First on CNN: Major medical society re-examines clinical guidelines for gender-affirming care
The society’s guidelines help the organization’s members determine the best practices to provide appropriate care for people who are transgender and gender-diverse. The organization said it will take about three years for the guidelines to come together.
Gender-affirming care is medically necessary, evidence-based individualized care that uses a multidisciplinary approach to help a person transition from their assigned gender to their affirmed gender.
The society’s current guidelines lay out the appropriate treatment for transgender or gender-diverse people, both children and adults. They describe when hormone treatment should be used and how the treatment should be managed. They standardize the terminology that professionals should use with patients and reaffirm the role that an endocrinologist should play in the patient’s broader individualized care.
Gender-affirming care is customized to each person’s needs and can include giving advice for the person or for their parents if they are younger; providing mental health support; and, when a person reaches the appropriate age, prescribing hormones when appropriate. Most trans youth do not get hormone therapy, but some do. Some adults may also consider surgery, but surgery is not recommended for children.
The committee revising the guidelines has had its first meeting. The last time the committee updated its gender-affirming care guidelines was in 2017; it previously revised them in 2009.
When the society updated its guidelines in 2017, it said there had been more than 3,000 publications since 2009 that clarified issues around gender and gender incongruence.
The current committee will go through the latest science to determine the best specific approaches to provide appropriate care to patients. Safer said it will take about two years to examine the material and about another year for the revised guidelines to come together.
Other guidelines under the society’s review include treatment for vitamin D deficiency, how to handle diabetes in pregnancy, and management of primary aldosteronism.
Although gender-affirming care has been restricted or banned outright in more than a dozen states, such care is considered the medical gold standard treatment.
Every major US medical association agrees that gender-affirming care is clinically appropriate for children and adults.
When the American Academy of Pediatrics called for a systematic review of the evidence last fall, it affirmed its support.
Several European countries have adopted more cautious approaches, restricting the use of puberty blockers, cross-sex hormones, and transition-related surgeries.
More than 1.6 million adults and teens identify as transgender in the US, about 0.6% of the population.
Safer said he understands that there is some political sensitivity surrounding the practice and that some gender-affirming care specialists have received threats because of their work. But he said he can’t understand why this standard kind of care is seen as political.