Putting patients first in transgender surgical care

Gender-affirmation surgery represents a validated set of procedures, but challenges remain.

The June issue of AMA Journal of Ethics^® (@JournalofEthics) features numerous perspectives for physicians and medical students on gender-affirming surgical care, exploring patient-centered informed consent and autonomy, accountability and shared decision-making processes. This issue also considers present-day challenges and considerations in the field of gender-affirmation surgery.

The June issue includes the following articles:

1. “Ethically Navigating the Evolution of Gender Affirmation Surgery.”

   1. The political landscape surrounding trans adolescents’ care access remains hostile, and this issue considers physicians’ roles as protectors of patient-centered, inclusive care.

2. “How Should a Transgender Patient’s History of Deep Vein Thrombosis and Smoking Influence Gender-Affirming Health Decision Sharing?”

   1. This commentary on a case considers a transgender patient’s mental health and risk for deep vein thrombosis in ethical decision-making about feminizing gender-affirming hormone therapy.

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3. “What’s Wrong With Criminalizing Gender-Affirming Care of Transgender Adolescents?” 

   1. This article canvasses states’ legal prohibitions and challenges to them and considers consequences for patients and physicians.

4. “Patient-Centered Approaches to Using BMI to Evaluate Gender-Affirming Surgery Eligibility”

   1. Body-mass index cutoffs are routinely used to assess eligibility for gender-affirming surgeries, yet they are not empirically based.

Delve further with the journal’s November 2016 issue on transgender health, which focused on the importance of expanding gender-affirming health care services, enhancing the quality of transgender patients’ clinical encounters, and improving general medical and mental health outcomes among gender diverse patients.

In the journal’s June “Ethics Talk” podcast, medical anthropologist Eric Plemons, PhD, discusses facial feminization surgery and how physicians can best support patient decisions about gender-affirming care. The June issue also features four author-interview podcasts. Listen to previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

Also, CME modules drawn from this month’s issue are collected at the AMA Ed Hub™ AMA Journal of Ethics webpage.

Submissions for the 2023 Conley Contests are being accepted through fall. U.S. MD and DO students, resident physicians or fellows in programs accredited by the ACGME or AOA are eligible to submit entries. The winning prize for the best essay and artwork, respectively, is $5,000.

Learn more about the Ethics Essay Contest and the Art of Medicine Contest.

Upcoming issues of the journal will focus on body mass index, robotic surgery ethics, and palliative psychiatry. Sign up to receive email alerts when new issues are published.