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Standards of Care for Transgender and Gender Diverse People

To identify the key insights or developments described in this article
1 Credit CME

Transgender and gender diverse are broad terms used to describe individuals whose gender identities and expressions differ from the gender attributed to the sex assigned at birth, typically either female or male. Estimates of the proportion of transgender and gender diverse individuals worldwide range from 0.6% to 3% and have increased in recent years, particularly among adolescents and young adults.1

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Article Information

Corresponding Author: Andrew M. Davis, MD, MPH, University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637 (amd@uchicago.edu).

Published Online: May 18, 2023. doi:10.1001/jama.2023.8121

Conflict of Interest Disclosures: None reported.

References
1.
Coleman  E , Radix  AE , Bouman  WP ,  et al.  Standards of care for the health of transgender and gender diverse people, version 8.   Int J Transgend Health. 2022;23(suppl 1):S1-S259. doi:10.1080/26895269.2022.2100644 PubMedGoogle ScholarCrossref
2.
Scheim  AI , Baker  KE , Restar  AJ , Sell  RL .  Health and health care among transgender adults in the United States.   Annu Rev Public Health. 2022;43:503-523. doi:10.1146/annurev-publhealth-052620-100313PubMedGoogle ScholarCrossref
3.
Shires  DA , Stroumsa  D , Jaffee  KD , Woodford  MR .  Primary care clinicians’ willingness to care for transgender patients.   Ann Fam Med. 2018;16(6):555-558. doi:10.1370/afm.2298 PubMedGoogle ScholarCrossref
4.
Feldman  JL , Luhur  WE , Herman  JL , Poteat  T , Meyer  IH .  Health and health care access in the US transgender population health (TransPop) survey.   Andrology. 2021;9(6):1707-1718. doi:10.1111/andr.13052 PubMedGoogle ScholarCrossref
5.
Aldridge  Z , Patel  S , Guo  B ,  et al.  Long-term effect of gender-affirming hormone treatment on depression and anxiety symptoms in transgender people: a prospective cohort study.   Andrology. 2021;9(6):1808-1816. doi:10.1111/andr.12884 PubMedGoogle ScholarCrossref
6.
Wernick  JA , Busa  S , Matouk  K , Nicholson  J , Janssen  A .  A systematic review of the psychological benefits of gender-affirming surgery.   Urol Clin North Am. 2019;46(4):475-486. doi:10.1016/j.ucl.2019.07.002PubMedGoogle ScholarCrossref
7.
van der Loos  MATC , Hannema  SE , Klink  DT , den Heijer  M , Wiepjes  CM .  Continuation of gender-affirming hormones in transgender people starting puberty suppression in adolescence: a cohort study in the Netherlands.   Lancet Child Adolesc Health. 2022;6(12):869-875. doi:10.1016/S2352-4642(22)00254-1 PubMedGoogle ScholarCrossref
8.
de Blok  CJ , Wiepjes  CM , van Velzen  DM ,  et al.  Mortality trends over five decades in adult transgender people receiving hormone treatment: a report from the Amsterdam cohort of gender dysphoria.   Lancet Diabetes Endocrinol. 2021;9(10):663-670. doi:10.1016/S2213-8587(21)00185-6 PubMedGoogle ScholarCrossref
9.
van de Grift  TC , Elaut  E , Cerwenka  SC , Cohen-Kettenis  PT , Kreukels  BPC .  Surgical satisfaction, quality of life, and their association after gender-affirming surgery: a follow-up study.   J Sex Marital Ther. 2018;44(2):138-148. doi:10.1080/0092623X.2017.1326190 PubMedGoogle ScholarCrossref
10.
de Vries  ALC , Hannema  SE .  Growing evidence and remaining questions in adolescent transgender care.   N Engl J Med. 2023;388(3):275-277. doi:10.1056/NEJMe2216191PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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