Meeting Coverage
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AMA
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One pediatric endocrinologist called it “lifesaving” for her patients
by
Joyce Frieden, Washington Editor, MedPage Today
November 12, 2024
Gender-affirming healthcare shouldn’t be limited to adults, members of the American Medical Association (AMA) House of Delegates said Monday at the delegates’ interim meeting in Orlando, Florida.
“As a pediatric endocrinologist myself, I’ve seen how appropriate, guideline-based [gender-affirming] care for my patients can be lifesaving,” said Brittany Bruggeman, MD, of Gainesville, Florida, an alternate delegate for the American Academy of Pediatrics who spoke for the delegation. “I have really seen the tremendous effects that when this care is done right by physicians and is based on guidelines — which is what this report calls for — it can dramatically improve the health of my patients. For this reason, the AMA should support doctors who are providing this care in a guideline-based way.”
The delegates were discussing a resolution offered by the Virginia delegation related to a report from the AMA Board of Trustees on “Advocating for the Informed Consent for Access to Transgender Healthcare.” The report, which an AMA reference committee had recommended that the delegates vote to adopt, stated that the association supports the provision of medically necessary gender-affirming care (GAC) but does not take a position on whether determination of medical necessity needs to include a gender dysphoria diagnosis.
The report further noted that the AMA “does not wish to … endorse one particular model of care over another. Rather, the AMA vigorously advocates for equitable payment policies while relying on the evidence-based professional guidelines and recommendations set by professional medical associations, as well as individual physician clinical judgment, on questions of appropriate clinical criteria.” The authors added that “GAC may be provided during or before adolescence; however, recognizing that providing GAC for children is fundamentally different than for adults due to differences in biology, psychology, and autonomy, the scope of this report is limited to gender-affirming medical interventions provided to adults.”
Tom Eppes, MD, of Forest, Virginia, speaking for the Virginia delegation, at first tried to get the report referred to the Board of Trustees for further study, with a report due back at the delegates’ 2025 annual meeting in June. He noted that “This report was released Saturday morning … less than 2 hours before the reference committee began. And unless you’re a speed reader, you didn’t have any chance to get through it. There was no chance to read it, no chance to discuss with delegations [or] comment online … We feel that this report needs to be reviewed in our House of Delegates in the same order that all other resolutions and reports have, and [the trustees should] report back next June for a vote.”
When that effort was voted down by delegates, Eppes, this time speaking for himself, then proposed that the new policy proposed in the board report — which said that the AMA “unambiguously supports access to and insurance coverage of medically necessary GAC” — include the words “for adults [over age 18]” at the end of that phrase.
