Several leading sexual and reproductive health associations have recognized these needs and have begun to integrate reproductive and sexual health for LGBTQ patients into their policies and guidelines. For example, the "Providing Quality Family Planning Services" guidelines set by the Centers for Disease Control and Prevention and U.S. Department of Health and Human Services Office of Population Affairs call for a person-centered approach that integrates the needs of LGBTQ patients. The American College of Obstetricians and Gynecologists has adopted a number of position statements on transgender health, which call for providers to create a welcoming environment for transgender patients and introduce the concept of gender-affirming care. However, these guidance documents for providers have room for expansion in emphasizing contraceptive services and other reproductive health care for LGBTQ patients. Recently, the Society of Family Planning published clinical recommendations on contraceptive counseling for transgender and gender-diverse people, recognizing the need for a tailored approach to contraceptive services for these patients.
Dr. Roberts: Sure. I do have one comment that you had brought up, Dr. Green regarding maternal mortality and maternal health. And the really big hot topic in the United States is birth equity and maternal mortality and morbidity amongst African American women. The interesting thing is, as an obstetrician gynecologist that I certainly have seen is, there really is a lack of data regarding information about women or individuals who identify as gay, lesbian, bisexual, transgender, that are choosing to conceive and give birth, and their experiences and layering that information as we're looking at birth equity in the African American community as a whole, and how important is to get that missing data point, so we can better serve our patients going forward.
On September 17, the AP reported that the Department of Education is threatening to withhold some federal funding from Connecticut school districts if they follow a state policy that allows transgender girls to compete as girls in high school sports.
Policymakers have a responsibility to take action to protect abortion providers and patients. The federal government must vigorously enforce Section 1557 of the ACA, which prohibits discrimination in health care, including based on race, national origin, sex, age, and disability.158 As part of this effort, policymakers should reinstate Obama-era regulations that included protections against discrimination on the basis of gender identity, sexual orientation, and pregnancy status, including termination of pregnancy; and it is vital for these identities to be explicitly included in anti-discrimination protections going forward. Specifically, there must be a prohibition against health care providers and insurers being able to deny abortion care, as well as other reproductive health services, on the basis of gender identity or sexual orientation. The federal government must also actively enforce the FACE Act to prevent violence targeting abortion providers and patients.
Gender identification, housing decisions, searching arrangements, access to healthcare, violence and sexual assault are just a number of the issues that make transgender people a unique population to manage in prison. The struggles they face have long been overlooked by prison officials worldwide. However, recent decades have seen a promising influx of policies and guidelines aiming to address the management of transgender prisoners. Countries vary drastically in their approaches, but what is the best way forward for the protection and safety of transgender people in prison?
Recent decades have witnessed a growth in advocacy for transgender rights, including calls for equality within the criminal justice system. Nevertheless, ongoing cases of suicide, physical and sexual assault demonstrate that prison systems are failing the transgender population time and time again. As underlined in Global Prison Trends 2020, the majority of EU member states lack special measures for the protection of LGBTQ people in prison, with few exemptions. Future efforts must be geared towards adequate policy and guidelines for those hit hardest by the rigid institutional regime of imprisonment, both in Europe and worldwide.
There is a longstanding policy debate on where transgender people should be detained within the prison estate. Housing practices vary by country but the most common methods are sex-based placement, identity-based placement, and segregation.
Have you witnessed or experienced instances of anti-LGBTQ discrimination in healthcare? Now is your time to speak up! The federal government is taking comments through October 3, 2022 on their proposed rule to reinstate LGBTQ+ nondiscrimination protections. Through a partnership with Duke Sexual and Gender Minority Health Program and National LGBT Cancer Network, GLMA is excited to share our new comment submission portal for people to share stories highlighting the importance of these protections. Please take a moment and speak up here!
On June 15, 2022, President Biden issued a Pride Month Executive Order directing key federal agencies to take comprehensive action to advance and protect LGBTQ+ health and equality. "This Executive Order couldn't come at a more critical time as state legislatures across the country introduce bills that threaten and attack transgender youth at unprecedented levels. Our communities need bold action from the country's leaders to safeguard our health and equality," said GLMA President Nick Grant, PhD, ABPP and GLMA Executive Director Hector Vargas, JD in a statement. Learn more about the Executive Order and read the full statement here.
On April 20, 2022, the Florida Department of Health issued non-binding guidance opposing science-based gender-affirming care for youth. The guidance goes so far as to suggest that social transition should not be considered a valid treatment option for youth. GLMA President Nick Grant, PhD, and GLMA Executive Director Hector Vargas, JD, issued a statement condemning this attack, calling it "unscientific propaganda." They said, Healthcare professionals, along with transgender youth and their families, are the experts on gender-affirming care. Not politicians. Yet the DeSantis administration is abusing its power for political gain, to interfere in the relationship between healthcare provider, patient, and family." Click here to see the full statement.
Earlier this week, Texas Governor Greg Abbott and Attorney General Ken Paxton issued a letter and opinion with a dangerous and false suggestion that gender-affirming care for transgender youth should be considered child abuse in the state. In response, GLMA President Nicholas Grant, PhD, and Executive Director Hector Vargas, JD, issued a statement condemning the actions. "Governor Abbott and Attorney General Paxton are jeopardizing the health and wellbeing of transgender and gender nonconforming youth in Texas with this baseless and cruel attempt to interfere with young people and their families who are simply seeking the best healthcare available. GLMA and our colleague health professional associations know that gender-affirming care is evidence-based, medically necessary and saves lives," they said. Read the full statement here.
On May 13, 2021, GLMA and the National Center for Transgender Equality sent an open letter to the National Governors Association in opposition to the more than 25 anti-trans bills that would ban medically necessary, life-saving, gender-affirming care for transgender youth being proposed in 13 states. More than 1,600 medical, mental, and behavioral health providers across the country have signed the open letter. The letter urges governors to oppose these bills, as they will allow government officials unwarranted interference in healthcare decisions that should be made with trans youth, their families, and their healthcare providers. "We're grateful to all the health professionals who have used their voices to set the record straight on this dangerous legislation," said GLMA President. Scott Nass, MD, MPA, FAAFP, AAHIVS. You can still sign on to this on-going open letter!
On May 10, 2021, the US Department of Health and Human Services announced that the Office of Civil Rights will interpret and enforce Section 1557 of the Affordable Care Act and Title IX's prohibitions on sex discrimination to include discrimination on the basis of sexual orientation and gender identity. "Every LGBTQ person should be able to access healthcare without fear of discrimination, and today's announcement is a major step towards this future," said GLMA President Scott Nass, MD, MPA, FAAFP, AAHIVS, and Executive Director Hector Vargas, JD, in a statement. "We look forward to working with Secretary Becerra and his team to fully implement today's reversal and address all the concerns raised in the lawsuit." Read the full statement here.
In 2021, at least 38 bills to ban or limit medically necessary, life-saving, gender-affirming care for trans youth have been proposed in 20 states. In partnership with the National Center for Transgender Equality, GLMA has put together an open letter and statement for healthcare providers to oppose these dangerous bills. This letter will send an important message nationally, but we'll also tailor it for states where legislatures are targeting trans youth healthcare, giving us a tool to respond nimbly wherever and whenever trans youth are under attack. Sign on to the letter so that legislators hear loud and clear from healthcare professionals: We refuse to stand by while lawmakers interfere with our duty to provide lifesaving care to trans youth.
On March 31, International Transgender Day of Visibility, GLMA condemns the spate of legislative attacks on healthcare for transgender youth in states across the US. Just two days before TDOV, the Arkansas legislature became the first in the US to adopt a ban on gender-affirming care for trans youth. We honor the struggle, strength, and resilience of trans people, including many of GLMA's members, and call on health professionals to use their voices to counter medically unsubstantiated legislation targeting the health and lives of trans youth. Read GLMA's full statement here. 2b1af7f3a8