Treatment Guidelines And Position Statements On Transgender Persons, Suggests APA Task Force

Development of clinical practice guidelines for psychiatrists handling patients who are transgender is required suggests report from the American Psychiatric Association (APA) Task Force on Treatment of Gender Identity Disorder (GID). The report also encourages the development of position statements regarding the health care and civil rights of people who are gender variant or transitioning gender. The task force report is available online in Springer's journal Archives of Sexual Behavior¹.

The task force was charged with reviewing the scientific literature regarding gender identity disorder at different stages in a person's life. It examined the research and clinical evidence relating to treatment, and provided an opinion as to whether or not the APA should develop practice recommendations. The literature regarding treatment of gender dysphoria, or discomfort about one's own gender, in individuals with disorders of sex development was also assessed.

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The report concluded that the quality of research evidence pertaining to most aspects of treatment for GID is not robust, but clinical consensus is sufficient to support the development of recommendations for the clinical management of GID in all age groups.

The task force also recommended that the APA create a separate mechanism for assessing the mental health needs of individuals with disorders of sex development, whether gender dysphoria is present or not.

In addition, the report recommended that the APA provide statements clarifying its positions on several issues. These include supporting the medical necessity of treatment for GID, defining the ethical issues regarding treatments for minors with GID or other manifestations of gender variance, and supporting the civil rights of persons who are gender variant, transgender, or transsexual.²

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The task force was formed to address concerns different from the diagnostic aspects of GID that were being considered as part of the next edition of the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM). Although psychiatric diagnosis and treatment are linked, they are separate aspects of clinical mental health practice, and the DSM does not make recommendations for treatment. The APA first introduced GID as a diagnostic condition in the 1980 DSM, but has not taken any official position on treatment or other concerns of transgender persons.

Task Force Chair William Byne, M.D., Ph.D., said, "The American Medical Association has adopted a resolution supporting insurance coverage for medically necessary treatment for individuals diagnosed with GID. The task force report recommends the APA adopt a similar position, and issue other statements in support of the rights of gender variant persons."

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