Legislation restricting gender-affirming care for transgender youth: Politics eclipse healthcare

Kraschel, Katherine L.; Chen, Alexander; Turban, Jack L.; Cohen, I. Glenn

doi:10.1016/j.xcrm.2022.100719

Cited by 39 publications

(27 citation statements)

References 9 publications

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“…In our cohort, fewer than 1200 patients in this age group underwent GAS, even in the highest volume years. GAS in adolescents has been the focus of intense debate and led to legislative initiatives to limit access to these procedures in adolescents in several states …”

Section: Discussionmentioning

confidence: 99%

“…However, numerous reports have described the political considerations and challenges in the delivery of transgender care . Despite many medical societies recognizing the necessity of gender-affirming care, several states have enacted legislation or policies that restrict gender-affirming care and services, particularly in adolescence . These regulations are barriers for patients who seek gender-affirming care and provide legal and ethical challenges for clinicians.…”

Section: Discussionmentioning

confidence: 99%

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National Estimates of Gender-Affirming Surgery in the US

Wright,

Chen,

Suzuki

et al. 2023

JAMA Netw Open

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ImportanceWhile changes in federal and state laws mandating coverage of gender-affirming surgery (GAS) may have led to an increase in the number of annual cases, comprehensive data describing trends in both inpatient and outpatient procedures are limited.ObjectiveTo examine trends in inpatient and outpatient GAS procedures in the US and to explore the temporal trends in the types of GAS performed across age groups.Design, Setting, and ParticipantsThis cohort study includes data from 2016 to 2020 in the Nationwide Ambulatory Surgery Sample and the National Inpatient Sample. Patients with diagnosis codes for gender identity disorder, transsexualism, or a personal history of sex reassignment were identified, and the performance of GAS, including breast and chest procedures, genital reconstructive procedures, and other facial and cosmetic surgical procedures, were identified.Main Outcome MeasuresWeighted estimates of the annual number of inpatient and outpatient procedures performed and the distribution of each class of procedure overall and by age were analyzed.ResultsA total of 48 019 patients who underwent GAS were identified, including 25 099 (52.3%) who were aged 19 to 30 years. The most common procedures were breast and chest procedures, which occurred in 27 187 patients (56.6%), followed by genital reconstruction (16 872 [35.1%]) and other facial and cosmetic procedures (6669 [13.9%]). The absolute number of GAS procedures rose from 4552 in 2016 to a peak of 13 011 in 2019 and then declined slightly to 12 818 in 2020. Overall, 25 099 patients (52.3%) were aged 19 to 30 years, 10 476 (21.8%) were aged 31 to 40, and 3678 (7.7%) were aged12 to 18 years. When stratified by the type of procedure performed, breast and chest procedures made up a greater percentage of the surgical interventions in younger patients, while genital surgical procedures were greater in older patients.Conclusions and RelevancePerformance of GAS has increased substantially in the US. Breast and chest surgery was the most common group of procedures performed. The number of genital surgical procedures performed increased with increasing age.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

National Estimates of Gender-Affirming Surgery in the US

Wright,

Chen,

Suzuki

et al. 2023

JAMA Netw Open

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“…Proponents of the bills suggest that gender identity may not be fully formed at that age and that undergoing treatment to affirm one’s gender identity may result in harm, particularly for treatments that have long-lasting effects (See Alabama Senate Bill 184 ( 2022 ); Arizona Senate Bill, 1138 ( 2022 ); Ohio House Bill 454 ( 2022 ), for examples). However, opponents have been quick to mobilize in response to the bills, arguing that transgender youth are being targeted because of discriminatory views of transgender people (e.g., Kraschel et al, 2022 ; Wyckoff, 2022 ). They further note that the bills do not comport with the World Professional Association for Transgender Health’s ( 2012 ) standards of care guidance, which states that adolescents should be provided with gender-affirming care to minimize their experience of gender dysphoria.…”

Section: Legislation On Gender-affirming Carementioning

confidence: 99%

Have You Heard the News? The Effects of Exposure to News About Recent Transgender Legislation on Transgender Youth and Young Adults

Dhanani

Totton

2023

Sex Res Soc Policy

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Introduction Over the last 3 years, there has been a proliferation of legislation aimed at restricting the rights of transgender Americans, including their access to gender-affirming health care. While the health implications of not having access to gender-affirming care are well documented, there may be additional indirect harms associated with proposing this type of legislation, such as those associated with being exposed to negative messages about transgender people or having to contend with friends and family who support the legislation. Methods This study was conducted between September and November 2021 and used a mixed-methods design to examine the implications of consuming news related to the recently proposed legislation as well as perceiving that people in one’s social network support such legislation on the health and well-being of transgender youth and young adults ( n = 113). Results Results showed that news consumption was associated with increased rumination and physical health symptoms and that perceived support for the legislation was associated with greater rumination, depressive symptoms, physical health symptoms, and fear of disclosing one’s identity. Themes from the open-ended questions further underscored that the current legislation has impacted transgender youth and young adults’ access to general health care; increased experiences of discrimination and other maltreatment; and resulted in some respondents engaging in unhealthy coping responses. Conclusions and Policy Implications Policy makers should consider these adverse consequences when responding to current, and crafting future, legislation directed at transgender Americans.

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“…Worryingly, public policy recently debated and enacted in places such as the United States (e.g., in Texas) threatens to investigate families of transgender children for “abuse” when they seek gender-affirming care. 8 Such discriminatory policy not only adds to courtesy stigma faced by well-intentioned members of transgender people's social networks, it also risks enforced social disruption by dividing families and communities.…”

mentioning

confidence: 99%

Gender identity services must better integrate members of transgender people's social networks in care

Doyle¹

2023

eClinicalMedicine

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Legislation restricting gender-affirming care for transgender youth: Politics eclipse healthcare

Cited by 39 publications

References 9 publications

National Estimates of Gender-Affirming Surgery in the US

National Estimates of Gender-Affirming Surgery in the US

Have You Heard the News? The Effects of Exposure to News About Recent Transgender Legislation on Transgender Youth and Young Adults

Gender identity services must better integrate members of transgender people's social networks in care

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