Statement of Position in Regard to Gender Affirming Care

Like so many other concerned observers across the United States and around the globe, Columbia Health and the Transgender and Gender Expansive Team (TGET) have been closely monitoring the numerous legislative actions taking place in state houses throughout the country intended to restrict or ban access to gender affirming medical care.

The sudden proliferation of hundreds of such bills in such a short span of time has caused alarm, confusion, and fear among trans and gender expansive people, as well as healthcare providers of diverse specialties, from surgeons, general practitioners, psychiatrists, psychotherapists, social workers, pediatricians, endocrinologists, to support staff.

The principles and standards of gender affirming care have been carefully established over decades (WPATH, IJTH) by centering the input and lived experiences of those seeking care while ensuring the validity and efficacy of treatment via scientific and medical research. Such care is grounded in the core principles of health care ethics of beneficence, non-maleficence, and respect for each person’s bodily autonomy, integrity, and dignity. And yet, the facts and knowledge we’ve accumulated are contradicted or at best ignored  in the form of trans health care bans as well as other harmful measures such as those limiting diverse gender expression. 

While many of these laws directly impact health care providers and their ability to provide lifesaving care to transgender and nonbinary patients, this burden pales in comparison to the harm caused to those in direct need of gender-affirming care. While such treatment can be said without exaggeration to be lifesaving, it is an unfortunate truth that it has always been extremely difficult for those in need to get access to care, even before the recent legislation.

In many parts of the United States, people have had to travel hours for a single appointment or are limited to telehealth care whether they prefer that modality or not. Even in cities such as New York, it has long been commonplace for a person to wait as long as a year just for an initial consultation with a surgeon.

Such realities run counter to the claims raised by legislators regarding people being rushed recklessly into gender affirming care. And yet we are now in danger of treatment becoming not just difficult but nearly impossible to obtain for far too many people. Many trans and gender expansive persons who have been receiving care are in danger of abruptly losing it--if they have not lost it already. When coupled with the rise of increasingly antagonistic and inflammatory social forces that equate gender diversity and nonconformity with predation, there is understandably a growing fear not just for healthcare access but for general safety and security.

Columbia Health and TGET are committed to solidarity with transgender and gender expansive people and seek to affirm the importance and validity of trans identities along with the right of all who need it to receive gender affirming care.

Specifically, we stand in support of the recently passed New York State laws S.2475-B (Hoylman-Sigal) / A.6046-B (Bronson), laws designed to prevent New York from cooperating in hostile states’ retaliation against gender affirming care providers, patients, family members, and those who support them. In this we speak in unison with the American Academy of Pediatrics, the World Professional Association of Transgender Health, the American Psychiatric Association, the American Psychological Association, the National Association of Social Workers, and many other professional, political, and sociological institutions in support of gender affirmative care.

While it is our hope that both advocacy and judicial review will start to roll back the wave of care limiting laws before long, we reaffirm our commitment to this work in the interim and to partnering with our transgender and gender expansive patients.

We will:

• Listen carefully to their goals and needs,
• Continue to strive to further our own learning and advocacy throughout the year- not just during Pride Month, and
• Continue to improve upon our services and capacity to provide gender affirmative care.

We additionally dedicate ourselves to remembering that the mission of ensuring that trans and gender expansive people receive the healthcare they need cannot succeed unless it is part of a larger endeavor to secure justice and equality for all marginalized people everywhere.

Learn more about gender affirmative care at Columbia Health.