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McNamara M, Gentry KR, Sequeira GM, Kidd KM. State-Level Bans on the Care of Transgender and Gender Diverse Youth in the United States: Implications for Ethics and Advocacy. J Pediatr 2024:114182. [PMID: 38964438 DOI: 10.1016/j.jpeds.2024.114182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 05/26/2024] [Accepted: 06/26/2024] [Indexed: 07/06/2024]
Affiliation(s)
| | - Katherine R Gentry
- University of Washington School of Medicine, Department of Anesthesiology & Pain Medicine; Seattle Children's Hospital, Treuman Katz Center for Pediatric Bioethics and Palliative Care
| | - Gina M Sequeira
- Seattle Children's Hospital, Department of Pediatrics; University of Washington School of Medicine, Department of Pediatrics
| | - Kacie M Kidd
- West Virginia University School of Medicine, Department of Pediatrics
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Serchen J, Hilden DR, Beachy MW. Lesbian, Gay, Bisexual, Transgender, Queer, and Other Sexual and Gender Minority Health Disparities: A Position Paper From the American College of Physicians. Ann Intern Med 2024. [PMID: 38914001 DOI: 10.7326/m24-0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
Lesbian, gay, bisexual, transgender, queer, or other sexual and gender minorities (LGBTQ+) populations in the United States continue to experience disparities in health and health care. Discrimination in both health care and society at large negatively affects LGBTQ+ health. Although progress has been made in addressing health disparities and reducing social inequality for these populations, new challenges have emerged. There is a pressing need for physicians and other health professionals to take a stance against discriminatory policies as renewed federal and state public policy efforts increasingly impose medically unnecessary restrictions on the provision of gender-affirming care. In this position paper, the American College of Physicians (ACP) reaffirms and updates much of its long-standing policy on LGBTQ+ health to strongly support access to evidence-based, clinically indicated gender-affirming care and oppose political efforts to interfere in the patient-physician relationship. Furthermore, ACP opposes institutional and legal restrictions on undergraduate, graduate, and continuing medical education and training on gender-affirming care and LGBTQ+ health issues. This paper also offers policy recommendations to protect the right of all people to participate in public life free from discrimination on the basis of their gender identity or sexual orientation and encourages the deployment of inclusive, nondiscriminatory, and evidence-based blood donation policies for members of LGBTQ+ communities. Underlying these beliefs is a reaffirmed commitment to promoting equitable access to quality care for all people regardless of their sexual orientation and gender identity.
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Affiliation(s)
- Josh Serchen
- American College of Physicians, Washington, DC (J.S.)
| | | | - Micah W Beachy
- University of Nebraska Medical Center, Omaha, Nebraska (M.W.B.)
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McNamara M, McLamore Q, Meade N, Olgun M, Robinson H, Alstott A. A thematic analysis of disinformation in gender-affirming healthcare bans in the United States. Soc Sci Med 2024; 351:116943. [PMID: 38759383 DOI: 10.1016/j.socscimed.2024.116943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 04/18/2024] [Accepted: 05/03/2024] [Indexed: 05/19/2024]
Abstract
CONTEXT Bans on gender-affirming care (GAC) for transgender and gender-expansive (TGE) people are grounded in scientific disinformation and have been challenged in American courts. METHODS Five legal filings by state officials in defense of GAC restriction from initial litigation were analyzed using reflexive thematic analysis. Themes and subthemes of disinformation were identified after review and analysis of these filings. FINDINGS Five themes of disinformation emerged: False and misleading claims about (1) gender dysphoria and gender identity, (2) the evidence regarding GAC, (3) standard practice of GAC, (4) the safety of GAC, and finally, (5) rejection of medical authority. These themes were well represented across the analyzed documents. CONCLUSIONS The five disinformation themes and subthemes have been noted in lower courts, but have seen some purchase in appellate courts, suggesting that medical disinformation in law may have far-reaching consequences for medical policy.
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Affiliation(s)
| | | | - Nicolas Meade
- Yale School of Medicine, United States; University of Missouri at Columbia, United States
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Rahman A, Jacobson A, Tetreault T, Goodrich E, Rogerson A, Samora J, Bellamy J. Continuing the Conversation: Letter to the Editor: Equity360: Gender, Race, and Ethnicity: Sex and Fairness in Sports. Clin Orthop Relat Res 2024; 482:737-740. [PMID: 38126969 PMCID: PMC10936991 DOI: 10.1097/corr.0000000000002939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/27/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Ayesha Rahman
- Co-Director of Hand & Upper Extremity Surgery, New-York Presbyterian Hospital, Queens, NY, USA
- Assistant Professor of Orthopedic Surgery, Weill Medical College of Cornell University, New York, NY, USA
- Assistant Professor of Clinical Orthopedic Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Alicia Jacobson
- MD candidate, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Tyler Tetreault
- Clinical Instructor, University of Colorado School of Medicine, Department of Orthopedics, Aurora, CO, USA
| | - Ezra Goodrich
- Clinical Instructor, Department of Orthopedics, Henry Ford Hospital, Detroit, MI, USA
| | - Ashley Rogerson
- Associate Professor, University of Rochester School of Medicine and Dentistry, Department of Orthopaedics, Rochester, NY, USA
| | - Julie Samora
- Department of Orthopedic Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Jaime Bellamy
- Assistant Professor, Womack Army Medical Center, Ft. Bragg, NC, USA
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Thompson HM, Wang TM, Talan AJ, Baker KE, Restar AJ. First They Came for Us All: Responding to Anti-Transgender Structural Violence With Collective, Community-Engaged, and Intersectional Health Equity Research and Advocacy. HEALTH EDUCATION & BEHAVIOR 2024; 51:5-9. [PMID: 37746726 DOI: 10.1177/10901981231201146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
This article is a call for collective action across health equity researchers and advocates to build a more just world. We attempt to make sense of senseless structural and interpersonal brutality in the context of the current political climate across the United States, whereby the spectrum of gender nonconformity has been and continues to be stigmatized. From drag performance to transgender identities to gender-affirming health care, extremists have instrumentalized primary levers of democracy-the courts, legislatures, and social media-to attempt to outlaw and eradicate gender expansiveness and those who provide forms of support and care, including gender-affirming medical care, to transgender, nonbinary, and gender-expansive (TNBGE) individuals.
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Affiliation(s)
| | | | - Ali J Talan
- Whitman-Walker Institute, Washington, DC, USA
| | | | - Arjee J Restar
- School of Public Health, University of Washington, Seattle, WA, USA
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Roblee C, Keyes O, Blasdel G, Haley C, Lane M, Marquette L, Hsu J, Kuzon WM. A History of Gender-Affirming Surgery at the University of Michigan: Lessons for Today. Semin Plast Surg 2024; 38:53-60. [PMID: 38495068 PMCID: PMC10942835 DOI: 10.1055/s-0043-1778042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The University of Michigan has played an important role in advancing gender-affirming surgery programs in the United States. The University of Michigan was home to a little-known gender identity clinic shortly after the opening of the first such clinic at Johns Hopkins. Since 1995, the University of Michigan Comprehensive Services Program (UMCGSP) has been continually offering surgical services to transgender and gender diverse patients. Here, we present the history of both programs, drawn from program documents and oral history, and explore their implications for the future sustainability of gender-affirming surgery programs. The original gender identity clinic opened in 1968, and operated in a multidisciplinary fashion, similar to other clinics at the time. Eventually, the clinic was closed due to disinvestment and lack of sufficient providers to maintain the program, problems which are being increasingly recognized as barriers for similar programs. The modern program, UMCGSP is perhaps the longest continually running gender-affirming surgical program at an academic center. In spite of challenges, key investments in education, statewide community engagement, and the development of a comprehensive care model have helped UMCGSP avoid the pitfalls of the earlier clinic and remain relevant throughout its nearly 30-year history. In the face of rising challenges to gender-affirming care in the United States, much can be learned from the sustainability of the UMCGSP. Institutions seeking to maintain gender-affirming surgery programs should ensure the availability of comprehensive care and promote the education of the health care workforce.
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Affiliation(s)
- Cole Roblee
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Os Keyes
- Department of Human Centered Design and Engineering, University of Washington, Seattle, Washington
| | - Gaines Blasdel
- University of Michigan Medical School, Medical School, Ann Arbor, Michigan
| | - Caleb Haley
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Megan Lane
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Lauren Marquette
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Jessica Hsu
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - William M. Kuzon
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
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Shumer D, Roberts SA. Placing a Report of Bicalutamide-Induced Hepatotoxicity in the Context of Current Standards of Care for Transgender Adolescents. J Adolesc Health 2024; 74:5-6. [PMID: 38103922 DOI: 10.1016/j.jadohealth.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Daniel Shumer
- Division of Pediatric Endocrinology, C.S. Mott Children's Hospital/University of Michigan Medical School, Ann Arbor, Michigan
| | - Stephanie A Roberts
- Division of Endocrinology, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
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Barbee H, McKay T. Transgender Youths and Sanctuaries for Gender-Affirming Care. JAMA HEALTH FORUM 2023; 4:e234244. [PMID: 38038984 DOI: 10.1001/jamahealthforum.2023.4244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
This Viewpoint suggests ways state and local governments can support transgender youths seeking gender-affirming care amid continued passage of antitransgender legislation.
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Affiliation(s)
- Harry Barbee
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Tara McKay
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee
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