APA offers New Position on Transgender Care

*Note: As much as I applaud this it does not say the APA will cease the pathologization of trans people. It remains to be seen what affect this position will have as it concerns the DSM-5.


APA Issues Official Positions Supporting Access to Care and the Rights of Transgender and Gender Variant Persons

ARLINGTON, Va. (August 16, 2012) — The American Psychiatric Association advocates for removal of barriers to care for gender transition treatment and for the protection of civil rights for transgender and gender variant individuals. APA has long expressed strong affirmation of lesbian and gay civil rights since the 1973 decision to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders. Now APA is issuing position statements in support of access to care and civil rights for transgender individuals.

Gender variant and transgender individuals must cope with multiple unique challenges, including significant discrimination, prejudice, and the potential for victimization from violent hate crimes. They often experience discrimination when accessing health care and are denied numerous basic civil rights and protections.

Long-standing medical and psychiatric literature demonstrates clear benefits of medical and surgical interventions to assist gender variant individuals seeking transition. However, transgender and gender variant people are frequently denied medical, surgical, and psychiatric care related to gender transition. Access to medical care (both medical and surgical) positively impacts the mental health of transgender and gender variant individuals.

Being transgender or gender variant implies no impairment in judgment, stability, reliability, or general social or vocational capabilities; however, these individuals often experience discrimination due to a lack of civil rights protections for their gender identity or expression. Transgender and gender variant persons are frequently harassed and discriminated against when seeking housing or applying to jobs or schools, are often victims of violent hate crimes, and face challenges in marriage, adoption and parenting rights,

Discrimination and lack of equal civil rights is damaging to the mental health of transgender and gender variant individuals. For example, gender-based discrimination and victimization were found to be independently associated with attempted suicide in a population of transgender individuals, 32% of whom had histories of trying to kill themselves, and in the largest survey to date of gender variant and transgender people 41% reported attempting suicide.*

The APA joins other organizations, including the American Medical Association and the American Psychological Association, in endorsing strong policy statements deploring the discrimination experienced by gender variant and transgender individuals and calling for laws to protect their civil rights.


Access to Care for Transgender and Gender Variant Individuals
The American Psychiatric Association:

1. Recognizes that appropriately evaluated transgender and gender variant individuals can benefit greatly from medical and surgical gender transition treatments.
2. Advocates for removal of barriers to care and supports both public and private health insurance coverage for gender transition treatment.
3. Opposes categorical exclusions of coverage for such medically necessary treatment when prescribed by a physician.
Discrimination against Transgender and Gender Variant Individuals
The American Psychiatric Association:
1. Supports laws that protect the civil rights of transgender and gender variant individuals.
2. Urges the repeal of laws and policies that discriminate against transgender and gender variant people.
3. Opposes all public and private discrimination against transgender and gender variant individuals in such areas as health care, employment, housing, public accommodation, education, and licensing.
4. Declares that no burden of proof of such judgment, capacity, or reliability shall be placed upon these individuals greater than that imposed on any other persons.
See the full position statements and background information:

Access to Care for Transgender and Gender Variant Individuals Discrimination against Transgender and Gender Variant Individuals
See also a recent report from the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder.

*Clements-Nolle K, Marx R, Katz M (2006): Attempted Suicide Among Transgender Persons, Journal of Homosexuality, 51:3, 53-69 http://dx.doi.org/10.1300/J082v51n03_04
Grant, Jaime M., Lisa A. Mottet, Justin Tanis, Jack Harrison, Jody L. Herman, and Mara Keisling. Injustice at Every Turn: A Report
of the National Transgender Discrimination Survey. Washington: National Center for Transgender Equality and National Gay and
Lesbian Task Force, 2011. http://endtransdiscrimination.org/PDFs/NTDS_Report.pdf
The American Psychiatric Association is a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention, and research of mental illnesses including substance use disorders. Visit the APA at www.psychiatry.org.

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