FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4383092647> ?p ?o ?g. }

• W4383092647 endingPage "409" @default.
• W4383092647 startingPage "406" @default.
• W4383092647 abstract "Bans on gender-affirming healthcare (GAC) for transgender and gender-diverse (TGD) adolescents are rapidly appearing throughout the United States. Approximately 156,500 TGD youth live in 32 states where access to GAC has been or is at risk of being restricted [[1]Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar]. Parents and guardians are confronted with intrusion into private decision-making for their children. Pediatric providers of many disciplines face punishments ranging from licensure loss to felony charges for providing or referring TGD youth for evidence-based and guideline-recommended care [[2]Mallory C. Chin M.G. Lee J.C. Legal penalties for physicians providing gender-affirming care.JAMA. 2023; 329: 1821-1822Crossref PubMed Scopus (1) Google Scholar]. Aiding and abetting clauses are included in some of these bans, which target a wide range of people who support TGD youth [[2]Mallory C. Chin M.G. Lee J.C. Legal penalties for physicians providing gender-affirming care.JAMA. 2023; 329: 1821-1822Crossref PubMed Scopus (1) Google Scholar]. Using American Board of Pediatrics workforce data, approximately 45% of board-certified adolescent medicine providers practice in the jurisdiction of a proposed or enacted ban (Table 1) [[1]Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar,[3]LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar,[5]Hughes L.D. Kidd K.M. Gamarel K.E. et al.“These laws will be devastating”: Provider perspectives on legislation banning gender-affirming care for transgender adolescents.J Adolesc Health. 2021; 69: 976-982Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar]. In this commentary, we focus on adolescent medicine specialists because many provide gender-affirming hormone therapies, and nearly all care for TGD youth and link them to appropriate services.Table 1Number of AM providers and provider to patient ratio by state comparing states that have enacted, considered or not considered a GAC ban since 2020fCommon abbreviations for states used.Ban enactedaLegislation or legal action, including executive or regulatory action, that passed all necessary stages in policy [1,3].Ban consideredbPolicy proposed in a state legislative session not enacted [1,3].No ban consideredcNo ban on gender-affirming care proposed.StateProvidersdNumber of adolescent medicine providers per state [4].RatioeRatio of adolescent medicine providers per 100,000 pediatric residents as reported by the American Board of Pediatrics [4].StateProvidersdNumber of adolescent medicine providers per state [4].RatioeRatio of adolescent medicine providers per 100,000 pediatric residents as reported by the American Board of Pediatrics [4].StateProvidersdNumber of adolescent medicine providers per state [4].RatioeRatio of adolescent medicine providers per 100,000 pediatric residents as reported by the American Board of Pediatrics [4].AL60.6AK00CA590.7AR20.3HI20.7CO151.2AZ70.4KS30.4CT60.8FL210.5LA20.2DC75.5GA80.3MI130.6DE52.5IA10.1NC90.4IL210.7ID10.2NJ241.2MA443.2IN60.4NH20.8MD292.2KY30.3OH341.3ME31.2MO80.6OK40.4MN120.9MS20.3OR80.9NM20.4MT10.4SC50.5NV22.3ND00VA130.7NY940.4NE00WI80.6PA381.4SD10.5WA251.5RI73.4TN90.6WY00VT10.9TX350.5UT10.1WV20.5TotalMeanTotalMeanTotalMean1130.41530.63451.7a Legislation or legal action, including executive or regulatory action, that passed all necessary stages in policy [[1]Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar,[3]LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar].b Policy proposed in a state legislative session not enacted [[1]Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar,[3]LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar].c No ban on gender-affirming care proposed.d Number of adolescent medicine providers per state [[4]American Board of PediatricsPediatric physicians workforce data book, 2019-2020. American Board of Pediatrics, Chapel Hill, NC2020Google Scholar].e Ratio of adolescent medicine providers per 100,000 pediatric residents as reported by the American Board of Pediatrics [[4]American Board of PediatricsPediatric physicians workforce data book, 2019-2020. American Board of Pediatrics, Chapel Hill, NC2020Google Scholar].f Common abbreviations for states used. Open table in a new tab Legal interference in healthcare for TGD youth threatens the relationships between clinicians, adolescents, and families [[5]Hughes L.D. Kidd K.M. Gamarel K.E. et al.“These laws will be devastating”: Provider perspectives on legislation banning gender-affirming care for transgender adolescents.J Adolesc Health. 2021; 69: 976-982Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar,[6]Kidd K.M. Sequeira G.M. Paglisotti T. et al.“This could mean death for my child”: Parent perspectives on laws banning gender-affirming care for transgender adolescents.J Adolesc Health. Jun 2021; 68: 1082-1088Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar]. It also erodes trust in medicine, warps public opinion, and may give cover for harassment and threats towards providers. To navigate these unprecedented challenges, the expertise of providers caring for TGD youth belongs in public discourse. Best-practice medical care for transgender youth is supported by every leading medical association including the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, the Endocrine Society, and the American Academy of Child and Adolescent Psychiatry [[7]Brief of amicus curiae American academy of pediatrics and additional national and state medical and mental health organizations in support of plaintiffs’ motion for temporary restraining order and preliminary injunction, Eknes-Tucker v. Ivey.https://www.aamc.org/media/60556/downloadDate: 2022Date accessed: April 4, 2023Google Scholar]. Supported public engagement, linkage of clinical services across state borders, institutional backing, and medical society advocacy are needed to protect access to evidence-based gender-affirming care. The legal landscape is complex and volatile, with a range of legal actions targeting healthcare for TGD youth [1Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar, 2Mallory C. Chin M.G. Lee J.C. Legal penalties for physicians providing gender-affirming care.JAMA. 2023; 329: 1821-1822Crossref PubMed Scopus (1) Google Scholar, 3LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar]. Since 2020, 36 states have attempted to restrict access to GAC, and 11 have enacted bans, primarily through legislative action [1Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar, 2Mallory C. Chin M.G. Lee J.C. Legal penalties for physicians providing gender-affirming care.JAMA. 2023; 329: 1821-1822Crossref PubMed Scopus (1) Google Scholar, 3LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar]. In Arkansas, the first ban on GAC for minors was passed by overriding the governor's veto in 2021 and immediately enjoined [[8]A.R. Legis. Assemb. Act 626. Reg. Sess. 2021-2022. 2021Google Scholar]. Texas was the first state to threaten parents of TGD youth with child abuse investigations in February 2022, and six states now classify such care as abuse [[2]Mallory C. Chin M.G. Lee J.C. Legal penalties for physicians providing gender-affirming care.JAMA. 2023; 329: 1821-1822Crossref PubMed Scopus (1) Google Scholar,[9]Letter from Greg AbbottGovernor of Texas, to jaime masters, commissioner, Texas department of family and protective services.https://gov.texas.gov/uploads/files/press/O-MastersJaime202202221358.pdfDate accessed: April 4, 2023Google Scholar]. The Oklahoma legislature undertook specific action to withhold millions of dollars in federal funding from the University of Oklahoma Medical Center if it continued to provide GAC, which effectively ended all access to such care in the state [[10]An act related to university appropriations.http://webserver1.lsb.state.ok.us/cf_pdf/2021-22%20ENR/SB/SB3XX%20ENR.pdfDate accessed: May 22, 2023Google Scholar]. In 2023, over 20 other states have introduced legislation to ban GAC for minors [1Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar, 2Mallory C. Chin M.G. Lee J.C. Legal penalties for physicians providing gender-affirming care.JAMA. 2023; 329: 1821-1822Crossref PubMed Scopus (1) Google Scholar, 3LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar]. At least 16 states passed legislation or enacted policy to restrict access to GAC, with many going into effect in the 3–12 months following preparation of this commentary (Table 1) [[1]Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar,[3]LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar]. A coordinated disinformation campaign across states is at play, with repeated false claims about gender dysphoria and gender diversity, medical treatments, standard practice, and scientific evidence appearing throughout the language of bans [[11]McNamara M. Lepore C. Alstott A. et al.Scientific misinformation and gender affirming care: Tools for providers on the front lines.J Adolesc Health. 2022; 71: 251-253Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar]. The small group of health professionals who have spoken in support of these bans have no relevant medical experience, and some are members of organizations that espouse anti-LGBTQ ideology [[12]Caraballo A. The anti-transgender medical expert industry.J Law Med Ethics. 2022; 50: 687-692Crossref PubMed Scopus (1) Google Scholar]. They rarely have ties to the states in which they are granted political platforms [[12]Caraballo A. The anti-transgender medical expert industry.J Law Med Ethics. 2022; 50: 687-692Crossref PubMed Scopus (1) Google Scholar]. Adolescent medicine providers have expertise to describe the harms of this legislation and underlying disinformation, but the current climate is hostile. Harassment and threats, via mail, phone calls, social media, and protests at clinics, are a new norm for those who care and advocate for TGD youth [[13]Under attack: Experiences of targeted harassment among adolescent gender care providers across the United States, Landon D. Hughes 2023 SAHM annual meeting, Chicago, IL. 2023Google Scholar]. In addition to their own personal safety, adolescent medicine providers must also consider the safety of their patients, clinic staff, and families. Some institutions have dissuaded or disallowed adolescent medicine providers from speaking out, which narrows the pool of vocal experts and concentrates harassment on a few. Some TGD adolescents and their families are relocating to states where access to GAC is preserved, but this creates further accessibility challenges for clinics in these areas as many have long waitlists [[14]Politico. “Conservative states are blocking trans medical care. Families are fleeing.”.https://www.politico.com/news/2022/11/27/trans-medical-care-red-states-families-00064394Date accessed: April 4, 2023Google Scholar]. Some states have acted to safeguard GAC and codify noncompliance with aiding and abetting penalties elsewhere. The Trans Legal Health Fund and TransFamily Support Services can provide grants to families in need [[15]Transgender legal health fund.https://transgenderlawcenter.org/trans-health-legal-fundDate accessed: April 4, 2023Google Scholar]. While such early supportive responses are encouraging, there is no full remedy for the ensuing psychosocial harm and financial disruption. Prior to the wave of legislation beginning in 2020, Black, Latine, and Indigenous adolescents were disproportionally less likely to receive GAC than their White peers [16Chen D. Abrams M. Clark L. et al.Psychosocial characteristics of transgender youth seeking gender-affirming medical treatment: Baseline findings from the trans youth care study.J Adolesc Health. 2021; 68: 1104-1111Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar, 17Johns M.M. Lowry R. Andrzejewski J. et al.Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school students - 19 states and large urban school districts, 2017.MMWR Morb Mortal Wkly Rep. 2019; 68: 67-71Crossref PubMed Google Scholar, 18Andrzejewski J. Dunville R. Johns M.M. et al.Medical gender affirmation and HIV and sexually transmitted disease prevention in transgender youth: Results from the survey of today's adolescent relationships and transitions, 2018.LGBT Health. 2021; 8: 181-189Crossref PubMed Scopus (11) Google Scholar]. Legislative bans widen these gaps, with 32% of Black TGD people living in the jurisdiction of proposed or enacted bans versus 28% of White TGD people [[3]LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar]. Additional research is needed to identify other groups who disproportionately experience barriers to accessing care. There is also a discrepancy in access to care provided by board-certified adolescent medicine providers in states with a history of proposed or enacted bans banning care compared to those who are not. According to American Board of Pediatrics workforce data, the ratio of adolescent medicine providers to 100,000 pediatric patients in the 36 states with a history of enacted or proposed bans is 0.5, compared to 1.7 in the 14 states where bans have not been considered [[1]Redfield E. Conron K. Tentindo W. Browning E. Prohibiting gender-affirming medical care for youth. The williams institute, UCLA.https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Youth-Health-Bans-Mar-2023.pdfDate accessed: April 4, 2023Google Scholar,[3]LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar,[4]American Board of PediatricsPediatric physicians workforce data book, 2019-2020. American Board of Pediatrics, Chapel Hill, NC2020Google Scholar]. As bans escalate, this gap is expected to widen. Adolescent medicine clinics in already under-resourced states are closing, and some providers are relocating to states where care is preserved. The effects of abortion bans on training programs in obstetrics/gynecology, and others may be a harbinger of similar gaps in adolescent medicine [[19]Orgera K. Grover A. Training location preferences of U.S. medical school graduates post dobbs v. jackson women’s health organization decision. American association of medical colleges.https://www.aamc.org/advocacy-policy/aamc-research-and-action-institute/training-location-preferencesDate accessed: May 22, 2023Google Scholar]. There is ample opportunity for public engagement in the current climate, though this work is often not part of medical training. On short notice, some clinicians are approached to testify in state hearings or speak with the press. Without support and experience, they may not feel safe or set up for success. Adolescent medicine providers supported by their institutions should proactively receive coaching in legislative testimony, media engagement, and addressing disinformation. This training may be available through communications and advocacy organizations. Such organizations also study effective messaging strategies to help clinical experts communicate effectively with lay audiences [[3]LGBTQ policy spotlight: Bans on medical care for transgender people. Movement advancement project.https://www.mapresearch.org/file/MAP-2023-Spotlight-Medical-Bans-report.pdfDate accessed: April 20, 2023Google Scholar]. Resources that describe and debunk disinformation on gender-affirming care may help providers prepare statements, talking points, and testimony [[11]McNamara M. Lepore C. Alstott A. et al.Scientific misinformation and gender affirming care: Tools for providers on the front lines.J Adolesc Health. 2022; 71: 251-253Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar,20Boulware S. Kamody R. Kuper L. et al.Biased science: The Texas and alabama measures criminalizing medical treatment for transgender children and adolescents rely on inaccurate and misleading scientific claims. Yale University.https://medicine.yale.edu/lgbtqi/research/gender-affirming-care/report%20on%20the%20science%20of%20gender-affirming%20care%20final%20april%2028%202022_442952_55174_v1.pdfDate accessed: April 4, 2023Google Scholar, 21McNamara M. Abdul-Latif H. Boulware S. et al.A critical review of the June 2022 Florida medicaid report on the medical treatment of gender dysphoria.https://medicine.yale.edu/lgbtqi/research/gender-affirming-care/florida%20report%20final%20july%208%202022%20accessible_443048_284_55174_v3.pdfDate accessed: April 4, 2023Google Scholar, 22Lepore C. Alstott A. McNamara M. Scientific misinformation is criminalizing the standard of care for transgender youth.JAMA Pediatr. 2022; 176: 965-966Crossref PubMed Scopus (6) Google Scholar, 23McNamara M. Lepore C. Alstott A. Protecting transgender health and challenging science denialism in policy.N Engl J Med. 2022; 387: 1919-1921Crossref PubMed Scopus (8) Google Scholar]. Also, many academic institutions have media offices that support faculty through press engagement. Adolescent medicine providers are well-suited to advocate for state sanctuary protections, the strongest of which include clauses that refuse compliance with other states' aiding and abetting penalties. These actions may be issued via direct legislation, such as in California, Connecticut, Maryland, Massachusetts, and Washington, or via executive order, such as in Minnesota and New Jersey. Such states should also allocate funds to defray the costs of care for those whose insurance plans will no longer cover GAC, as well as out-of-state travel. Providers in “safe” states must prepare their institutions and clinical operations teams for additional patients. Access should be prioritized for those low on medication and those experiencing high levels of distress. Social workers and mental health professionals should be involved early, perhaps even before the initial visit. Telehealth may help to distribute care more evenly and equitably for those who can be physically present in the state in which a provider is licensed. Clinics in the same geographic area should consider forming regional coalitions to further reduce barriers for patients and families and develop processes for comanaging patients across state lines. Those in states impacted by bans must determine what care is allowed and provide that care to the fullest possible extent. These options will vary by state and may not be possible where legislation is most restrictive. Existing care structures can be expanded to include increased support for mental health and social transition. A trauma-informed, resilience-centered approach is critical, as some states have enacted harsh punishments for expressing LGBTQ+ identities and anti-LGBTQ+ violence is on the rise. Parents may need supportive letters from community members such as teachers, faith leaders, and physicians if child abuse investigations ensue. Research is also needed on the outcomes and experiences of TGD youth who are forced to discontinue GAC against their will, for which there is currently no available data. It can be inferred from evidence on the benefits of GAC that many adolescents will experience worsening mental health as appearance congruence lessens and gender dysphoria worsens [[5]Hughes L.D. Kidd K.M. Gamarel K.E. et al.“These laws will be devastating”: Provider perspectives on legislation banning gender-affirming care for transgender adolescents.J Adolesc Health. 2021; 69: 976-982Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar,24Chen D. Berona J. Chan Y.M. et al.Psychosocial Functioning in transgender youth after 2 years of hormones.N Engl J Med. 2023; 388: 240-250Crossref PubMed Scopus (28) Google Scholar, 25de Vries A.L. McGuire J.K. Steensma T.D. et al.Young adult psychological outcome after puberty suppression and gender reassignment.Pediatrics. 2014; 134: 696-704Crossref PubMed Scopus (567) Google Scholar, 26Green A.E. DeChants J.P. Price M.N. Davis C.K. Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth.J Adolesc Health. 2022; 70: 643-649Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar, 27Tordoff D.M. Wanta J.W. Collin A. et al.Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care.JAMA Netw Open. 2022; 5e220978Crossref PubMed Scopus (88) Google Scholar]. Anxiety, depression, eating disorders, and suicidality will likely worsen as adolescents are forced to discontinue effective treatment or are unable to initiate care. Collaborative efforts must quickly form to gather data on the outcomes of TGD youth who experience interruptions in care, which may support litigation challenging bans and educate the public about the dangers of this unprecedented political interference. Collecting data on sexual orientation and gender identity in the jurisdiction of anti-LGBTQ+ legislation is likely to be an additional challenge. Efforts must be undertaken to protect the privacy of research participants from minoritized groups and to ensure that standardized questions are consistently included in both clinical and community-based research. Institutions, department chairs, and division heads must consider the difficult position that adolescent medicine providers face. Clinician-led advocacy is an asset to institutions' reputations, creates a climate of safety, and aligns with diversity, equity, and inclusion principles. Institutional leaders may consider protecting time for advocacy and media engagement to minimize burnout and sustain clinical programming. Amid rampant disinformation, institutional leaders unfamiliar with the nuances of GAC should consider their adolescent medicine faculty as sources of credible information. We strongly encourage institutions to support academic freedom and not dissuade or forbid adolescent medicine providers from sharing their expertise with the public via research, media engagement, and other forms of advocacy. Institutions are well-situated to support and protect adolescent medicine providers. Hospital-based security teams should be prepared to respond to harassment and threats against providers caring for TGD youth, and institutional media teams should receive additional training in cyber security and how to respond to online threats. Institutions should provide necessary protection for clinicians based on the nature of threats received, so providers are not left to do this work on their own [[13]Under attack: Experiences of targeted harassment among adolescent gender care providers across the United States, Landon D. Hughes 2023 SAHM annual meeting, Chicago, IL. 2023Google Scholar]. In-house legal counsel should stay apprised of the quickly shifting legal climate and work alongside clinical teams to interpret emerging legislation. They can also advise clinicians on the implications of this legislation for their clinical practice. We strongly caution institutions not to pre-emptively cease clinical care in response to the possibility of a ban, given the likelihood of harm this will have on patients and their families. GAC for youth is likely to be one of many inappropriately politicized aspects of healthcare in the future. Updated position statements are needed that defend the standard of care for TGD people of all ages, condemn legal interference in the doctor-patient relationship, and call for scientific integrity in health policy. Such support would allow those who appear in public discourse to be viewed as emissaries of consensus and protect them from concentrated harassment. The Hefler Society, the international professional association of child abuse physicians, quickly condemned equating GAC with abuse and weaponizing child protection services [[28]The helfer society. Position statement of the Ray E. Helfer society on gender affirming care being considered child abuse and neglect.https://www.helfersociety.org/assets/docs/Helfer%20Society%20Statement%20On%20Texas%20Transgender%20Action%2002.22.pdfDate accessed: April 4, 2023Google Scholar]. The World Professional Association of Transgender Health has issued fact-checking responses to disinformation claims in legacy media [[29]WPATH and USPATHUSPATH and WPATH respond to NY times, Article “they paused puberty, but is there a cost?”.https://www.wpath.org/media/cms/Documents/Public%20PoAvailalicies/2022/USPATHWPATH%20Statement%20re%20Nov%2014%202022%20NYT%20Article%20Nov%2022%202022.pdf?_t=1669173834Date accessed: April 4, 2023Google Scholar]. An amicus brief of major medical organizations challenging Alabama's ban on GAC was given considerable weight in the preliminary injunction [[7]Brief of amicus curiae American academy of pediatrics and additional national and state medical and mental health organizations in support of plaintiffs’ motion for temporary restraining order and preliminary injunction, Eknes-Tucker v. Ivey.https://www.aamc.org/media/60556/downloadDate: 2022Date accessed: April 4, 2023Google Scholar]. Adolescent medicine faces unprecedented challenges in educating the next generation of youth-serving clinicians. The American Association of Medical Colleges and the American College of Graduate Medical Education should disseminate guidance for ameliorating training gaps so that trainees in states where bans are going into effect have opportunities to learn where care is preserved. Such efforts improve quality of education and increase the number of providers trained to care for TGD adolescents. Bans on GAC threaten bodily autonomy and misuse science to harm marginalized groups. State of residence is now a primary social determinant of health for TGD youth, with racially and ethnically diverse people facing the worst vulnerabilities. Adolescent medicine providers are increasingly called upon to oppose such efforts. They should be valued as first-line defenders of scientific integrity in health policy. Wherever possible, sanctuary protections must be enacted to safeguard GAC. We must develop novel ways to protect TGD adolescents, which may be realized through redistributing clinical resources, expanding specialized mental health services, and conducting research that evaluates the unprecedented experience of forced detransition. Processes must be developed to identify and address disinformation in health policy." @default.
• W4383092647 created "2023-07-05" @default.
• W4383092647 creator A5004876985 @default.
• W4383092647 creator A5020314705 @default.
• W4383092647 creator A5054480464 @default.
• W4383092647 creator A5054656602 @default.
• W4383092647 creator A5087963768 @default.
• W4383092647 date "2023-09-01" @default.
• W4383092647 modified "2023-10-06" @default.
• W4383092647 title "Bans on Gender-Affirming Healthcare: The Adolescent Medicine Provider's Dilemma" @default.
• W4383092647 cites W2102092674 @default.
• W4383092647 cites W2911994102 @default.
• W4383092647 cites W3080600979 @default.
• W4383092647 cites W3093352997 @default.
• W4383092647 cites W3128654054 @default.
• W4383092647 cites W3204927969 @default.
• W4383092647 cites W4200077854 @default.
• W4383092647 cites W4214552015 @default.
• W4383092647 cites W4283770255 @default.
• W4383092647 cites W4292623243 @default.
• W4383092647 cites W4309518196 @default.
• W4383092647 cites W4317355000 @default.
• W4383092647 cites W4377011272 @default.
• W4383092647 doi "https://doi.org/10.1016/j.jadohealth.2023.05.029" @default.
• W4383092647 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37410003" @default.
• W4383092647 hasPublicationYear "2023" @default.
• W4383092647 type Work @default.
• W4383092647 citedByCount "0" @default.
• W4383092647 crossrefType "journal-article" @default.
• W4383092647 hasAuthorship W4383092647A5004876985 @default.
• W4383092647 hasAuthorship W4383092647A5020314705 @default.
• W4383092647 hasAuthorship W4383092647A5054480464 @default.
• W4383092647 hasAuthorship W4383092647A5054656602 @default.
• W4383092647 hasAuthorship W4383092647A5087963768 @default.
• W4383092647 hasBestOaLocation W43830926471 @default.
• W4383092647 hasConcept C111472728 @default.
• W4383092647 hasConcept C138885662 @default.
• W4383092647 hasConcept C15744967 @default.
• W4383092647 hasConcept C159110408 @default.
• W4383092647 hasConcept C160735492 @default.
• W4383092647 hasConcept C17744445 @default.
• W4383092647 hasConcept C199539241 @default.
• W4383092647 hasConcept C2778496695 @default.
• W4383092647 hasConcept C2781247642 @default.
• W4383092647 hasConcept C512399662 @default.
• W4383092647 hasConcept C71924100 @default.
• W4383092647 hasConceptScore W4383092647C111472728 @default.
• W4383092647 hasConceptScore W4383092647C138885662 @default.
• W4383092647 hasConceptScore W4383092647C15744967 @default.
• W4383092647 hasConceptScore W4383092647C159110408 @default.
• W4383092647 hasConceptScore W4383092647C160735492 @default.
• W4383092647 hasConceptScore W4383092647C17744445 @default.
• W4383092647 hasConceptScore W4383092647C199539241 @default.
• W4383092647 hasConceptScore W4383092647C2778496695 @default.
• W4383092647 hasConceptScore W4383092647C2781247642 @default.
• W4383092647 hasConceptScore W4383092647C512399662 @default.
• W4383092647 hasConceptScore W4383092647C71924100 @default.
• W4383092647 hasIssue "3" @default.
• W4383092647 hasLocation W43830926471 @default.
• W4383092647 hasLocation W43830926472 @default.
• W4383092647 hasOpenAccess W4383092647 @default.
• W4383092647 hasPrimaryLocation W43830926471 @default.
• W4383092647 hasRelatedWork W1811296007 @default.
• W4383092647 hasRelatedWork W2007638484 @default.
• W4383092647 hasRelatedWork W2350209916 @default.
• W4383092647 hasRelatedWork W2354517252 @default.
• W4383092647 hasRelatedWork W2356631479 @default.
• W4383092647 hasRelatedWork W2363851383 @default.
• W4383092647 hasRelatedWork W2386467653 @default.
• W4383092647 hasRelatedWork W2387460998 @default.
• W4383092647 hasRelatedWork W2475524763 @default.
• W4383092647 hasRelatedWork W4386266213 @default.
• W4383092647 hasVolume "73" @default.
• W4383092647 isParatext "false" @default.
• W4383092647 isRetracted "false" @default.
• W4383092647 workType "article" @default.