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AMA strengthens gender affirming care policies

Organization’s openly gay president sworn in on Tuesday

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American Medical Association President Dr. Jesse Ehrenfeld (center left) (Photo courtesy AMA)

The American Medical Association on Monday voted to strengthen its policies governing access to gender affirming care for transgender and gender diverse individuals.

The group committed to opposing the criminalization of patients for seeking gender affirming care, and of families and healthcare providers for facilitating access to or administering that care.

Additionally, the AMA pledged to work with federal and state legislators and regulators to oppose policies criminalizing these guideline-directed healthcare interventions and to educate the Federation of State Medical Boards on their importance.

The resolution was introduced by the Endocrine Society, which issued a press release Monday celebrating the move: “As political attacks on gender-affirming care escalate, it is the responsibility of the medical community to speak out in support of evidence-based care.”

“Medical decisions should be made by patients, their relatives and health care providers, not politicians,” the Endocrine Society wrote.

The resolution was cosponsored by the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Urological Association, the American Society for Reproductive Medicine, the American College of Physicians, the American Association of Clinical Endocrinology, GLMA: Health Professionals Advancing LGBTQ+ Equality and the AMA’s Medical Student Section.

The Endocrine Society explained the legislative bans on gender affirming care — passed in states in which 30 percent of the nation’s trans and gender-diverse youth now live — are misguided.

“Pediatric gender-affirming care is designed to take a conservative approach,” the group wrote.

“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.

“Major medical organizations also agree on waiting until an individual has turned 18 or reached the age of majority in their country to undergo gender-affirming genital surgery.”

Additionally, the Endocrine Society noted research that shows gender affirming care can be lifesaving.

“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 10 transgender adults who wanted puberty-delaying treatment, but did not receive it, reported lifetime suicidal ideation.”

AMA inaugurates first gay president

Jesse Ehrenfeld, the AMA’s first openly gay president, was inaugurated during the 2023 Annual Meeting of House of Delegates on Tuesday.

An anesthesiologist who formerly served as the Joseph A. Johnson Jr. Distinguished Leadership Professor of anesthesiology, surgery, biomedical informatics and health policy at Vanderbilt University’s School of Medicine; Ehrenfeld spoke to the Washington Blade for an exclusive interview last month.

During his inaugural speech on Tuesday, Ehrenfeld relayed a personal story about how his now 4-year-old son, born early and severely underweight, needed a blood transfusion. “At this moment,” he said, “watching my son cling to life, I was struck by the painful reality that, even though I was a physician and now, a father … neither I, nor my husband, could donate blood — simply because we are gay.”

“Just recently, the FDA, thanks in large part to a decade of advocacy by our AMA and others, rescinded some of these discriminatory practices, making it possible for my husband and I to give someone else’s child a much-needed blood transfusion,” Ehrenfeld said. “This kind of advocacy is why I am so proud to lead our AMA at this moment.”

“Today there is an unconscionable effort to interfere in medicine,” Ehrenfeld said. “An assault on patient and physician autonomy. Legislative over-reach. Attacks on maternal health … on LGBTQ patients.”

“We have a duty to push back against legislative interference in the practice of medicine that is leading to the criminalization of care.”

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Health

UNAIDS to commemorate Zero Discrimination Day’s 10th anniversary

UN agency urges global action to protect human rights

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A UNAIDS anti-discrimination exhibit at Tocumen International Airport in Panama in 2018. (Washington Blade photo by Michael K. Lavers)

As the world marks the 10th anniversary of Zero Discrimination Day; UNAIDS is sounding the alarm on the increasing threats to human rights, calling for renewed efforts to protect the rights of all individuals as a fundamental step towards ensuring health for everyone.

Established by UNAIDS a decade ago, Zero Discrimination Day aims to promote equality and fairness regardless of gender, age, sexuality, ethnicity or HIV status. The progress achieved over the past years is now in jeopardy, however, due to rising attacks on the rights of women, LGBTQ people and other marginalized communities.

UNAIDS Executive Director Winnie Byanyima emphasized the critical link between protecting human rights and safeguarding public health. 

“The attacks on rights are a threat to freedom and democracy and are harmful to health,” she said in a press release. “Stigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyone’s rights that we can protect everyone’s health.”

Despite challenges, there has been notable progress. 

At the onset of the AIDS pandemic more than 40 years ago, two-thirds of countries criminalized consensual same-sex sexual relations. They are now decriminalized in two-thirds of countries. An additional 38 countries around the world have pledged to end HIV-related stigma and discrimination, contributing to positive changes that include 50 million more girls attending school compared to 2015.

To sustain and enhance these advancements; UNAIDS urges global support for women’s rights movements, LGBTQ rights, racial justice, economic justice, climate justice and peace initiatives. By standing with communities advocating for their rights, the U.N. aims to reinforce the collective effort towards a more inclusive and equitable world.

Zero Discrimination Day is observed on March 1.

Events and activities that will take place around the world throughout the month will serve as reminders of the essential lesson and call to action: Protecting everyone’s health is synonymous with protecting everyone’s rights.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals and secure a safer, fairer, kinder and happier world — for everyone,” said Byanyima.

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Health

New CDC report finds transgender women at higher risk for HIV

More than 1,600 people in seven cities surveyed

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The Centers for Disease Control and Prevention in Atlanta (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention issued a new study report this week that revealed that restricted by employment and housing discrimination and lack of access to needed gender-affirming healthcare for transgender women increasing the risk of contracting HIV. 

Researchers reviewed data from a 2019-2020 survey, the National HIV Behavioral Surveillance Among Transgender Women, which found that the demographics of HIV/AIDS have been disproportionally high, especially among Black and Latina trans women, who had experienced employment and housing discrimination coupled with lack of access to gender-affirming healthcare.

The Jan. 25 Morbidity and Mortality Weekly Report was based on data studies of more than 1,600 trans women in seven major urban locales. Participants from Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle were chosen by referrals from people and community-based organizations who knew or were part of the local population of trans women.

The study’s researchers noted: “Employment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.”

The study stated that trans women’s inability to access quality healthcare, including gender-affirming treatment or access to PrEP, and can expose them to potential incarceration as many turn to “survival sex work” and violence, which increases the risk of contracting HIV. 

The study’s author’s pointed out: “When economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis …demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.”

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Health

A Whole New Perspective on Well-Being

The Mather’s team recognizes that everyone’s wellness journey is completely unique to their life experiences and influences.

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The Mather is incorporating biophilic design—a design approach to facilitate access to nature or things that replicate natural patterns.

It’s easy to spot the distinctive, elegant silhouette of The Mather, a Life Plan Community for those 62+ opening this spring in Tysons, Virginia. What is not apparent to the naked eye is The Mather’s unique wellness philosophy, which is literally built into the community. 

The Mather’s team recognizes that everyone’s wellness journey is completely unique to their life experiences and influences.

Nature is one of the important factors that contribute to well-being. So The Mather is incorporating biophilic design—a design approach to facilitate access to nature or things that replicate natural patterns. This can include interior spaces with sightlines to a garden, choosing natural wood and stone as interior materials, or incorporating fragrant flowers and plants indoors to spark memories and provide tactile opportunities such as gardening. 

Residents of The Mather will be able to select from plentiful amenities, programs, and other offerings to target their personal wellness goals and preferences.

“Providing biophilic design within interior settings connects residents to the natural world,” says Mary Leary, CEO and President of Mather, the organization behind The Mather. “Research shows that a connection to nature provides positive benefits to mental states and overall well-being. At The Mather, biophilic design is the intersection of buildings and programs with nature in an urban setting.”

“The Mather is attracting a diverse group of older adults,” says Mary. “As a result, we aim to incorporate wellness practices from around the world, including Wyda movement theory of the Celtic Druids, which helps people achieve harmony with nature and contentment through mindfulness.” This holistic regenerative approach is similar to Qi Gong and yoga, while born in a different part of the world. Mather Institute has a special focus on mindfulness to support older adults’ practice of present moment awareness, which can lead to increased overall well-being, compassion, and joy.

A very different example of a wellness offering at The Mather is the Gharieni Welnamis spa wave bed, which uses computer-controlled vibrational therapy and audio frequencies to train the brain to relax. “The bed increases mindfulness, concentration, and creativity—all of which support our mission of creating Ways to Age Well,SM” says Mary.

These and other personalized ways to wellness will ensure that residents of The Mather can choose from seemingly countless ways to focus on their well-being. In other words, the sky’s the limit!

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