January 23, 2020

South Dakota Legislators Seek Ban on Providing Gender-Affirming Medical Care to Adolescents and Minors

On January 14, a bill was introduced in the South Dakota legislature that would criminalize any health care provider who performs gender-affirming surgeries or prescribes medications that, in the words of the bill, would help “change or affirm the minor’s perception of the minor’s sex.” This is the same state legislature that, in 2016, passed the first “bathroom bill,” which prohibited transgender students from choosing to use the bathroom corresponding to their gender identity. That bill was ultimately vetoed by the Governor.

This new bill (House Bill 1057) defines “the biological state of being female or male” as being “based on sex organs, chromosomes, and endogenous hormone profiles.” It proposes that performing any gender-affirming operation or surgery or prescribing hormone replacement therapy to aid a child’s gender transition should be illegal, as should any attempt “to change or affirm the minor’s perception of the minor’s sex” in a way that doesn’t match the birth status. The bill makes all of these actions Class 4 felonies. The bill also defines sex as “the biological state of being female or male, based on sex organs, chromosomes, and endogenous hormone profiles” — The Hill reports – with one exception. Under HB 1057, parents or guardians can still give doctors permission to treat a minor with “ambiguous” sex characteristics or who have been “diagnosed a disorder of sexual development.”

If passed, the bill’s opponents claim that its provisions would criminalize care that many young trans people need to survive. Chase Strangio of the ACLU’s Transgender Justice Project, observed that it is based on a medically inaccurate definition of sex and “make[s] it a crime for doctors to provide the care that their profession has determined is medically necessary.” Not surprisingly, the American Academy of Pediatrics, the Endocrine Society, and a number of other major medical organizations view the bill as contrary to the evidence-based treatment that is part of their standards of care. It’s “essentially a bill requiring doctors to risk the lives of their patients for no medical reason — the only reason being dislike of and fear of trans people,” Strangio added.

It should be added – though probably goes without saying – that HIV disproportionately affects trans individuals, and this stigmatization of trans people and the care they receive only further endangers the lives of those patients and puts them at increased risk for HIV transmission.

The Academy will continue to monitor this bill (and other state-level bills with similar ideological intent), and encourage any of our members or credentialees living and/or practicing in South Dakota (and in states with similar bills) to raise your voices as providers in opposition.

Mayo Clinic Assesses Rising Stress Levels among Physicians

A recent study of 15,000 physicians indicated that nearly half of the “Generation X” participants (ages between 40 and 54) had higher rates of burnout than their older or younger peers.  Research conducted at the Mayo Clinic last year suggests physicians experience higher rates of burnout than other full-time workers in the U.S.  The “Gen Xers” displayed the highest rates; a phenomenon that Gary Price of the Physician’s Foundation potentially attributes to the fact that they “are in the prime of their professional careers, at their busiest… and perhaps with more family competing pressures than younger physicians.”

The survey also showed higher stress rates among women than men physicians. Price notes that, “societal factors, including time spent on domestic responsibilities, discrimination and harassment, likely play a role” in this trend.

The Academy continues to monitor HIV provider workforce shortage issues and advocate positions that help ameliorate the ongoing problem.