Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The path to gender-affirming care is closing: We need to open it

Anonymous
Policy
April 2, 2022
46 Shares
Share
Tweet
Share

Imagine losing control of your child’s life-saving care. The mental anxiety is overwhelming enough – then suddenly, all the decisions that should be up to your child, you, and your child’s physician are snatched out of your hands by faceless institutions. This is the fate currently befalling the families of transgender youth in Texas.

The Gender Education and Care, Interdisciplinary Support Clinic (GENECIS) in Dallas, has been effectively shut down, reducing the capacity for gender-affirming care across all of Texas. For the past seven years, the clinic provided interdisciplinary care to transgender youth, including primary, endocrine, and psychiatric care. The clinic’s closure was followed by an abrupt statement from its parent institution stating that it would “cease offering puberty blockers and hormone therapies to new pediatric patients” due to the lack of evidence of long-term effects and lack of FDA approval. We believe GENECIS should be reopened due to its critical role in providing gender-affirming care to the youth of Texas.

Gender-affirming care is defined “as judgment-free, individualized care oriented toward understanding and appreciating a person’s gender.” Multiple medical societies such as the American Medical Association and the American Academy of Pediatrics support gender-affirming care. At least eight studies, including one directly out of the GENECIS clinic, revealed improvements in mental health domains for adolescent patients receiving gender-affirming care without associated evidence of harm. The American Psychiatric Association concluded in 2020 that gender-affirming treatment, including the use of puberty blockers, “is associated with relief of emotional distress.” Furthermore, the Endocrine Society asserts that gender-affirming care is “medically necessary” and has established evidence-based guidelines including pubertal suppression, hormone replacement therapy, eventual gender-affirming surgical procedures, and multi-disciplinary access to specialties such as psychiatry.

The GENECIS clinic has followed all of these, so why then would it need to be shut down? GENECIS clinic’s parent institution argues gender-affirming therapy is too risky. For instance, the long-term effects of off-label leuprolide use have not been fully studied. However, a reasonable counter-argument can be made that the medical benefits of blocking puberty outweigh the medical risks; the studies above suggest that transgender youth receiving these therapies demonstrate better mental health outcomes including suicidal ideation, non-suicidal self-harm, depression, and anxiety as opposed to their peers without stated therapy. Therefore, withholding gender-affirming care is also a care decision with well-characterized negative impacts. GENECIS’s work has also encountered political opposition in Texas. Public officials argue that gender-affirming care constitutes child abuse and have attempted to investigate families whose children have been treated by this clinic. Though this may possibly be a well-meaning public and political concern for these patients, given all of the evidence for gender-affirming care, how could this patient-parent-physician decision-making possibly be considered child abuse?

Perhaps, rather, this concern for transgender youth is rooted in political, social, and medical discrimination against transgender youth, limiting life-saving opportunities and “medically necessary” treatment. Dr. Ximena Lopez, previously director of the GENECIS clinic, is currently filing a lawsuit on the basis of such concerns. The closing of GENECIS exposes just how fragile transgender health care protections can be in the United States. You can encourage your medical institutions to support Dr. Lopez’s lawsuit investigating the potential for medical discrimination. Unfortunately, political encroachment around these medical topics is inevitable as the government is meant to care for its constituents. We need to encourage fact-based policy rooted in academic guidelines. If the concern revolves around issues of safety, then why not funnel more resources into such multidisciplinary clinics and more rigorously study those long-term effects as we would with any medical therapies? Even if this clinic were to reopen, this does not address the significant lack of accessibility for transgender health across Texas and across the nation. We need to encourage more medical centers to open and fund such interdisciplinary initiatives, so that transgender patients do not have to travel across states for such critical care. It is estimated that there are over 1.4 million individuals identifying as transgender in the United States, and these individuals deserve better.

The authors are an anonymous medical student and a physician.

Image credit: Shutterstock.com

Prev

It's time to flip the script on peer evaluations

April 2, 2022 Kevin 0
…
Next

Asking for and receiving help is a sign of courageous leadership [PODCAST]

April 2, 2022 Kevin 0
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
It's time to flip the script on peer evaluations
Next Post >
Asking for and receiving help is a sign of courageous leadership [PODCAST]

More by Anonymous

  • Navigating the broken medical system: challenges faced by foreign medical graduates

    Anonymous
  • In the trenches of health care: Facing unbearable strain

    Anonymous
  • Iranian doctors’ bravery: Upholding medical ethics amidst oppression

    Anonymous

Related Posts

  • Why health care replaced physician care

    Michael Weiss, MD
  • How social media can help or hurt your health care career

    Health eCareers
  • Care is no longer personal. Care is political.

    Eva Kittay, PhD
  • Health care workers need policy changes, not just applause

    Yuemei (Amy) Zhang, MD
  • Health care is not a service commodity

    Peter Spence, MD, MBA
  • Why health care fails to deliver better value in patient care

    Kristan Langdon, DNP and Timothy Lee, MPH

More in Policy

  • Pediatricians grapple with guns in America, from Band-Aids to bullets

    Tasia Isbell, MD, MPH
  • Health care wins, losses, and lessons

    Robert Pearl, MD
  • Maximizing care amidst provider shortages: the power of measurement-based care

    Tom Zaubler, MD
  • Unveiling excessive medical billing and greed

    Amol Saxena, DPM, MPH
  • Chronic health issues and homelessness

    Michele Luckenbaugh
  • The impact of certificate of need laws on rural health care

    Jaimie Cavanaugh, JD and Daryl James
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • Balancing motherhood and medicine [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Misunderstandings about opioid use disorder

      Amy Baxter, MD | Conditions
  • Recent Posts

    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • 5 things to know about weight from a bariatric surgeon

      Maria Iliakova, MD | Conditions
    • Out-of-office infusions in oncology care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of business knowledge for medical professionals

      Curtis G. Graham, MD | Physician
    • Using the language of art to create work-life balance

      Sarah Samaan, MD | Physician
    • Levamisole is good for your dog, but bad for your cocaine

      Robert Killeen, MD | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 16 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Higher Suicide Risk in Nurses, Other Health Workers
  • COVID Drug and New Mutations; Costco Offers $29 Care; Trump Unmasked Over Bronzer
  • Long COVID Rare in U.S. Kids, Has Affected 7% of Adults
  • Vascular Conditions Offer No Clarity on Pollution-Dementia Link
  • FDA Staff Voice Serious Concerns About Investigational ALS Cell Therapy

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • Balancing motherhood and medicine [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Misunderstandings about opioid use disorder

      Amy Baxter, MD | Conditions
  • Recent Posts

    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • 5 things to know about weight from a bariatric surgeon

      Maria Iliakova, MD | Conditions
    • Out-of-office infusions in oncology care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of business knowledge for medical professionals

      Curtis G. Graham, MD | Physician
    • Using the language of art to create work-life balance

      Sarah Samaan, MD | Physician
    • Levamisole is good for your dog, but bad for your cocaine

      Robert Killeen, MD | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The path to gender-affirming care is closing: We need to open it
16 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...