SCIENCE SEZ
Endocrine Society applauds Ohio governor veto of state ban on gender-affirming care for minors
Move recognizes parental rights, medical decision-making over politics
Business AnnouncementWASHINGTON—The Endocrine Society, the world’s oldest and largest professional medical society devoted to the study and treatment of hormone-related conditions, applauds Governor Mike Dewine’s veto of a proposed Ohio law that would have banned gender-affirming care for minors. The bill he vetoed contradicts mainstream medical practice and scientific evidence and would have taken medical decision-making out of the hands of families and their physicians and instead relied upon government officials.
More than 2,000 scientific studies have examined aspects of gender-affirming care since 1975, including more than 260 studies cited in the Endocrine Society’s Clinical Practice Guideline.
Major medical and scientific organizations including the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics are in alignment with the Endocrine Society on the importance of gender-affirming care.
In June, the Endocrine Society worked with other medical societies in American Medical Association (AMA) House of Delegates to pass a resolution with overwhelming support to protect access to evidence-based gender-affirming care for transgender and gender-diverse individuals. In the resolution, the AMA committed to opposing any criminal and legal penalties against patients seeking gender-affirming care, family members or guardians who support them in seeking medical care, and health care facilities and clinicians who provide gender-affirming care.
Pediatric gender-affirming care is designed to take a conservative approach. When young children experience feelings that their gender identity does not match the sex recorded at birth, the first course of action is to support the child in exploring their gender identity and to provide mental health support, as needed.
Medical intervention is reserved for older adolescents and adults, with treatment plans tailored to the individual and designed to maximize the time teenagers and their families have to make decisions about their transitions.
As Governor DeWine noted, only a small number of Ohio’s children would be impacted by the proposed legislation, but it would have profound and even life-threatening consequences for those affected by gender dysphoria. Around 300,000 teenagers ages 13-17 in the United States, or 1.4% of the population, identify as transgender, according to the Williams Institute. An estimated 4,780 adolescents with a diagnosis of gender dysphoria started puberty-delaying medication between 2017 and 2021, according to an analysis performed by Komodo Health Inc for Reuters.
Gender-affirming care can be life saving for a population with high suicide rates. For example, a 2020 study analyzed survey data from 89 transgender adults who had access to puberty-delaying medication while adolescents and data from more than 3,400 transgender adults who did not. The study found that those who received puberty-delaying hormone treatment had lower likelihood of lifetime suicidal ideation than those who wanted puberty-delaying treatment but did not receive it, even after adjusting for demographic variables and level of family support. Approximately nine in ten transgender adults who wanted puberty-delaying treatment, but did not receive it, reported lifetime suicidal ideation.
Medical decisions should be made by patients, their relatives and health care providers, not politicians.
For more information, please see the Endocrine Society’s Transgender Health fact sheet or our Transgender Health Minors fact sheet.
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Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.
The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.
Johns Hopkins researchers: Regret rarer than believed among patients who undergo gender affirming surgery
In a Viewpoint article published Dec. 27, 2023, in JAMA Surgery, three Johns Hopkins researchers urge the medical community to dismiss a widely held, but scientifically unsupported belief that many people who are transgender and gender diverse (TGD), and undergo gender affirming surgery (GAS), later regret their decision to undergo such procedures.
The researchers are:
- Harry Barbee, Ph.D., assistant professor and interdisciplinary social scientist at the Johns Hopkins Bloomberg School of Public Health
- Bashar Hassan, M.D., a postdoctoral research fellow in plastic and reconstructive surgery at the Johns Hopkins Center for Transgender and Gender Expansive Health (CTH) and the University of Maryland Medical Center’s R Adams Cowley Shock Trauma Center
- Fan Liang, M.D., medical director at the CTH and assistant professor of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine
In their article, the three report findings from a retrospective look at the limited amount of evidence-based studies addressing post-GAS regret. They also describe how research, health care and public policy can be guided by using scientific data to properly define post-surgical regret — currently believed to be very low — to address health needs across diverse populations.
Among the findings from their review of the available-to-date medical literature on post-GAS regret are:
- Less than 1% of TGD people who receive GAS report regret, which appears dramatically lower than rates of surgical regret among people who are cisgender.
- Differences in post-GAS regret between people who are TGD and those who are cisgender may be linked to the reasons each group has for undergoing the surgery (for example, gender alignment vs. cancer treatment).
- That reduction in regret also may due to careful implementation of existing evidence-based, multidisciplinary guidelines and standards of care for those who are TGD, such as requiring a well-documented history of gender dysphoria (feeling mismatch between biological sex and gender identity).
- Accurately evaluating patient satisfaction and regret following GAS remains a significant challenge.
To improve the assessment and understanding of post-GAS regret, the researchers recommend:
- Using Gender-Q, a promising specific and comprehensive patient-reported outcome measure currently undergoing international field testing and validation.
- Assessing post-GAS regret no earlier than one year following surgery to overcome any biases.
- Incorporating baseline assessments of factors that may influence regret, such as age, race, education level and quality of life.
- More nuanced research of post-GAS regret that could uncover opportunities to improve public policy, and consequently, the long-term health of the population identifying as TGD.
Anyone in the media having questions, needing additional materials or wanting to set up an interview with Barbee, Hassan or Liang, should contact Michael E. Newman, Johns Hopkins Medicine media relations at mnewma25@jhmi.edu or 240-602-5365.
JOURNAL
JAMA Surgery
ARTICLE PUBLICATION DATE
27-Dec-2023
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