New England Journal Perspective Two Steps Back — Rescinding Transgender Health Protections in Risky Times

[sultanasofa]

A perspective published by a leading medical journal, containing some rather hyperbolic language:
"In Donald Trump’s United States, transgender people apparently do not have the same right as their cisgender counterparts to receive medically appropriate, patient-centered care — or, indeed, any health care at all.....Under the current circumstances, HHS’s announcement may be a death sentence for members of populations that the Trump administration has, for the past nearly 4 years, deemed expendable."

Whilst the data they quote is appropriately referenced, I would question that authors' interpretations
"Prior to HHS’s announcement, trans and gender-diverse people already faced disparities in health and health care: as compared with cisgender people, they have higher rates of mood disorders, tobacco and substance use, and HIV and other sexually transmitted infections (STIs), for example, and lower utilization of preventive care services.2 These disparities are fueled by pervasive structural, interpersonal, and individual-level stigma that prevents transgender people from obtaining access to effective and affirming health services. In a 2015 national survey, one third of transgender people reported having had a negative health care experience within the previous year.3 Trans people encounter medical providers who are not knowledgeable about transgender health, and trans people are not infrequently denied not just care related to gender transition but even general health care services; a transgender nonbinary person we know was recently denied a routine exam and testing for STIs by a gynecologist who simply said her practice was “not seeing transgender patients right now.” Transgender patients also report being intentionally misgendered and verbally harassed by health care providers, who may blame them (or their medically necessary hormone replacement therapy) for their own health conditions. And they face larger systems-level issues, such as electronic health records that have not been appropriately modified, which can cause delays in necessary sex-specific diagnostic or preventive services. Stigma — both enacted (resulting in discrimination) and felt — results in about a quarter of transgender people avoiding medically necessary care.3"

www.nejm.org/doi/full/10.1056/NEJMp2024745

What does this have to do with FWR?

Has a similar report on women's health been issued? Has the Trump presidency had a negative effect on female reproductive medicine? If so please post the link.

unwashedanddazed - this is relevant to FWR because the way that governments and health departments choose to address these issues has the potential to impact on women.

So is there evidence in this article that transmen are not receiving the same standard of healthcare as transwomen? Are they being discriminated against because they are female?

Given the litigious nature of American's, and the fact that much of transitioning 'healthcare' is untested, or off-label (and pretty dangerous - Lupron eg.) and apparently unregulated I'm not surprised that some healthcare providers might be hesitant in treating such patients.

As I recall, there was a transman on twitter a while ago who was furious that the doctor required confirmation of their birth sex before they would treat them. For purposes of patient safety, effectiveness of treatments and avoidance of unintended harm I would say that a doctor should be well within their rights to require that information.

With the untested nature of much of transitioning treatments, the doctor could rightly have a concern that any treatment they prescribe could have adverse effects when combined with existing treatment - this is pretty much uncharted territory.

Also, given that phalloplasty is a heavily promoted treatment that has a shockingly high failure rate, it is clear that transitioning 'healthcare' providers do not have patient health at heart.

I think this is relevant to FWR as it illustrates the problems caused in so many areas by gaslighting people to believe that their sex is not important or that they have actually changed their sex.

It adds weight to the argument for absolute clarity in this situation and not allowing feelings to override fact.