At Plume, we are committed to providing gender-affirming care to all of our members. But what exactly is gender-affirming care? Let’s take a step back and discuss the key components that define this type of care, as well as review some of the evidence showing that gender-affirming care leads to the best health outcomes for our community.
Gender-affirming care is, at its core, exactly what it sounds like – health care that affirms you to live authentically in your gender. More explicitly, this means a departure from the outdated “one size fits all” framework of a doctor dictating the same set of hormones and surgery for every trans person seeking medical care. Instead, it allows each person to seek only those interventions they desire to affirm their own gender identity ((Deutsch, M. Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People. (June 27, 2016.) Available at: https://transcare.ucsf.edu/guidelines)). In practice, this means that your healthcare provider works with you on your own, unique gender journey, and helps to facilitate any medical interventions necessary for your transition. Additionally, it recognizes that while there are many medical interventions that some folks need to affirm their gender, other folks may not desire or pursue these types of treatments ((Puckett JA, Cleary P, Rossman K, Newcomb ME, Mustanski B. Barriers to Gender-Affirming Care for Transgender and Gender Nonconforming Individuals. Sex Res Social Policy. 2018;15(1):48‐59. doi:10.1007/s13178-017-0295-8 available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842950/)) .
Gender-affirming care also means affirming you as a whole person, and recognizing that gender affirmation is more than medical procedures. This means always honoring your name, pronouns, and gender identity, celebrating and respecting other identities that intersect with your gender, and always meeting you where you are on your journey without any judgments or assumptions [^1]. It means decreasing barriers that have historically made it difficult for our community to access care, like a lack of providers, issues with insurance, and long wait times between appointments.
Now let’s talk about the science behind the practice. Gender-affirming care is considered standard of care and a medical necessity by nearly every major medical association in the United States, including the American Medical Association, the American Academy of Family Physicians, and the American Psychiatric Association ((Am. Medical Assn., Health insurance coverage for gender-affirming care of transgender patients (2019). Available at: https://www.ama-assn.org/system/files/2019-03/transgender-coverage-issue-brief.pdf)) . Whenever something is deemed “medically necessary,” it means this care is evidence-based and supported by science.
As such, gender-affirming care is considered medically necessary due to the overwhelming evidence that such care greatly improves health outcomes for our community. When we get the care we need, the high rates of depression, anxiety, and suicide attempts that burden our community decrease substantially ((Murad MH, Elamin MB, Garcia MZ, et al. Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes. Clin Endocrinol (Oxf). 2010;72(2):214‐231. doi:10.1111/j.1365-2265.2009.03625.x)) . We are so much healthier, in fact, that providing this care has been shown to be cost-effective compared to the costs associated with denying affirming treatment ((Padula WV, Heru S, Campbell JD. Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis. J Gen Intern Med. 2016;31(4):394‐401. doi:10.1007/s11606-015-3529-6)).
At Plume, we are deeply committed to the science and values of gender-affirming care because it supports you, as an individual, in living your authentic life. We recognize that not all people may need or desire medical services during their journey to expressing their authentic journey, but for those who do, we are proud to be a resource. In future posts, we’ll look further into some of the treatments that may be a part of your gender-affirming care, while always keeping in mind that everyone who receives gender-affirming care is on an individual journey.
