“Redefining Gender Would Have Serious Physical And Mental Health Consequences, " Health Affairs Blog, November 27, 2018.DOI: 10.1377/hblog20181120.814387
The Department of Health and Human Services (HHS) is considering a change to the legal definition of gender under Title IX, a civil rights law that prohibits discrimination on the basis of sex and gender identity. This proposal would specify that an individual’s gender is determined by the genitalia an individual has at birth, unless “reliable genetic evidence” indicates otherwise. In addition to ignoring that some individuals are born with indeterminate genitalia—and that there is no agreement that genitalia ought to be the primary marker of one’s gender—the proposed change threatens to further marginalize the transgender and gender diverse (TGD) community. Indeed, the Trump administration already has rescinded protections for transgender students and has attempted to prevent transgender people from serving in the nation’s military.
The definition of gender proposed by the Trump administration directly negates the scientific community’s understanding of gender, which is based on decades of research. There is no single biological determinant of gender identity or individuals’ internal and deeply held sense of who they are. Gender identity does not always correspond to external genitalia or to genetic makeup, and scientists generally agree that gender identity results from a complex array of biological, environmental, cultural, and social factors. Denying scientific evidence, the proposed HHS definition of gender would ignore the unique physical and mental health needs of 1.4 million adults and 150,000 adolescents who identify as TGD.
In an article published recently in the American Academy of Pediatrics’ journal, we argue that the TGD community needs greater recognition and support of their health and mental health needs, in part through better research on the long-term impact of gender-affirming treatment options, some of which are poorly understood by medical providers and community members alike. This must be undertaken with great care—marginalized communities have a history of being mistreated by the medical research enterprise, and any research efforts raise important questions about confidentiality and potential for misuse of data, including further discrimination. Read more via Health Affairs