Medicine ignores those who encroach

By Ada Cerundolo.

Patients who have transitioned wonder why, even after receiving extensive medical support for gender transition, the medical establishment continues to ignore their transition. There is no code to classify patients who relapse and, as a result, there is no mechanism to record the rate of infection.

A patient must be more than a number, but detainers can’t have that either. regretted later Infection Gender is so taboo that there is no way to record it in medical records with an official diagnosis code.

FAIR in Medicine, where I collaborate, requested the International Classification of Diseases diagnosis codes that represent delineations through the Centers for Disease Control and Prevention. Nine months later, subject matter experts appointed by the American Psychiatric Association (APA) and the American Academy of Pediatrics (AAP) are still reviewing our application.

International Classification of Diseases diagnosis codes label patients’ medical problems and transport them electronically through the US healthcare system. They are combinations of letters and numbers that facilitate communication, help prevent medical errors, and prompt insurance companies to reimburse for treatment.

There are codes for patients who are “affected by an orca” or who are “having relationship problems with in-laws” and even for people who are “trapped in (a) jet engine. ” However, detransition remains an unrecognized medical entity as it does not have an associated diagnosis code.

The codes position the labels so that they can be identified in CDC’s electronic database, allowing better understanding through research. While codes exist to document a change in birth sex (HID), There is no code to classify regret patients., As a result, there is no mechanism to record transition rates, a potential indicator of harm from the treatment patients receive when changing gender. This is unacceptable in the era of evidence-based medicine, especially when some treatments are irreversible.

Gender-affirming care uses hormones and surgery to align gender-nonconforming patients’ appearance with their feelings. gender identity, Gender dysphoria, discomfort with one’s birth sex, is often a prelude to affirming a new gender identity and gender-affirming treatment. Gender incongruence resulting from non-conforming identification with one’s own gender is considered to cause gender dysphoria and guides treatment.

Usually (as in other disciplines) patients undergo examinations to identify the diagnosis and determine the appropriateness of treatment. But researching a person’s gender dysphoria is considered stigmatizing for gender non-conforming populations and is considered a “control” of transgender care.

However, more and more patients are emerging from gender-affirming treatments and realizing that their gender dysphoria was caused by more than just gender incongruence, joining the population known as detransitioners. Regret at sex change is reported to be uncommon, with reported rates ranging from 0.3 to 3.8 percent, but some evidence suggests rates are as high as 30 percent.

De-transition is difficult to measure, as one study found that 75 percent of people who de-transitioned did not inform their gender-care practitioner about their de-transition. There is still no reliable estimate of the retention rate.

Meanwhile, the gender change is A rapidly growing industry in America., there are an estimated 300 more gender clinics treating minors (up from zero in 2006) and a nearly threefold increase in gender-affirming surgeries between 2016 and 2019. Gender reassignment treatment does not achieve what patients expect. Detecting patients who suspend or reverse treatment helps evaluate the benefits of treatment.

The official publication of the American Psychiatric Association, “Gender-Affirming Psychiatric Care”, advocates gender-affirming care, but ignores transitioning, except to describe older transgender people transitioning due to pressure factors. Social. This omission ignores the young people who are opting out of the transition and filing lawsuits detailing the harm it will cause them, with some facing lifelong physical changes, sterilization, and hormone replacement.

The APA-approved book also suggests that an evaluation for gender dysphoria that precludes gender-affirming treatments such as puberty suppression and hormone therapy “constitutes a form of GICE (gender identity conversion therapy).” The possibility of misdiagnosis is discussed, but only from the perspective of confusing transgender identity with something else, not the other way around.

The American Academy of Pediatrics similarly recommends gender-affirming care, although it has only recently begun a systematic review of the evidence. The results of similar reviews in other countries have shown that the benefits do not outweigh the risks, Leading to recommendations that move away from medicalization for gender-questioning youth.

The assumption that gender discrepancy is always the cause of gender dysphoria leaves no room for the possibility that some patients may have other psychological stressors that contribute to their mental distress (leading to inappropriate gender transitions.) And cause hindrances in future. The acknowledgment that transition exists immediately calls into question the concept of gender affirmation.

Medicine must accept the truth by recognizing gender changes in our health system. We hope that the APA and AAP will recognize this underserved group of patients and agree that safe medication should always be a priority, regardless of gender identity.

Ada Cerundolo MD is a FAIR Associate in Medicine at the Foundation Against Intolerance and Racism.

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