgender or gender nonbinary identity as a mental disorder and the promotion of treatments that prescribe gender identity or expression consistent with one’s birth-assigned sex as effective for clients with gender dysphoria..."
Date: February 2021
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APA Comments on Nondiscrimination in Health and Health Education Programs or Activities
The APA opposed the repeal of transgender-specific protections under Section 1557 of the Affordable Care Act noting: "We are especially concerned about the discrimination many transgender people experience in the healthcare system because the proposed rule eliminates the general prohibition of discrimination based on gender identity, as well as specific health insurance coverage protections for transgender people. ...
APA practice guidelines recognize that care for transgender persons can include assessment, psychotherapy or surgery." Even though these treatments may be clinically necessary, providers or insurance plans under the proposed rule may refuse to provide or pay for them. ...
Additionally, after publication of the rule implementing Section 1557, one study showed that over 95% of insurers removed exclusions for gender dysphoria treatments from their 2017 plans, ensuring that a greater number of transgender consumers can have access to treatment. If the proposed rule were implemented, positive gains made in improving transgender health outcomes in recent years would be lost."
Date: 2019
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Transgender, Gender Identity & Gender Expression Non-Discrimination
Anton, B. S., Proceedings of the American Psychological Association for the legislative year 2008: Minutes of the annual meeting of the Council of Representatives. American Psychologist, 64, 372–453 (2009).
"Therefore be it resolved that APA opposes all public and private discrimination on the basis of actual or perceived gender identity and expression and urges the repeal of discriminatory laws and policies; ...
Therefore be it further resolved that APA calls upon psychologists in their professional roles to provide appropriate, nondiscriminatory treatment to transgender and gender variant individuals and encourages psychologists to take a leadership role in working against discrimination towards transgender and gender variant individuals; ...
Therefore be it further resolved that APA supports the provision of adequate and necessary mental and medical health care treatment for transgender and gender variant individuals;
Therefore be it further resolved that APA recognizes the efficacy, benefit and medical necessity of gender transition treatments for appropriately evaluated individuals and calls upon public and private insurers to cover these medically necessary treatments;
Therefore be it further resolved that APA supports access to appropriate treatment in institutional settings for people of all gender identities and expressions; including access to appropriate health care services including gender transition therapies; ..."
Date: 2008
American Public Health Association
About the organization:
The American Public Health Association is the nation’s leading public health organization with 25,000 members and works to advance the health of all people and all communities.
Statements:
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Promoting Transgender and Gender Minority Health through Inclusive Policies and Practices
APHA:
- Urges Congress and state legislatures to enact legislation to protect the rights, legal benefits, and access to services of people of all gender identities and expressions. ...
- Urges public and private workplaces to institute nondiscriminatory policies and practices inclusive of transgender and gender-nonconforming people. ...
- Encourages public health and health care practices that are inclusive of transgender and gender-nonconforming people.
- Encourages public and private entities to adopt policies and practices inclusive of transgender and gender-nonconforming people in different settings and across all sectors.
Date: 2016
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The Lesbian, Gay, Bisexual, and Transgender (LGBT) Caucus of the APHA joined an amicus brief in Fulcher v. Secretary of Veterans Affairs, which challenged the U.S. Department of Veterans Affairs' refusal to engage in rulemaking to reconsider its ban on providing transgender-related surgery to veterans.
Date: 2017
American Society of Plastic Surgeons
About the organization:
The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery.
Statements:
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Public comments on CMS Hospital Inpatient Prospective Payment Systems proposed rule for FY18
American Society of Plastic Surgeons to Seema Verma, Comment Letter on Proposed Rule on Medicare Program; Hospital Inpatient Prospective Payment System for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2018 Rates (June 13, 2017).
"We would be remiss to not also ask the Agency to review current policy for breast implant placement for trans females. As we are sure you are aware, in the typical patient, estrogen therapy alone does not result in what would be considered adequate growth of breast tissue. Augmentation procedures are necessary, and should be included as a reimbursable service.
We would encourage CMS to review the nuances of CPT coding for breast prosthesis, and adjust existing policy that excludes augmentation mammoplasty (CPT 19325) as a covered service for MtF patients undergoing gender confirmation surgery."
Date: June 13, 2017
Endocrine Society
About the organization:
Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. They have published clinical guidelines, Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. The Guideline is co-sponsored by the American Association of Clinical Endocrinologists, American Society of Andrology, European Society for Pediatric Endocrinology, European Society of Endocrinology, Pediatric Endocrine Society, and World Professional Association for Transgender Health.
Statements:
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Transgender Health Position Statement
- "There is a durable biological underpinning to gender identity that should be considered in policy determinations.
- Medical intervention for transgender youth and adults (including puberty suppression, hormone therapy and medically indicated surgery) is effective, relatively safe (when appropriately monitored), and has been established as the standard of care. Federal and private insurers should cover such interventions as prescribed by a physician as well as the appropriate medical screenings that are recommended for all body tissues that a person may have.
- Increased funding for national pediatric and adult transgender health research programs is needed to close the gaps in knowledge regarding transgender medical care and should be made a priority."
Date: December 2020
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Abby Walch, Caroline Davidge-Pitts, Joshua D Safer, Ximena Lopez, Vin Tangpricha, Sean J Iwamoto, Proper Care of Transgender and Gender Diverse Persons in the Setting of Proposed Discrimination: A Policy Perspective, The Journal of Clinical Endocrinology & Metabolism, dgaa816, https://doi.org/10.1210/clinem/dgaa816.
Date: December 2020
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Wylie C. Hembree et al., Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline, Journal of Clinical Endocrinology & Metabolism, November 2017, 102(11):1–35.
Date: 2017
Federation of Pediatric Organizations
About the organization:
The Federation of Pediatric Organizations (FOPO) is an umbrella organization made up of the leadership of the Academic Pediatric Association, the American Academy of Pediatrics, the American Board of Pediatrics, the American Pediatric Society, the Association of Medical School Pediatric Department Chairs, the Association of Pediatric Program Directors, and the Society for Pediatric Research. The purpose of the Federation of Pediatric Organizations (FOPO) is to promote optimal health for children by building on the efforts and expertise of the member organizations, and on the relationships between the member organizations to accomplish shared goals.
Statements:
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Statement in Support of Transgender Children and Youth,
their Families, and Health Care Providers"We stand with pediatricians who partner with families every day to make the best possible decision for each individual child based on available research and evidence pertinent to that child’s care. Transgender and gender diverse children and youth deserve to lead safe, healthy lives in environments that allow them to be their authentic selves. That can only happen if physicians are allowed to treat these children in the same manner, and with the same respect, that we expect them to treat every other child. Our mission to advance child health will succeed only if we work to improve health outcomes for all children."
Date: March 28, 2022
GLMA: Health Professionals Advancing LGBTQ Equality
About the organization:
GLMA is a national organization committed to ensuring health equity for lesbian, gay, bisexual, transgender, queer (LGBTQ) and all sexual and gender minority (SGM) individuals, and equality for LGBTQ/SGM health professionals in their work and learning environments. To achieve this mission, GLMA utilizes the scientific expertise of its diverse multidisciplinary membership to inform and drive advocacy, education, and research.
Statements:
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GLMA 127-18-101: Transgender Healthcare
"Therapeutic treatment, including hormone therapy, mental health therapy and gender affirming surgeries, are medically necessary for the treatment of gender dysphoria. These gender-affirming medical and surgical treatments should be covered by all public and private insurance plans."
Date: 2018
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Health Insurance Coverage for Gender-Affirming Care of Transgender Patients
"GLMA: Health Professionals Advancing LGBTQ Equality recognizes that mental healthcare, hormone replacement therapy, and/or gender-affirming surgery are medically necessary for the treatment of transgender people who meet the criteria for gender dysphoria and advocates that these services not be excluded from any public or private insurance programs."
Date: 2018
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GLMA joined an amicus brief in Fulcher v. Secretary of Veterans Affairs, which challenged the U.S. Department of Veterans Affairs' refusal to engage in rulemaking to reconsider its ban on providing transgender-related surgery to veterans.
Date: 2017
National Association of Nurse Practitioners in Women's Health
About the organization:
The National Association of Nurse Practitioners in Women's Health's (NPWH) mission is to ensure the provision of quality primary and specialty healthcare to women of all ages by women's-health and women's-health-focused nurse practitioners.
Statements:
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Healthcare for Transgender and Gender Non-Conforming Individuals
"NPWH encourages all NPs who provide sexual and reproductive healthcare to seek out learning opportunities to improve their ability to provide evidence-based, culturally competent care for transgender and GNC individuals. NPWH supports the role of NPs in providing gender-affirming hormone therapy and pre- and post-gender-affirming surgery care for individuals who desire such treatment."
Date: Oct. 2017
National Association of Social Workers
About the organization:
Founded in 1955, the National Association of Social Workers (NASW) is the largest membership organization of professional social workers in the world, with more than 120,000 members. NASW works to enhance the professional growth and development of its members, to create and maintain professional standards, and to advance sound social policies.
Statements:
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Transgender and Gender Identity Issues
National Association of Social Workers, Transgender and Gender Identity Issues, in Social Work Speaks: National Association of Social Workers Policy Statements 2009-2012, 347 (8th ed. 2009).
NASW "supports the rights of all individuals to receive health insurance and other health coverage without discrimination on the basis of gender identity, and specifically without exclusion of services related to transgender or transsexual transition (or sex change), to receive medical and mental health services through their primary care physician and the appropriate referrals to medical specialists, which may include hormone replacement therapy, surgical interventions, prosthetic devices, and other medical procedures."
Note: the current version can be found in Social Work Speaks: National Association of Social Workers Policy Statements 2018–2020 (11th ed. 2018).
Date: 2009
National Commission on Correctional Health Care
About the organization:
The mission of the National Commission on Correctional Health Care is to improve the quality of health care in jails, prisons and juvenile confinement facilities. NCCHC establishes standards for health services in correctional facilities, operates a voluntary accreditation program for institutions that meet those standards, produces resource publications, conducts educational conferences and offers certification for correctional health professionals. NCCHC is supported by the major national organizations representing the fields of health, mental health, law and corrections. Each supporting organization has named a liaison to the NCCHC board of directors to create a robust, multidisciplinary governing structure that reflects the complexities of correctional health care.
Statements:
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Transgender, Transsexual, and Gender Nonconforming Health Care in Correctional Settings
"Because jails, prisons, and juvenile confinement facilities have a responsibility to ensure the physical and mental health and well-being of inmates in their custody, correctional health staff should manage transgender patients in a manner that respects their biomedical and psychological needs. The National Commission on Correctional Health Care recommends that the following principles guide correctional health professionals in addressing the needs of transgender patients: ...
- Because transgender patients may be under different stages of care prior to incarceration, there should be no blanket administrative or other policies that restrict specific medical treatments. Policies that make treatments available only to those who received them prior to incarceration or that limit transition and/or maintenance are inappropriate and out of step with medical standards and should be avoided. ...
- Accepted treatments for gender dysphoria should be made available to people with gender dysphoria. Providing mental health care, while necessary, is not sufficient. ...
- When determined to be medically necessary for a particular patient, hormone therapy should be initiated and regular laboratory monitoring should be conducted according to community medical standards.
- Sex reassignment surgery should be considered on a case-by-case basis and provided when determined to be medically necessary for a patient."
Date: 2015
Pediatric Endocrine Society
About the organization:
The Pediatric Endocrine Society (PES) is the leading professional society for this specialty in the United States. The mission of PES is to advance and promote the endocrine health and well-being of children and adolescents. The PES has over 1,400 members representing the multiple disciplines of Pediatric Endocrinology.
The PES Transgender and Gender Non-Conforming Youth Special Interest Group is dedicated to providing safe, comprehensive and evidence based medical care to transgender and gender nonconforming youth.
Statements:
-
Transgender Health Position Statement
"Medical intervention for transgender youth and adults (including puberty suppression, hormone therapy and medically indicated surgery) is effective, relatively safe (when appropriately monitored), and has been established as the standard of care. Federal and private insurers should cover such interventions as prescribed by a physician as well as the appropriate medical screenings that are recommended for all body tissues that a person may have."
Date: December 2020
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Pediatric Endocrine Society/Endocrine Society Joint Position Statement on Transgender Health
"There is a durable biological underpinning to gender identity that should be considered in policy determinations.
Medical intervention for transgender youth and adults (including puberty suppression, hormone therapy, and medically indicated surgery) is effective, relatively safe (when appropriately monitored), and has been established as the standard of care.6 Federal and private insurers should cover such interventions as prescribed by a physician as well as the appropriate medical screenings that are recommended for all body tissues that a person may have.
Increased funding for national pediatric and adult transgender health research programs is needed to close the gaps in knowledge regarding transgender medical care and should be made a priority."
Date: December 2020
-
Abby Walch, Caroline Davidge-Pitts, Joshua D Safer, Ximena Lopez, Vin Tangpricha, Sean J Iwamoto, Proper Care of Transgender and Gender Diverse Persons in the Setting of Proposed Discrimination: A Policy Perspective, The Journal of Clinical Endocrinology & Metabolism, dgaa816, https://doi.org/10.1210/clinem/dgaa816.
Date: December 2020
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Discriminatory policies threaten care for transgender, gender diverse individuals
"The Endocrine Society and the Pediatric Endocrine Society oppose legislative efforts to block transgender and gender diverse individuals from accessing gender-affirming medical and surgical care, the two medical societies said in a joint policy perspective published in The Journal of Clinical Endocrinology & Metabolism."
Date: December 2020
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PES Fact Sheet: Introduction to Health for Transgender Youth
Date: June 17, 2020
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PES Fact Sheet: Masculinizing Treatment for Transgender Males
Date: 2018
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PES Fact Sheet: Feminizing Treatment for Transgender Females
Date: 2018
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Ximena Lopez, Maja Marinkovic, Toni Eimicke, Stephen M. Rosenthal & Jerrold S. Olshan, “Statement on gender-affirmative approach to care from the pediatric endocrine society special interest group on transgender health.” Current opinion in pediatrics vol. 29,4 (2017): 475-480. doi:10.1097/MOP.0000000000000516
"[T]ransgender youth have optimal outcomes when affirmed in their gender identity, through support by their families and their environment, as well as appropriate mental health and medical care. For this reason, the Pediatric Endocrine Society Special Interest Group on Transgender Health joins other academic societies involved in the care of children and adolescents in supporting policies that promote a safe and accepting environment for gender nonconforming/transgender youth, as well as adequate mental health and medical care."
Date: May 27, 2017
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PES Statement Promoting Safety of Transgender Youth
"The Pediatric Endocrine Society (PES), the leading professional society for this specialty in the United States, strongly opposes the guidance issued on February 22, 2017, by the Departments of Justice and Education, which eliminates protection of the rights of transgender youth."
Date: March 2017
Society for Adolescent Health and Medicine
About the organization:
Founded in 1968, the Society for Adolescent Health and Medicine (SAHM) is a multidisciplinary organization committed to improving the physical and psychosocial health and well-being of all adolescents through advocacy, clinical care, health promotion, health service delivery, professional development and research.
Statements:
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AAP SAHM Comments on Nondiscrimination in Health and Health Education Programs or Activities
SAHM opposed the repeal of transgender-specific protections under Section 1557 of the Affordable Care Act noting: "The proposal would also eliminate the provision that prohibits a health plan from categorically or automatically excluding or limiting coverage for health services related to gender transition. The rollback of these protections could have a devastating impact on access to medically necessary services for youth who identify as TGD [transgender and gender diverse] and adversely affect self-esteem and contribute to the perception that they are undervalued by society and the health care system. Furthermore, insurance denials can reinforce a socioeconomic divide between those who can finance the high costs of uncovered care and those who cannot."
Date: 2019
World Medical Association
About the organization:
The World Medical Association (WMA) is an international organization representing physicians. The organization was created to ensure the independence of physicians, and to work for the highest possible standards of ethical behavior and care by physicians, at all times. Membership consists of 114 National Medical Associations.
Statements:
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Statement on Transgender People
The WMA recommends, among other things, the following:
- "The WMA emphasises that everyone has the right to determine one’s own gender and recognises the diversity of possibilities in this respect. The WMA calls for physicians to uphold each individual’s right to self-identification with regards to gender.
- The WMA asserts that gender incongruence is not in itself a mental disorder; however it can lead to discomfort or distress, which is referred to as gender dysphoria (DSM-5).
- The WMA affirms that, in general, any health-related procedure or treatment related to an individual’s transgender status, e.g. surgical interventions, hormone therapy or psychotherapy, requires the freely given informed and explicit consent of the patient.
- The WMA urges that every effort be made to make individualised, multi-professional, interdisciplinary and affordable transgender healthcare (including speech therapy, hormonal treatment, surgical interventions and mental healthcare) available to all people who experience gender incongruence in order to reduce or to prevent pronounced gender dysphoria. [...]"
Date: Oct. 2015
World Professional Association for Transgender Health
About the organization:
The World Professional Association for Transgender Health (WPATH) is an international, interdisciplinary, professional association devoted to the understanding and treatment of individuals with Gender Dysphoria (GD). Founded in 1979, and currently with over 1500 medical, mental health, social scientist, and legal professional members, all of whom are engaged in clinical practice and/or research that affects the lives of transgender and transsexual people, WPATH is the oldest professional association in the world that continuously has been concerned with this clinical specialty.
Recognized by the American Medical Association as "leading international, interdisciplinary professional organization devoted to the understanding and treatment of gender identity disorders," WPATH issues the widely followed Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People.
Statements:
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Listing procedures that should be covered by insurance plans based on the Standards of Care.
Date: June 28, 2018
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"The WPATH Board of Directors urges health insurance carriers and healthcare providers in the United States to eliminate transgender or transsexual exclusions from their policy documents and medical guidelines, and to provide coverage for transgender patients; also to include in their policy documents and medical guidelines the medically prescribed sex reassignment or gender affirming/confirming services necessary for subscribers’ treatment and well-being; and to ensure that ongoing healthcare, both routine and specialized, is readily accessible and affordable to all their subscribers on an equal basis."
Date: Dec. 21, 2016
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Date: 2011
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