Every major medical association and leading world health authority supports health care for transgender people and youth. They are also increasingly speaking out against the disinformation being spread by opponents of this care. Below are excerpts from 30+ organizations’ statements.
Reporters covering state bills and other discussions about this care should note that every major medical association supports health care for transgender people and youth as safe and lifesaving.
The following have issued statements in support of health care for transgender people and youth:
American Academy of Child and Adolescent Psychiatry
American Academy of Dermatology
American Academy of Pediatrics
American Academy of Physician Assistants
American Association of Clinical Endocrinology
American Association of Geriatric Psychiatry
American College Health Association
American College of Nurse-Midwives
American College of Obstetricians and Gynecologists
American College of Physicians
American Counseling Association
American Medical Student Association
American Psychiatric Association
American Society of Plastic Surgeons
American Society for Reproductive Medicine
American Urological Association
Federation of Pediatric Organizations
GLMA: Health Professionals Advancing LGBTQ Equality
The Journal of the American Medical Association
National Association of Nurse Practitioners in Women’s Health
National Association of Social Workers
Pediatrics (Journal of the American Academy of Pediatrics ) and Seattle Children’s Hospital
United States Professional Association for Transgender Health (USPATH)
World Health Organization (WHO)
World Professional Association for Transgender Health
In the December 23 issue of the journal Pediatrics, doctors from Seattle Children’s Hospital published an article that describes bans on care for transgender youth as a form of child abuse.
In “Prohibition of Gender-Affirming Care as a Form of Child Maltreatment: Reframing the Discussion,” the authors write: “These legislative efforts operate under the guise of protecting children. In reality, they punish caregivers and physicians when they choose to support children. They deny children access to routine health care that has been shown to decrease dramatically high rates of suicide and depression for TGD (transgender and gender diverse) youth. They fuel discriminatory rhetoric, which negatively impacts the mental health of TGD children and imperils their safety.”
Ohio Children’s Hospital submitted testimony to the Ohio state Senate in December 2023 in defense of transgender health care for youth and against Ohio’s HB68, which sought to ban it:
“It is so unfathomable to hear the statements made regarding what pediatric providers do and don’t do when treating youth who are expressing a conflict between the sex they were assigned at birth and the gender with which they identify. This false narrative is intended to incite fear in order to take away parental rights and restrict health care,” wrote Associate Chief Medical Officer for Behavioral Health at Ohio Children’s Hospital-Dayton, Kelly Blankenship.
“At Dayton Children’s Hospital, all service lines within our hospital follow national standards of care to ensure quality, safety, and deliver best outcomes,” Blankenship continued. “All care delivered is age-appropriate, and aligned with clinical practice guidelines based on research… Our health care providers evaluate all symptoms, and patients are screened and evaluated for all comorbid mental health conditions before determining if treatment is needed. We seek to ensure that the decision of each parent is informed by medically sound information and is free from coercion or undue influence. Again, Dayton Children’s does not perform hysterectomies, or any genital surgeries, as part of gender affirming medical care. The care provided by the medical and mental health professionals at Dayton Children’s is all evidence-based. We believe all young people should have access to comprehensive, developmentally appropriate, mental health care and gender-affirming health care provided in a safe and inclusive environment. Transgender children, adolescents, and their families deserve care that is grounded in science, compassion and ethics.”
Nick Lashutka, President and CEO of the Ohio Children’s Hospital, submitted additional testimony in May 2023: “The allegations made against children’s hospitals by supporters of HB 68 are deeply offensive and disappointing. Children’s hospitals across Ohio are filled with pediatric experts who have dedicated their lives to caring for kids.”
“Here are the facts.” Lashutka continued, “1. Children’s hospitals in Ohio have responded to a need in the community to serve a very small, but complex population. 2. All medical gender dysphoria treatment requires parental consent. It is supported by a multi-disciplinary team of professionals, including pediatric specialists in psychiatry, adolescent medicine, and endocrinology. 3. Again, we DO NOT perform surgeries on minors for the condition of gender dysphoria. 4. Individuals diagnosed with gender dysphoria are consistent, persistent, and insistent for a lengthy period of time. The notion that kids declare a feeling and are immediately medicated at one of our clinics is false. 5. Patients do not self-diagnose their gender dysphoria; they present with symptoms of gender dysphoria. Their health care providers evaluate these symptoms, and only their health care providers make diagnoses. 6. All comorbid mental health conditions are screened and evaluated before determining if additional treatment is needed. 7. Patients do not receive blockers or hormones at their first appointment.”
On June 12, 2023, The American Medical Association passed a resolution drafted by The Endocrine Society to protect access to evidence-based care for transgender and gender-diverse youth, noting “it is the responsibility of the medical community to speak out in support of evidence-based care. Medical decisions should be made by patients, their relatives and health care providers, not politicians.”
The resolution was cosponsored by:
- The American Academy of Pediatrics
- The American College of Obstetricians and Gynecologists
- The American Urological Association
- The American Society for Reproductive Medicine
- The American College of Physicians
- The American Association of Clinical Endocrinology
- GLMA: Health Professionals Advancing LGBTQ+ Equality
- the AMA’s Medical Student Section
The resolution stated the widespread misinformation and bans on care “do not reflect the research landscape. More than 2,000 scientific studies have examined aspects of gender-affirming care since 1975, including more than 260 studies cited in the Endocrine Society’s Clinical Practice Guideline.”
Additional excerpts from organization statements:
American Academy of Child and Adolescent Psychiatry: “The AAP’s 2018 policy statement ‘Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents’ defines gender affirmation as developmentally appropriate, nonjudgmental, supportive care provided in a safe clinical space. The policy states that pediatric providers, often the first medical professionals to discover a child’s gender identity concerns, have a special role in caring for these patients who have a high risk of depression, anxiety and suicide. The care model is not one-size-fits-all, said Brittany Allen, M.D., FAAP, a member of the AAP Section on LGBTQ Executive Committee. It recognizes the wide spectrum of normal, healthy gender identities.” (January 6, 2022)
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, 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.” (November 8, 2019)
American Academy of Dermatology: “The AADA 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. Transgender and gender-diverse individuals can benefit greatly from medical and surgical gender-affirming treatments. These treatments are often medically necessary for the health and well-being of these patients and are not to be considered as cosmetic or elective. Decisions about care should remain within the confines of the physician-patient relationship, guided by strong medical evidence and the best interests of the individual patient.” (June 1, 2021)
American Medical Association: “Empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression. For gender diverse individuals, standards of care and accepted medically necessary services that affirm gender or treat gender dysphoria may include mental health counseling, non-medical social transition, gender-affirming hormone therapy, and/or gender-affirming surgeries. 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. 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.” (April 26, 2021)
The American Medical Association passed a resolution drafted by The Endocrine Society to protect access to evidence-based gender-affirming care for transgender and gender-diverse youth. (June 12, 2023)
American Nurses Association: “The American Nurses Association strongly opposes any legislation or policy action that places restrictions on transgender health care and that criminalizes gender-affirming care. Due to recent state legislative efforts, transgender and gender-diverse youth and their parents or guardians who choose to access gender-affirming care may come under legal assault in many states. Health care professionals, including nurses and advanced practice registered nurses (APRNs) who provide gender-affirming care, may also be subject to judicial process or other legal action. These restrictive laws interfere with the trust and confidentiality between patients, parents or guardians, and clinicians in the delivery of evidence-based care. The legislative intent and medical claims behind these laws are not grounded in reputable science and conflict with the nurse’s obligation to promote, advocate, and protect the rights, health, and safety of patients. ANA’s Position Statement Nursing Advocacy for LGBTQ+ Populations (2018) underlines the mandate that nurses “must deliver culturally congruent care and advocate for lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) populations.” (October 26, 2022)
American Academy of Pediatrics: “There is strong consensus among the most prominent medical organizations worldwide that evidence-based, gender-affirming care for transgender children and adolescents is medically necessary and appropriate. It can even be lifesaving. The decision of whether and when to start gender-affirming treatment, which does not necessarily lead to hormone therapy or surgery, is personal and involves careful consideration by each patient and their family.” (August 10, 2022)
American Academy of Pediatrics: “The American Academy of Pediatrics recommends that youth who identify as transgender have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space. We also recommend that playing on sports teams helps youth develop self-esteem, correlates positively with overall mental health, and appears to have a protective effect against suicide. These bills not only ignore these recommendations, they undermine them.” (March 16, 2021)
American Academy of Physician Assistants: “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 the treatment of gender dysphoria when medically necessary.” (Signatories: American Academy of Nursing, American Academy of PAs, American Academy of Pediatrics, American Academy of Psychiatry and The Law American Association for Geriatric Psychiatry, American College Health Association, American College of Physicians, American Medical Association, American Medical Student Association, American Medical Women’s Association, American Nurses Association, American Pediatric Surgical Association) (May 24, 2019)
American Association of Clinical Endocrinology: “Transgender and gender diverse people represent a sizable and growing segment of the U.S. and world Population. It is estimated that over 1 million people in the U.S. alone are transgender or gender diverse. Many transgender and gender diverse people seek hormone therapy under the supervision of an endocrinologist or other medically trained health care professional to better align their bodies with their gender identities. Being transgender is widely accepted to require medical treatment for those patients who seek it. Medical treatment may include behavioral assessment, hormone therapy, and surgery. These treatments are well established in the relevant established, international professional society guidelines including those from the Endocrine Society co-sponsored by the American Association of Clinical Endocrinology (AACE) and the World Professional Association for Transgender Health (WPATH).” (March 7, 2022)
American Association of Geriatric Psychiatry: “With the overarching goals of improving the healthcare of older transgender individuals and of inspiring pertinent clinical research, a session at the 2017 American Association for Geriatric Psychiatry Annual Meeting focused on an interdisciplinary approach to transgender aging. The older the transgender adult, the more likely the individual grew up in a historical context when there was greater social stigma towards their gender identity, even among mental health professionals… In spite of notable health disparities, some evidence points to resilience among transgender older adults. The mental health professional often serves as the first contact for a patient who is struggling with gender identity.” (February 7, 2018)
American College Health Association: “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.” (February 8, 2023)
American College of Nurse-Midwives: The American College of Nurse-Midwives (ACNM) supports efforts to provide transgender and gender non-binary (TGNB) people with access to safe, comprehensive, culturally-responsive, and respectful health care. ACNM is committed to taking the following actions: Incorporating gender-inclusive language into ACNM documents. Offering educational opportunities to members of the midwifery community on how to care for TGNB people. Advancing legislation and policies that prohibit discrimination based on gender expression and/or identity. Supporting measures to ensure TGNB people have comprehensive and unrestricted access to health insurance coverage. (March 2021)
American College of Obstetricians and Gynecologists: “The American College of Obstetricians and Gynecologists opposes discrimination on the basis of gender identity, urges public and private health insurance plans to cover necessary services for individuals with gender dysphoria, and advocates for inclusive, thoughtful, and affirming care for transgender individuals.” (January 2017)
American College of Physicians: “A growing number of states are banning gender-affirming health care and pursuing anti-LGBTQ+ legislation, contrary to ACP policy, which urges non-discrimination in health care. ACP opposes these restrictions on health care for transgender individuals, who already may face extreme barriers to accessing care, and strongly objects to any unnecessary government interference with any health care services.” (April 24, 2023)
American Counseling Association: “The American Counseling Association (ACA) is committed to nondiscrimination and prevention of harassment in all forms (verbal, physical, sexual, emotional, and psychological), including protections for all diverse groups including protections for transgender and nonbinary individuals. ACA recognizes the stress and psychological impact of discrimination and is committed to helping counselors advocate for nondiscrimination policies and practices in their schools, colleges/universities, clinical mental health settings, communities, and in the nation.” (March 29, 2019)
American Heart Association: 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… These experiences of healthcare and health insurance discrimination contribute to significant health disparities.” (September 2019)
American Medical Student Association: “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 cisgender service personnel, including health care.” (August 2017)
American Medical Women’s Association: The American Medical Women’s Association (AMWA) supports the US Department of Health and Human Services adopting revisions to Section 1557 of the Affordable Care Act that codify protections for LGBTQ+ people from mistreatment by physicians, other clinicians, and insurers. Adopting this rule will restore and strengthen protections for LGBTQ+ people by clarifying that the definition of “sex” discrimination applies to discrimination based on sex characteristics, intersex traits, and pregnancy and pregnancy termination, and aligns with federal court decisions prohibiting discrimination based on gender identity and sexual orientation. AMWA urges adoption of these crucial protections.
American Psychiatric Association: “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.” (Joint statement with the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American College of Obstetricians and Gynecologists, American Osteopathic Association; April 2, 2021)
American Society of Plastic Surgeons: “The delivery of gender affirming care is not a political issue, but rather a health care issue – Gender dysphoria is a medical diagnosis, not a political choice. ASPS firmly believes that plastic surgery services can help gender dysphoria patients align their bodies with whom they know themselves to be and improve their overall mental health and well-being. The Society will continue its efforts to advocate for full access to medically necessary transition care and stand up to those who oppose it – from the board rooms of big tech to Capitol Hill.” (June 22, 2021)
American Urological Association: “The AUA is committed to the principle that medical decision-making for transgender children is the responsibility of parents acting in their child’s best interest to ensure their physical and mental health, safety and well-being, and that consultation with medical professionals and education via medically safe (respected, peer-reviewed) resources must not be legislated or criminalized.”
Federation of Pediatric Organizations: “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.” (March 28, 2022)
GLMA: Health Professionals Advancing LGBTQ Equality: Many but not all transgender people experience gender dysphoria, a medical condition defined by the American Psychiatric Association as a “conflict between a person’s physical or assigned gender and the gender with which he/she/they identify.” Standards of care and accepted medically necessary services that affirm gender or treat gender dysphoria may include but are not limited to mental health counseling, non-medical social transition, gender-affirming hormone therapy, and/or gender-affirming surgeries. 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 and has called for health insurance coverage for treatment of gender dysphoria.” (March 2019)
The Journal of the American Medical Association: “Transgender and gender diverse patients should receive nonjudgmental care from appropriately trained health care professionals. Gender-affirming primary care includes preventive care, mental health and substance use disorder screening, hormone therapy, and education about nonmedical/nonsurgical gender-affirming interventions. (September 15, 2022)
National Association of Nurse Practitioners in Women’s Health: “The National Association of Nurse Practitioners in Women’s Health (NPWH) affirms each individual’s right to quality, evidence-based sexual and reproductive healthcare and celebrates diversity of sexuality, gender identity, and gender expression. NPWH is committed to providing quality sexual and reproductive healthcare to all individuals, regardless of gender identity or expression… Transgender and Gender Diverse individuals have a right to care that aligns with and affirms their gender identity.” (May 2022)
National Association of Social Workers: Gender-Affirming Health Care Saves Lives: “The National Association of Social Workers (NASW) asserts that discrimination and prejudice directed against any individuals on the basis of gender identity or expression are damaging to the social, emotional, psychological, physical and economic well-being of transgender and gender diverse (TGD) people and society as a whole. The unprecedented increase in legislation focused on TGD youth seeking affirming health care, the professionals who provide their medical care, and the families and social supports that offer resources to them is an unfortunate indicator of the lack of understanding and misinformation that currently exists… NASW will work to repeal discriminatory legislation and regulations that do not honor someone’s self-identified gender identity, transgender-inclusive health care access, health insurance options, or use of language promoting health equity and inclusive communication.”
Pediatric Endocrine Society: “Bills that threaten the health of transgender and gender diverse (TGD) youth have been introduced in multiple state legislatures across the United States. These bills undermine medical recommendations and seek to criminalize health care professionals who provide gender-affirming care such as puberty suppressing medications and gender-affirming hormone therapy. We caution legislators and the public that the support and implementation of these bills will worsen mental health, increase the risk of suicide, and contribute to poorer overall health in our TGD patients. Such bills contradict evidence-based Standards of Care recommendations from the Pediatric Endocrine Society as well as Position Statements from several national and international medical associations with expertise in the care of TGD youth, such as the American Academy of Pediatrics, the Endocrine Society, the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association and the World Professional Association for Transgender Health. The Pediatric Endocrine Society recommends an affirmative model of care that supports one’s gender identity, and follows a multidisciplinary approach that includes involvement of mental health professionals, patients and their families. Puberty suppression and/or gender-affirming hormone therapy is recommended within this evidence-based approach on a case-by-case basis as medically necessary and is potentially lifesaving. The implementation of these recommendations has been demonstrated to improve the psychological health and well-being of TGD youth.” (April 2021)
Texas Medical Association: “filed friend-of-the-court brief in the case in support of medically necessary, gender-affirming care, and opposing the criminalization of such treatment… TMA’s brief addresses “the acceptance and medical necessity of gender-affirming care for adolescents with gender dysphoria” and raises concerns the state actions “will create barriers in access to care for transgender adolescents, a vulnerable population that already faces barriers in access to care. The full range of evidence and the current recommendations developed by the American Academy of Pediatrics, and affirmed by every major American medical association, supports the medical necessity and appropriateness of providing gender-affirming support and care to transgender youth and adolescents. Medical care for transgender youth and adolescents is evidence-based and has proven effectiveness.” (March 10, 2022)
Texas Pediatric Society: Statement opposing Actions in Texas Threatening Health of Transgender Youth: “TPS has long-advocated against prohibitions on gender-affirming care in Texas. For young people who identify as transgender, studies show that gender-affirming care can reduce emotional distress, improve their sense of well-being and reduce the risk of suicide. “Evidence-based medical care for transgender and gender diverse children is a complex issue that pediatricians are uniquely qualified to provide. This directive undermines the physician-patient-family relationship and will cause undue harm to children in Texas. TPS opposes the criminalization of evidence-based, gender-affirming care for transgender youth and adolescents. We urge the prioritization of the health and well-being of all youth, including transgender youth.”
United States Professional Association for Transgender Health (USPATH): “USPATH and the World Professional Association for Transgender Health (WPATH) denounces the emergency regulation halting gender-affirming healthcare for transgender and gender diverse (TGD) children and adolescents issued by Missouri Attorney General Andrew Bailey as lacking scientific grounding. The WPATH Standards of Care for the Health of Transgender and Gender Diverse People, now in its 8th version (SOC8), is the foremost evidence-based guideline for the provision of TGD healthcare. SOC8 is based on the best available science with input from over 100 global medical professionals and experts and represents best-practice guidelines for the provision of gender-affirming healthcare. Gender-affirming interventions are based on decades of clinical experience and research and are not considered experimental. Gender affirming hormone therapy (GAHT) is a component of widely accepted medically necessary care for TGD people.” (March 22, 2023)
World Health Organization (WHO): “WHO’s role, to promote health for all, means it is committed to inclusive healthcare and equitable access for trans, gender diverse and all other people… Our fight is for #HealthForAll” (28), demonstrating WHO’s highest level commitment to support countries to attend to the health needs of transgender and gender diverse people.”
World Medical Association: “The WMA emphasizes that everyone has the right to determine one’s own gender and recognizes the diversity of possibilities in this respect. The WMA calls for physicians to uphold each individual’s right to self-identification with regard 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 individualized, 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.” (October 2015)
World Professional Association for Transgender Health: “Both the World Professional Association for Transgender Health (WPATH) and the US affiliate, the United States Professional Association for Transgender Health (USPATH), vehemently oppose the broad and sweeping legislation being introduced and ratified in states across the country to ban access to gender-affirming health care to transgender and gender diverse (TGD) people. WPATH’s long-standing Standards of Care for Transgender and Gender Diverse People, now in its eighth version (SOC8), explain in detail the science- and evidence-based benefits of gender affirming care for TGD people. Any legislation that restricts or prohibits access to this care is against best practice medical standards and is condemned by WPATH and USPATH.” (March 8, 2023)
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