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How Cisgender Clinicians Can Help Prevent Harm During Encounters With Transgender Patients

Learning Objectives
1. Explain a new or unfamiliar viewpoint on a topic of ethical or professional conduct
2. Evaluate the usefulness of this information for health care practice, teaching, or conduct
3. Decide whether and when to apply the new information to health care practice, teaching, or conduct
1 Credit CME
Abstract

Transgender people commonly experience discrimination from clinicians, which directly contributes to worse mental and physical health outcomes among this population. This article describes mechanisms by which stigma perpetuates health inequity among transgender patients and highlights its unique effects on transgender patients of color. The article concludes with recommendations to cisgender clinicians on how to help prevent stigmatizing interactions with transgender patients.

Introduction

People who are transgender experience discrimination in every aspect of their lives, including health care settings. Perceived discrimination by clinicians contributes to health care avoidance, increased substance use, poor general health, and poor mental health among transgender individuals.13 Moreover, transgender people of color (TPOC) experience even higher rates of gender-based discrimination by clinicians and have worse health outcomes than their White counterparts.46 In this article, we describe mechanisms through which clinicians and health care systems perpetuate stigmatization of transgender patients. We also describe how compounded cissexist and racial discrimination shapes unique health inequities experienced by TPOC. Finally, we offer recommendations that cisgender clinicians can enact to prevent stigmatization of transgender patients.

Antitransgender Stigma

Stigmatization is a social process whereby human differences are identified, labeled, and linked to negative stereotypes, resulting in the social devaluation of labeled groups.7,8 People who are labeled experience a loss of status, which adversely affects their capacity for upward social mobility, their overall life chances, and their health.9 One widely accepted framework of stigma conceptualizes it as occurring at 3 different levels: structural, interpersonal, and individual.9,10

Structural stigma refers to the systematic devaluation of people through institutional policies and cultural norms that limit access to important social resources. Interpersonal stigma refers to discriminatory actions carried out against a person due to the perpetrator’s conscious or subconscious negative views about a labeled group. Finally, individual stigma refers to the negative beliefs individuals have about themselves due to the internalization of structural and interpersonal stigma.10 From a sociocultural perspective, stigma is believed to encourage conformity to social norms by punishing those who display attributes associated with labeled groups.7

Antitransgender stigma at every level is generated by institutional and cultural cissexism—an ideology that holds that cisgender people and their experiences are more natural and legitimate than those of transgender people.9,11 At a societal level, structural and interpersonal stigma render transgender people targets of discrimination, harassment, violence, and mistreatment in every aspect of their lives.9 The 2015 US Transgender Survey found that, as a whole, transgender people face alarmingly high lifetime rates of verbal harassment (46%), physical assault (9%), workplace discrimination (30%), mistreatment in primary and secondary education (77%), and mistreatment in undergraduate education (24%), as well as homelessness within the past year (12%) because of their gender identity.12

In health care settings, interpersonal stigma against transgender people is common. In fact, participants in the 2005–2006 Virginia Transgender Health Initiative Study reported experiencing health care discrimination more commonly than employment discrimination or housing discrimination.13 One-third of respondents of the 2015 US Transgender Survey who had seen a health care practitioner in the preceding year reported at least one negative health care-associated experience related to being transgender.12Quiz Ref ID Overt acts of discrimination by clinicians include refusal of services because of gender identity, abusive language, physically aggressive treatment, and attempts to stop patients from transitioning gender.14,15 More insidious displays of interpersonal stigma include misgendering and deadnaming patients. Misgendering is the repeated use of gender pronouns inconsistent with a person’s current gender identity (eg, using “he” or “him” when referring to a transgender woman), while deadnaming is the use of a patient’s legal or former name rather than their chosen name.1618 Clinicians also stigmatize transgender patients by asking them intrusive questions about their private lives out of personal curiosity, such as inquiring about their genitals, their sexual partners, or their sexual activity during encounters in which that information is not medically relevant.16,19

Quiz Ref IDStructural stigma against transgender persons within the health care system is also pervasive. One prominent example is pathologization of transgender experiences in reference works such as the Diagnostic and Statistical Manual of Mental Disorders.20 For example, gender dysphoria is a miscodification that pathologizes normal gender variance and contributes to delegitimization of transgender individuals’ experiences by characterizing transgender persons as mentally disordered.20,21 Moreover, that transgender people seeking to obtain medical interventions, such as hormone replacement therapy or gender-affirming surgery, are routinely made to undergo psychological evaluation before receiving treatment implies that transgender individuals are not competent enough to make these kinds of medical decisions on their own.22 Electronic health records that do not allow for accurate documentation of gender identity, gender pronouns, or chosen names also promote erasure of transgender identities and can lead to stigmatizing experiences, such as misgendering or deadnaming.23

Minority Stress Among Transgender People

The minority stress model developed by Ilan Meyer provides a framework for conceptualizing how stigma, prejudice, and discrimination create hostile social situations that result in higher prevalence of mental health disorders among sexual and gender minorities.24 The 3 steps of this model proceed as follows: (1) hostile interpersonal interactions resulting from an individual’s transgender identity create overt stress and/or physical harm; (2) the individual then learns to anticipate and watch for situations that may lead to repeated instances of stress or harm; and, eventually, (3) the individual internalizes the negative prejudices and stereotypes held by society, leading to increased psychopathology.25 In other words, experiencing enacted stigma produces anticipated stigma, and both ultimately contribute to the worsening of individual stigma.

Quiz Ref IDTransgender individuals who experience stigmatizing events in health care settings are more likely to delay or forgo future care out of fear of discrimination.1,2,13,2528 Avoiding health care secondary to anticipated discrimination from clinicians is associated with mental health pathology, including depression, suicidal ideation, and suicide attempts.25,29,30 Additionally, some transgender people engage in the use of recreational substances such as alcohol, cigarettes, vaping, and marijuana to cope with emotional consequences of discrimination, including health care discrimination.3,25,3133 New research is beginning to reveal the ways in which minority stress among transgender individuals contributes to physical disease through immune dysregulation, chronic inflammation, and elevated cortisol levels.3436

Minority Stress Among TPOC

Quiz Ref IDTPOC experience compounded forms of minority stress due to the overlapping effects of cissexism and racism, and they are more likely to face barriers to health care access and to experience worse health outcomes than their cisgender peers of the same race.5,6,37 Among transgender individuals, those who hold the additional marginalized identity of being a person of color are at increased risk of experiencing overt health care discrimination because of their gender identity. Notably, they are more likely than White transgender people to be discriminated against by physicians in hospitals (26.1% vs 18.5%) and emergency rooms (16.8% vs 10.1%) and by paramedics in ambulances (8.6% vs 3.0%).4 TPOC are also more likely than White transgender individuals to experience discrimination when accessing social services such as mental health clinics (14.1% vs 9.1%), drug treatment centers (5.6% vs 1.9%), domestic violence shelters (9.6% vs 4.1%), and rape crisis centers (7.3% vs 3.9%).38

In interpersonal interactions with clinicians, TPOC are more likely than their White counterparts to experience refusal of physical touch (18.4% vs 14.7%), to be denied medical care (28.7% vs 26.4%), to be subjected to harsh language (25.9% vs 19.7%), and to experience physically rough or abusive treatment (9.6% vs 7.3%).15 Consequently, TPOC experience a greater anticipated fear of health care discrimination.1 Ultimately, TPOC are more likely than their White counterparts to have concerns that their gender identity will be a significant barrier to obtaining medical care (53.5% vs 51.8%).15

Recommendations

Clinicians have a responsibility to recognize the ways in which they directly contribute to the perpetuation of health disparities among transgender patients. Although action at a social and structural level will be necessary to bring about the greatest amount of change in care delivery and overall health for this patient population, clinicians can act at an individual level to prevent the stigmatization of transgender patients. To this end, we present several recommendations that cisgender clinicians can implement.

Quiz Ref IDSignal an inclusive clinical environment. Help ease patients’ fear of health care discrimination by openly communicating a commitment to gender-affirming care. Prominently display your clinic’s nondiscriminatory policy indicating protection against discrimination based on gender identity. Use visual cues, such as rainbow-colored “safe space” signage on your office door, website, or work badge. Additionally, consider submitting your contact information to online directories of trans-affirming health professionals, such as Trans in the South or GLMA’s online provider directory.39,40

Employ gender sensitivity in communication. Recognize that language can intentionally and unintentionally lead to marginalization and stigmatization of transgender individuals.41 Train staff members to avoid using gender-specific language until they know the patient’s name and pronouns.2 Use affirming questions on intake paperwork, such as “What is your gender identity?” “What was your designated sex at birth?” “How do you self-identify by name and pronouns?”4244 Respect patients by using names and pronouns with which they identify. If you use incorrect gender pronouns, offer a brief but sincere apology and correct the mistake.17 In addition to preferred name and pronouns, ask patients which words they prefer to use for their body or employ ungendered and neutral language, such as “external genitals” rather than “male genitals” or “penis.”45 Familiarize yourself with gender inclusive terminology by referencing a glossary of transgender terms.11,4648 Avoid asking patients intrusive questions regarding genitals, sexual partners, or sexual activity. Finally, unless medically necessary, refrain from performing a genital exam, as such exams can cause significant anxiety and distress for many transgender people.

Consider multiple marginalized experiences. TPOC experience unique forms of discrimination and have worse health care access and health outcomes than their White transgender and cisgender counterparts.1,46,32 When caring for transgender patients with multiple marginalized identities, recognize that unless you share the same set of marginalized identities, you lack a full understanding of their circumstances and experiences.49 Contemplate how your personal biases and lack of shared life experiences may shape your clinical decision making to the patient’s detriment. Acknowledge the power differential inherent in the patient-physician relationship and relinquish some of that power by engaging the patient in shared decisionmaking that takes their unique circumstances into account, allowing them to lead the way.49

Engage with the transgender community. Although clinical knowledge regarding biomedical aspects of transgender care is important and necessary, it is equally important to seek out opportunities that increase your exposure to gender minority patients.14 One way to do so is by enrolling in a cultural competency training session at a local lesbian, gay, bisexual, transgender (LGBT) resource center or through an online platform such as the National LGBTQIA+ Health Education Center.50 Collaborating with these groups in respectful and supportive ways fosters trust and helps to destigmatize transgender people.51 Although less interactive, media—such as documentaries, books, news articles, or scholarly literature that feature transgender narratives—are also easily accessible resources for familiarizing yourself with the experiences of gender minorities.52

Avoid pathologizing and gatekeeping. Recognize that, according to the World Professional Association for Transgender Health’s Standards of Care, a diagnosis of gender dysphoria is not required for adult patients to access transition-related interventions.20,47 Become familiar with the difference between using gender dysphoria as a diagnostic label and to enable access to gender-affirming care, and only use it when genuinely necessary in order to avoid pathologizing transgender patients.20 Implement an informed consent model for hormone therapy initiation instead of requiring adult patients to obtain a psychological evaluation before beginning treatment.22,53

Although these steps alone will not lead to large-scale changes, they can mitigate some of the most common structural barriers that prevent many transgender patients from accessing gender-affirming care. In addition, consider how you can promote broader structural change by wielding the influence you have in positions of power—such as your seat on a medical board, your academic rank, or your connections to policymakers—to amplify the voices of transgender people. Clinicians in any capacity should feel empowered to promote equity for transgender individuals through advocacy in—and that extends beyond—their communities and their institutions.51

Conclusion

There is a wealth of evidence demonstrating that clinicians perpetuate the stigmatization of transgender patients, leading to poor health outcomes in this vulnerable population. TPOC are disproportionately affected by health care discrimination and inequity. Large-scale organizational changes that reject structural cissexism and racism, in conjunction with public health initiatives and policy changes, will be necessary to bring about the greatest degree of change for this population. Cisgender clinicians can act on a personal level and on a broader scale to prevent the stigmatization of transgender patients in health care settings.

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Article Information

AMA Journal of Ethics

AMA J Ethics. 2022;24(8):E753-761.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships.

If applicable, all relevant financial relationships have been mitigated.

Conflict of Interest Disclosure: The author(s) had no conflicts of interest to disclose.

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.

Author Information:

  • Ximena Lopez, MD is a pediatric endocrinologist and associate professor at the University of Texas Southwestern Medical Center in Dallas. She is the medical director and founder of the GENder Education and Care Interdisciplinary Support Program, which provides multidisciplinary care to transgender and gender diverse youth; Antonio D. Garcia is a third-year medical student at the University of Texas Southwestern Medical Center in Dallas. His research interests include language barriers in health care, racial and ethnic disparities in health care, and gender minority health disparities.

References
1.
Kcomt  L, Gorey  KM, Barrett  BJ, McCabe  SE.  Health Care avoidance due to anticipated discrimination among transgender people: a call to create trans-affirmative environments.  SSM Popul Health. 2020;11:100608.Google ScholarCrossref
2.
Seelman  KL, Colón-Diaz  MJP, Lecroix  RH, Xavier-Brier  M, Kattari  L.  Transgender noninclusive health care and delaying care because of fear: connections to general health and mental health among transgender adults.  Transgend Health. 2017;2(1):17–28.Google ScholarCrossref
3.
Reisner  SL, Pardo  ST, Gamarel  KE, Hughto  JMW, Pardee  DJ, Keo-Meier  CL.  Substance use to cope with stigma in health care among US female-to-male trans masculine adults.  LGBT Health. 2015;2(4):324–332.Google ScholarCrossref
4.
Kattari  SK, Walls  NE, Whitfield  DL, Langenderfer-Magruder  L.  Racial and ethnic differences in experiences of discrimination in accessing health services among transgender people in the United States.  Int J Transgend. 2015;16(2):68–79.Google ScholarCrossref
5.
Lett  E, Asabor  EN, Beltrán  S, Dowshen  N.  Characterizing health inequities for the US transgender Hispanic population using the behavioral risk factor surveillance system.  Transgend Health. 2021;6(5):275–283.Google ScholarCrossref
6.
Lett  E, Dowshen  NL, Baker  KE.  Intersectionality and health inequities for gender minority Blacks in the US.  Am J Prev Med. 2020;59(5):639–647.Google ScholarCrossref
7.
Phelan  JC, Link  BG, Dovidio  JF.  Stigma and prejudice: one animal or two?  Soc Sci Med. 2008;67(3):358–367.Google ScholarCrossref
8.
Earnshaw  VA, Quinn  DM.  The impact of stigma in health care on people living with chronic illnesses.  J Health Psychol. 2012;17(2):157–168.Google ScholarCrossref
9.
King  WM, Hughto  JMW, Operario  D.  Transgender stigma: a critical scoping review of definitions, domains, and measures used in empirical research.  Soc Sci Med. 2020;250:112867–.Google ScholarCrossref
10.
White  Hughto JM, Reisner  SL, Pachankis  JE.  Transgender stigma and health: a critical review of stigma determinants, mechanisms, and interventions.  Soc Sci Med. 2015;147(147):222–231.Google Scholar
11.
Serano  J.  Outspoken: A Decade of Transgender Activism and Trans Feminism. Switch Hitter Press; 2016.
12.
James  SE, Herman  JL, Rankin  S, Keisling  M, Mottet  L, Anafi  M.  The Report of the 2015 US Transgender Survey. National Center for Transgender Equality; 2016. Accessed April 26, 2022. https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf
13.
Bradford  J, Reisner  SL, Honnold  JA, Xavier  J.  Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study.  Am J Public Health. 2013;103(10):1820–1829.Google ScholarCrossref
14.
Kosenko  K, Rintamaki  L, Raney  S, Maness  K.  Transgender patient perceptions of stigma in health care contexts.  Med Care. 2013;51(9):819–822.Google ScholarCrossref
15.
Tillery  B, Hirshman  R;  Somjen Frazer Consulting. When health care isn’t caring: LGBT people of color and people of color living with HIV. Results from Lambda Legal’s Health Care Fairness Survey.  Lamba Legal; 2010. Accessed March 24, 2022. https://www.lambdalegal.org/sites/default/files/publications/downloads/whcic-insert_lgbt-people-of-color.pdfGoogle Scholar
16.
Meyer  HM, Mocarski  R, Holt  NR, Hope  DA, King  RE, Woodruff  N.  Unmet expectations in health care settings: experiences of transgender and gender diverse adults in the Central Great Plains.  Qual Health Res. 2020;30(3):409–422.Google ScholarCrossref
17.
Dolan  IJ, Strauss  P, Winter  S, Lin  A.  Misgendering and experiences of stigma in health care settings for transgender people.  Med J Aust. 2020;212(4):150.Google ScholarCrossref
18.
Poteat  T, German  D, Kerrigan  D.  Managing uncertainty: a grounded theory of stigma in transgender health care encounters.  Soc Sci Med. 2013;84(84):22–29.Google Scholar
19.
McPhail  D, Rountree-James  M, Whetter  I.  Addressing gaps in physician knowledge regarding transgender health and health care through medical education.  Can Med Educ J. 2016;7(2):e70–e78.Google ScholarCrossref
20.
Ashley  F.  The misuse of gender dysphoria: toward greater conceptual clarity in transgender health.  Perspect Psychol Sci. 2021;16(6):1159–1164.Google ScholarCrossref
21.
Inch  E.  Changing minds: the psycho-pathologization of trans people.  Int J Ment Health. 2016;45(3):193–204.Google ScholarCrossref
22.
Ashley  F.  Gatekeeping hormone replacement therapy for transgender patients is dehumanising.  J Med Ethics. 2019;45(7):480–482.Google ScholarCrossref
23.
Kronk  CA, Everhart  AR, Ashley  F,  et al.  Transgender data collection in the electronic health record: current concepts and issues.  J Am Med Inform Assoc. 2022;29(2):271–284.Google ScholarCrossref
24.
Meyer  IH.  Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.  Psychol Bull. 2003;129(5):674–697.Google ScholarCrossref
25.
Rood  BA, Reisner  SL, Surace  FI, Puckett  JA, Maroney  MR, Pantalone  DW.  Expecting rejection: understanding the minority stress experiences of transgender and gender-nonconforming individuals.  Transgend Health. 2016;1(1):151–164.Google ScholarCrossref
26.
Jaffee  KD, Shires  DA, Stroumsa  D.  Discrimination and delayed health care among transgender women and men: implications for improving medical education and health care delivery.  Med Care. 2016;54(11):1010–1016.Google ScholarCrossref
27.
Hendrickson  SG, Contreras  CV, Schiller  E, Walsh  D.  Exploring health care experiences of transgender people living in Texas.  Nurs Outlook. 2020;68(4):476–483.Google ScholarCrossref
28.
Hughto  JMW, Pachankis  JE, Reisner  SL.  Health Care mistreatment and avoidance in trans masculine adults: the mediating role of rejection sensitivity.  Psychol Sex OrientatGend Divers. 2018;5(4):471–481.Google Scholar
29.
Bockting  WO, Miner  MH, Swinburne  Romine RE, Hamilton  A, Coleman  E.  Stigma, mental health, and resilience in an online sample of the US transgender population.  Am J Public Health. 2013;103(5):943–951.Google ScholarCrossref
30.
Bockting  WO, Miner  MH, Swinburne  Romine RE,  et al.  The Transgender Identity Survey: a measure of internalized transphobia.  LGBT Health. 2020;7(1):15–27.Google ScholarCrossref
31.
Kidd  JD, Levin  FR, Dolezal  C, Hughes  TL, Bockting  WO.  Understanding predictors of improvement in risky drinking in a US multi-site, longitudinal cohort study of transgender individuals: implications for culturally-tailored prevention and treatment efforts.  Addict Behav. 2019;96:68–75.Google ScholarCrossref
32.
Kattari  SK, Bakko  M, Hecht  HK, Kattari  L.  Correlations between health care provider interactions and mental health among transgender and nonbinary adults.  SSM Popul Health. 2019;10:100525.Google ScholarCrossref
33.
Kcomt  L, Evans-Polce  RJ, Veliz  PT, Boyd  CJ, McCabe  SE.  Use of cigarettes and e-cigarettes/vaping among transgender people: results from the 2015 US Transgender Survey.  Am J Prev Med. 2020;59(4):538–547.Google ScholarCrossref
34.
Christian  LM, Cole  SW, McDade  T,  et al.  A biopsychosocial framework for understanding sexual and gender minority health: a call for action.  NeurosciBiobehav Rev. 2021;129(129):107–116.Google Scholar
35.
McQuillan  MT, Kuhns  LM, Miller  AA, McDade  T, Garofalo  R.  Gender minority stress, support, and inflammation in transgender and gender-nonconforming youth.  Transgend Health. 2021;6(2):91–100.Google ScholarCrossref
36.
Manigault  AW, Figueroa  WS, Hollenbeck  CR,  et al.  When family matters most: a test of the association between sexual minority identity disclosure context and diurnal cortisol in sexual minority young adults.  Psychosom Med. 2018;80(8):717–723.Google ScholarCrossref
37.
Sarno  EL, Swann  G, Newcomb  ME, Whitton  SW.  Intersectional minority stress and identity conflict among sexual and gender minority people of color assigned female at birth.  Cultur Divers Ethnic Minor Psychol. 2021;27(3):408–417.Google ScholarCrossref
38.
Kattari  SK, Walls  NE, Whitfield  DL, Langenderfer  Magruder L.  Racial and ethnic differences in experiences of discrimination in accessing social services among transgender/gender-nonconforming people.  J Soc Work DisabilRehabil. 2017;26(3):217–235.Google Scholar
39.
Trans in the South: a directory of trans-affirming health & legal service providers.  Campaign for Southern Equality.  Accessed April 26, 2022. https://southernequality.org/resources/transinthesouth/
40.
Resources: find a provider.  GLMA (Health Professionals Advancing LGBTQ Equality).  Accessed April 26, 2022. https://www.glma.org/index.cfm?pageId=939
41.
Bouman  WP, Schwend  AS, Motmans  J,  et al.  Language and trans health.  Int J Transgend. 2017;18(1):1–6.Google ScholarCrossref
42.
Romanelli  M, Lindsey  MA.  Patterns of health care discrimination among transgender help-seekers.  Am J Prev Med. 2020;58(4):e123–e131.Google ScholarCrossref
43.
Cahill  S, Makadon  H.  Sexual orientation and gender identity data collection in clinical settings and in electronic health records: a key to ending LGBT health disparities.  LGBT Health. 2014;1(1):34–41.Google ScholarCrossref
44.
Deutsch  MB.  Creating a safe and welcoming clinic environment.  UCSF Transgender Care. June 17, 2016. Accessed September 1, 2020. https://transcare.ucsf.edu/guidelines/clinic-environment
45.
Trans Care.  Trans-affirming clinical language.  TransHub. Accessed September 1, 2020. https://transhub.org.au/s/Trans-Affirming-Clinical-Language-Guide_Final.pdf
46.
Trans* identities and lives glossary.  University of Rhode Island Gender and Sexuality Center.  Accessed April 26, 2022. https://web.uri.edu/gender-sexuality/resources/lgbtqa-glossary/trans-101-glossary/
47.
Coleman  E, Bockting  W, Botzer  M,  et al.  Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7.  Int J Transgend. 2012;13(4):165–232.Google ScholarCrossref
48.
Penn Non-Cis; Penn Association for Gender Equity.  Trans-inclusive language guide. University of Pennsylvania; 2021. Accessed January 15, 2022. archive.law.upenn.edu/live/files/11569-trans-inclusive-language-guide
49.
Wilson  Y, White  A, Jefferson  A, Danis  M.  Intersectionality in clinical medicine: the need for a conceptual framework.  Am J Bioeth. 2019;19(2):8–19.Google ScholarCrossref
50.
Learning resources.  LGBTQIA + Health Education Center.  Accessed April 26, 2022. https://www.lgbtqiahealtheducation.org/resources/
51.
Ashley  F, Domínguez  S.  Transgender health care does not stop at the doorstep of the clinic.  Am J Med. 2021;134(2):158–160.Google ScholarCrossref
52.
Sallans  RK.  Lessons from a transgender patient for health care professionals.  AMA J Ethics. 2016;18(11):1139–1146.Google Scholar
53.
Cavanaugh  T, Hopwood  R, Lambert  C.  Informed consent in the medical care of transgender and gender-nonconforming patients.  AMA J Ethics. 2016;18(11):1147–1155.Google Scholar
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