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Health Care for Transgender and Gender Diverse Individuals

ACOG Committee Opinion Summary, Number 823

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doi: 10.1097/AOG.0000000000004296
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Abstract

Recommendations and Conclusions

The American College of Obstetricians and Gynecologists makes the following conclusions and recommendations regarding health care for transgender and gender diverse individuals:

The American College of Obstetricians and Gynecologists opposes discrimination on the basis of gender identity, urges public and private health insurance plans to cover necessary services for individuals with gender dysphoria, and advocates for inclusive, thoughtful, and affirming care for transgender individuals.

  • Obstetrician–gynecologists should make their offices inclusive and inviting to all individuals who need obstetric or gynecologic health care. They should take steps to educate themselves and their medical teams about appropriate language and the health care needs of transgender patients.
  • Fertility and parenting desires should be discussed early in the process of transition, before the initiation of hormone therapy or gender affirmation surgery.
  • Gender-affirming hormone therapy is not effective contraception. Sexually active individuals with retained gonads who do not wish to become pregnant or cause pregnancy in others should be counseled about the possibility of pregnancy if they are having sexual activity that involves sperm and oocytes.
  • The majority of medications used for gender transition are common and can be safely prescribed by a wide variety of health care professionals with appropriate training and education, including, but not limited to, obstetrician–gynecologists, family or internal medicine physicians, endocrinologists, advanced practice clinicians, and psychiatrists.
  • Hysterectomy with or without bilateral salpingo-oophorectomy is medically necessary for patients with gender dysphoria who desire this procedure.
  • To guide preventive medical care, any anatomical structure present that warrants screening should be screened, regardless of gender identity.

Number 823 (Replaces Committee Opinion 512, December 2011, and Committee Opinion 685, January 2017)

For a comprehensive overview of these recommendations, the full-text version of this Committee Opinion is available at http://dx.doi.org/10.1097/AOG.0000000000004294.

Scan this QR code with your smartphone to view the full-text version of this Committee Opinion.

Committee on Gynecologic Practice and Committee on Health Care for Underserved Women

This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice and Committee on Health Care for Underserved Women in collaboration with committee members Beth Cronin, MD and Colleen K. Stockdale MD, MS.

Full-text document published online on February 18, 2021.

Copyright 2021 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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Official Citation

Health care for transgender and gender diverse individuals. ACOG Committee Opinion No. 823. American College of Obstetricians and Gynecologists. Obstet Gynecol 2021;137:e75–88.

© 2021 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.