Scientific Misinformation and Gender Affirming Care: Tools for Providers on the Front Lines

McNamara, Meredithe; Lepore, Christina; Alstott, Anne; Kamody, Rebecca C.; Kuper, Laura E.; Szilagyi, Nathalie; Boulware, Susan D.; Olezeski, Christy L.

doi:10.1016/j.jadohealth.2022.06.008

Cited by 11 publications

(9 citation statements)

References 37 publications

(49 reference statements)

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“…Pediatric clinicians are particularly adept at handling misinformation and may encounter such concerns from guardians in the current political climate. It may be beneficial to review common themes of misinformation about medical treatments for GD and relay correct information [39 ▪ ]. An effective technique for handling misinformation is the ‘truth sandwich model’: state the truth, fact-check the falsehood, then repeat correct information [40].…”

Section: Sociopolitical Climatementioning

confidence: 99%

Transgender and gender-diverse youth: an update on standard medical treatments for gender dysphoria and the sociopolitical climate

Arnold

McNamara

2023

Current Opinion in Pediatrics

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Purpose of review Transgender and gender-diverse (TGD) youth experience a discordance between their binary sex assigned at birth and gender identity. All TGD youth benefit from compassionate care delivered by clinicians who are informed in matters of gender diversity. Some of TGD youth experience clinically significant distress, termed gender dysphoria (GD), and may benefit from additional psychological support and medical treatments. Discrimination and stigma fuel minority stress in TGD youth and thus many struggle with mental health and psychosocial functioning. This review summarizes the current state of research on TGD youth and essential medical treatments for gender dysphoria. These concepts are highly relevant in the current sociopolitical climate. Pediatric providers of all disciplines are stakeholders in the care of TGD youth and should be aware of updates in this field. Recent findings Children who express gender-diverse identities continue to express these identities into adolescence. Medical treatments for GD have a positive effect on mental health, suicidality, psychosocial functioning, and body satisfaction. The overwhelming majority of TGD youth with gender dysphoria who receive medical aspects of gender affirming care continue these treatments into early adulthood. Political targeting and legal interference into social inclusion for TGD youth and medical treatments for GD are rooted in scientific misinformation and have negative impacts on their well being. Summary All youth-serving health professionals are likely to care for TGD youth. To provide optimal care, these professionals should remain apprised of best practices and understand basic principles of medical treatments for GD.

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Section: Sociopolitical Climatementioning

confidence: 99%

Transgender and gender-diverse youth: an update on standard medical treatments for gender dysphoria and the sociopolitical climate

Arnold

McNamara

2023

Current Opinion in Pediatrics

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“…Given that the balance of evidence favors GAC, arguments against these therapies are frequently based on inflammatory, misleading, and overtly false claims. A recent publication addressing scientific misinformation surrounding GAC addresses several of the most common claims alongside existing evidence [25 ▪ ]. In addition to recognizing and discounting the explicit falsehoods in many of these arguments, it is equally important for providers to acknowledge the actual safety profile of gender-affirming care via a candid and nuanced discussion of the existing evidence and unknowns.…”

Section: Opposition To Gender-affirming Carementioning

confidence: 99%

Legislation, medicine, and politics: care for gender diverse youth

Preston,

Lopez

2023

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review A recent increase in legislation in the United States prohibiting gender-affirming care (GAC) for transgender youth follows a wave of its politicization despite support from all pertinent mainstream medical associations. This review describes the standards of GAC for transgender youth, the origins of legislation prohibiting this care, a review of current legislation in the United States and a discussion on the impact on patients, providers, and the medical field. Recent findings A critical evaluation of historical parallels and current organizations supporting this legislation reveals it stems not from concerns within the medical field but from political and religious interests. This intrusion sets a dangerous precedent, undermining evidence-based medicine, providers’ ability to practice according to standards of care, and patients’ and guardians’ autonomy and medical decision-making. This wave of antitrans rhetoric and legislation has resulted in threats to health providers and hospitals, ‘moral distress” in providers, and migration of providers and patients from hostile states. Summary Similar to antiabortion legislation, these legislative efforts will likely result in negative health outcomes and worsening disparities. The medical community must confront these forces directly through an understanding of the political and structural forces at play and adopting strategies to leverage collective power.

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“…Testimony has also been elicited from professionals who lack expertise in the field and have ties to discriminatory advocacy organizations. Some have inaccurately reported that gender affirming surgical procedures are performed on children and/or that TGD youth are being rushed into irreversible medical treatment they are likely to regret (see McNamara et al, 2022, for a summary and critique of this misinformation).…”

Section: Overview Of the Current Sociopolitical Contextmentioning

confidence: 99%

“…This is particularly true given the degree to which misinformation is actively circulating. Mental health providers will benefit from staying informed about the types of misinformation circulating and the clinical and research literature relevant to these areas (see McNamara et al, 2022).…”

Section: Clinical Applicationmentioning

confidence: 99%

Supporting and advocating for transgender and gender diverse youth and their families within the sociopolitical context of widespread discriminatory legislation and policies.

Kuper¹,

Cooper²,

Mooney³

2022

Clinical Practice in Pediatric Psychology

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Objective: The aims of this commentary are to: (a) provide an overview of the current sociopolitical context experienced by transgender and gender diverse (TGD) youth and caregivers, (b) summarize the research that has been conducted about how the sociopolitical context impacts the mental health and wellbeing of TGD youth and caregivers, (c) discuss the clinical implications of these findings, and (d) identify steps mental health providers can take to be advocates for TGD youth and their families. Methods: Authors include a psychologist and adolescent medicine physician working within a multidisciplinary gender program for youth and a psychologist in independent practice who specializes in working with LGBTQ+ (lesbian, gay, bisexual, transgender, and/or queer) youth, especially TGD youth. Clinical implications and advocacy steps were informed by our synthesis of the research literature as well as our own experiences working within the field of TGD health. Results: TGD youth and families have identified a range of stressors and coping strategies associated with the sociopolitical climate. Existing guides to clinical practice with TGD people can be adapted to incorporate these findings. We propose a “menu” of advocacy steps for providers to consider. Conclusions: Awareness of the larger sociopolitical context is crucial to providing high quality care to TGD youth and their families. By participating in advocacy efforts, mental health providers can have a unique and meaningful impact on the social and structural factors that impact the mental health and wellbeing of this population. Ethical principles within the field of psychology highlight how advocacy efforts are an important component of practice.

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Scientific Misinformation and Gender Affirming Care: Tools for Providers on the Front Lines

Cited by 11 publications

References 37 publications

Transgender and gender-diverse youth: an update on standard medical treatments for gender dysphoria and the sociopolitical climate

Transgender and gender-diverse youth: an update on standard medical treatments for gender dysphoria and the sociopolitical climate

Legislation, medicine, and politics: care for gender diverse youth

Supporting and advocating for transgender and gender diverse youth and their families within the sociopolitical context of widespread discriminatory legislation and policies.

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