Dear USPATH colleagues,

I hope you’re doing well and had a restful Memorial Day weekend and are enjoying the start of Summer.

Pride month is in full swing and there is much to celebrate. A federal judge has thrown out Florida’s law blocking evidence-based care for transgender people; Judge Hinkle noted that transgender people are constitutionally entitled to the legitimate treatment they need. This ruling allows youth to access care consistent with the WPATH Standards of Care, including puberty pausing medications, as well as allows transgender adults to access services from a licensed health care professional including NPs and PAs. A major win for the people of Florida!

Also, during Pride month, we recently attended the annual meeting of the American Medical Association. AMA delegates voted to approve USPATH to be an official observer of their House of Delegates; this will allow our organization to send one representative to observe the actions of the House of Delegates. As an official observer, USPATH will have the right to speak and debate on the floor of the House of Delegates upon invitation from the Speaker. Further, the AMA approved the creation of an LGBTQ+ Section, with USPATH board member, Dr. Jason Schneider, as its inaugural chair. The LGBTQ+ Section will have a delegate, allowing them to introduce business and vote in the AMA House of Delegates. We expect a long and fruitful collaboration with the new AMA LGBTQ+ Section.

This month we also commemorate and celebrate Juneteenth and recognize it as a call to action to confront systemic racism and work toward dismantling oppressive structures. The liberation of transgender people is connected to the liberation of additional marginalized groups, particularly Black Americans. This requires we take an intersectional perspective, highlighted in this article by activist Dominique Morgan.

Lest I forget, I want to note that this past May, USPATH joined Whitman-Walker Institute, Movement Advancement Project, and other collaborating organization in submitting public comments in support of the Census Bureau improving data collection on LGBTQI+ communities through the American Community Survey (ACS). ACS data are used to allocate trillions of dollars in funding, enforce civil rights to protect people from discrimination, develop policies and programs to advance equity, and are safeguarded by the strongest confidentiality safeguards in federal law (see fact sheets from the Movement Advancement Project [MAP] for more information).

During our June USPATH board we covered several items that I would like to highlight:

1. We reviewed recent donations to USPATH, and thank those early donors helping us further our mission to promote transgender and gender diverse health in the United States through evidence-based care, education, research, and public policy. If you haven’t already, please consider donating.
2. Our Student and Trainee Special Interest Group (SIG) has begun meeting regularly. A separate email to student members will detail how to sign up for our communications channel for the Student and Trainee SIG. Those interested in joining can also email uspath@PROTECTED.
3. Our Research Committee continues to work with our Policies and Procedures team to finalize their charter. More details will be available in the coming weeks.
4. Our Board continues to work with Whitman-Walker Institute to finalize a survey of our membership on several issues. You will receive separate email invitations to complete future surveys.

As always, while we do our best to monitor and respond to every issue related to transgender health, we are not omniscient. As such, we appreciate any USPATH member sending us local or national issues that warrant USPATH consideration. For example, our USPATH membership and board continue to be on the lookout for high-quality research assessing and addressing the health and well-being of transgender and non-binary persons (see examples below in “what we’re reading lately”). Similarly, we make it a point to respond to poor quality research. Several USPATH board members have submitted a retraction request to Cureus editors regarding the study “Risk of Suicide and Self-Harm Following Gender-Affirmation Surgery” by John J. Staub et al. I encourage USPATH members with expertise in research methods to consider doing the same.

Also, as we continue to protect access to medically necessary care for transgender people, we encourage people to refer to our joint response with WPATH to the report from the NHS regarding gender-affirming care. Similarly, I recommend reviewing responses to the NHS report, such as this critical appraisal by Chris Noone and team.

As a reminder, our colleagues at the Protecting Affirming Care for Trans Youth (PACT) Coalition can assist with writing op-eds and letters to the editor, as well as preparing for speaking with journalists. Please feel free to reach out to Sara Mar at smar@PROTECTED with requests for information or other assistance.

Lastly, please take a moment to stop by Doc Matters to share your moments of Pride this month. As we’re celebrating over 50 years of Pride, please drop your moments of Pride as a post in DocMatters so we might celebrate together!

And while Pride is a month-long celebration, it should not end July 1. Be sure to take time to enjoy this month and to then carry your efforts forward to the rest of the year.  

In Solidarity,

Carl G Streed, Jr., MD, MPH, FACP, FAHA

President, US Professional Association for Transgender Health

What we’re reading lately (in no particular order):

Trans Computer Scientist Lynn Conway, Whose Work Revolutionized Microchips, Has Died. By Samantha Reidel. https://www.them.us/story/lynn-conway-computer-scientist-trans-advocate

Trajectories of Gender Identity and Depressive Symptoms in Youths. By André Gonzales Real et al. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2818886

Transgender-Affirming Hospital Policies. By HRC. https://www.thehrcfoundation.org/professional-resources/transgender-affirming-hospital-policies

Gender affirming treatment and employment rate in 3,812 Danish transgender persons and 38,120 controls. By Dorte Glintborg et al. https://pubmed.ncbi.nlm.nih.gov/38771642/

Desire for Gender-Affirming Medical Care Before Age 18 in Transgender and Nonbinary Young Adults. By Gina M. Sequeira et al. https://www.liebertpub.com/doi/10.1089/lgbt.2023.0436

Half of All U.S. States Limit or Prohibit Youth Access to Gender Affirming Care. By Lindsey Dawson and Anna Rouw. https://www.kff.org/other/issue-brief/half-of-all-u-s-states-limit-or-prohibit-youth-access-to-gender-affirming-care/

Utilization of the 988 Suicide & Crisis Lifeline’s LGBTQ Service. By Lindsey Dawson and Heather Saunders. https://www.kff.org/mental-health/issue-brief/utilization-of-the-988-suicide-crisis-lifelines-lgbtq-service/

Sexual and gender minority content in undergraduate medical education in the United States and Canada: current state and changes since 2011. By Carl Streed Jr. et al. https://link.springer.com/article/10.1186/s12909-024-05469-0

Isotretinoin for Acne in Transgender and Gender-Diverse Individuals Receiving Masculinizing Hormone Therapy. By Jame Choe et al. https://jamanetwork.com/journals/jamadermatology/fullarticle/2819418

Heed lessons from past studies involving transgender people: first, do no harm. By Mathilde Kennis et al. https://www.nature.com/articles/d41586-024-01521-7

The Use of Injectable Estradiol in Transgender and Gender Diverse Adults: A Scoping Review of Dose and Serum Estradiol Levels. By Micol Rothman et al. https://pubmed.ncbi.nlm.nih.gov/38782202/

Gender Explained, A New Understanding of Identity in a Gender Creative World. By Diane Ehrensaft and Michelle Jurkiewicz. https://www.penguin.co.uk/books/462635/gender-explained-by-jurkiewicz-dr-diane-ehrensaft-and-dr-michelle/9781785045240

How my grandfathers’ war wounds formed my belief that transgender youths deserve care. By Alex Dworak. https://nebraskaexaminer.com/2024/06/20/how-my-grandfathers-war-wounds-formed-my-belief-that-transgender-youths-deserve-care/

Conferences we’re looking forward to (in order by date):

9th National LGBTQ Health Conference, Atlanta, GA, August 15 – 17, 2024. https://lgbtqhealthconf2024.dryfta.com/

Philadelphia Trans Wellness Conference, Philadelphia, PA, September 5 – 7, 2024. https://mailchi.mp/c43edfc51bde/ptwc-2022-sign-up

WPATH 28^th Scientific Symposium, Lisbon, Portugal, September 25 – 30, 2024. https://www.wpath.org/WPATH-28th-Scientific-Symposium

GLMA's 42^nd Annual Conference on LGBTQ+ Health, Charlotte, NC, September 30 – October 2, 2024. https://www.glma.org/conference.php

TransPride YOUniting Health & Wellness Conference, Virtual, November 7 – 9, 2024. https://www.transpridepgh.org/