Healthcare Barriers from Binary Gender Systems

Excited to share our new National Academy of Medicine report on how sex and gender identity influence disability evaluations by the Social Security Administration (SSA). We were commissioned by SSA & took part in a 1+ year process to report on the unique health challenges faced by Transgender and Gender Diverse (TGD) individuals, as well as those with Variations in Sex Traits (VSTs). We developed conclusions that could make for a more inclusive and accurate assessment process when people apply for disability benefits. **Key Takeaways:**   1️⃣ **TGD and VST Populations:** The report underscores that individuals from these populations often face significant barriers to healthcare, which can delay disease detection and worsen long-term health outcomes. These health disparities can directly impact their eligibility for disability benefits.     2️⃣ **Inclusive Language**, particularly for conditions like reproductive cancers and HIV: By removing gendered terms and focusing on the condition itself, disability evaluations can be inclusive for all individuals, regardless of gender identity. 3️⃣ **Data Collection:** Routine collection of data on gender identity, sex recorded at birth, and relevant care (e.g., gender-affirming treatments) is vital for an accurate evaluation. These data are lacking in many healthcare systems, but incorporating them into disability applications could help lead to more accurate determinations.  4️⃣ **Special Considerations:** The report highlights the need for careful evaluation of sex-specific diagnostic criteria for conditions like pulmonary function and kidney disease. In some cases, the sex recorded at birth may be the appropriate reference point, but in others—particularly for those receiving gender-affirming hormones—additional or alternative metrics may be necessary. One option is to use the measurement most likely to support an individual's disability application in cases where both 'male' and 'female' reference ranges are considered. 5️⃣ **Training for Disability Adjudicators:** Given the complexities in assessing disability claims for TGD individuals and those with VSTs, staff can receive training on the unique health and social challenges faced by these populations. This could ensure more accurate, fair, and compassionate disability determinations. By improving how disability claims are evaluated for TGD and VST individuals, we can move closer to a system that truly supports everyone. https://lnkd.in/egUKPbHT #SSA #HealthEquity #healthcare

Today's NYTimes has an op/ed about the changing language of "sex" and "sex assigned at birth". Here's the bottom line in healthcare: if you are not asking (at least) TWO questions you are going to make medical mistakes. Said differently: if you assume everything about a person's anatomy and organs just by asking gender or just by asking sex you are missing a lot. The transman with pelvic pain in the ER and no one knows he has a uterus. The transwoman with prostate cancer who never gets a screening. The person for whom being misgendered has caused so much harm they no longer come to the doctor and receive no early detection screenings or vaccines. Medical mistakes and medical mistrust are the real culprits so say it however you can muster but ask every patient every time about their gender and their anatomy and make every patient know you are trustworthy with all their personal information. This isn't about your comfort with changing language but how we use language to build trust, illicit the correct information, and ultimately, save lives. https://lnkd.in/eRMkna3p

The Hidden Price Tag of Transition: 𝙐𝙣𝙙𝙚𝙧𝙨𝙩𝙖𝙣𝙙𝙞𝙣𝙜 𝙩𝙝𝙚 𝙁𝙞𝙣𝙖𝙣𝙘𝙞𝙖𝙡 𝘾𝙤𝙨𝙩𝙨 𝙤𝙛 𝘽𝙚𝙞𝙣𝙜 𝙏𝙧𝙖𝙣𝙨 💰🏳️⚧️ Many don't realize the significant financial burden that often comes with transitioning. As a trans woman and DEI expert, I want to shed light on these often-overlooked costs: Medical Expenses: • Hormone Therapy: • Gender Confirmation Surgery: • Mental Health Support: Legal Costs Wardrobe Overhaul - Replacing an entire wardrobe can cost thousands Voice Training Hair Removal - Electrolysis or laser treatments Lost Income - Many trans individuals face job discrimination or need time off for procedures. These costs can be a significant barrier for many in the trans community. As employers and allies, it's crucial to consider how we can support our trans colleagues through inclusive healthcare policies and financial wellness programs. What are your thoughts on addressing these financial challenges? How can organizations better support their trans employees? Let's discuss in the comments! 👇 #TransInclusion #WorkplaceEquity #FinancialWellness #DEI

A 2019 UNDP report revealed that 56% LGBTQIA+ Indians have faced discrimination in healthcare. And Tamil Nadu just took the first step to change that by mandating LGBTQIA+ sensitisation for all doctors, medical faculty, and students. It may sound like just another policy decision until you hear how deeply bias has scarred healthcare experiences for people from the LGBTQIA+ community. Because discrimination in healthcare rarely looks like outright denial of treatment. 📌 It looks like: 👉 Being misgendered when you’re most vulnerable. 👉 Being mocked or dismissed when you seek support. 👉 Being denied dignity because you don’t fit into someone’s definition of “normal.”   📌 A 2024 study revealed that many transgender persons in India avoid or delay care entirely due to stigma and misgendering. And it’s not just India. 📌 In the US, a 2024 KFF survey showed 39% of LGBTQ adults delayed medical care out of fear of mistreatment. When people avoid doctors because they fear being humiliated, it’s not just a healthcare issue - it’s a human dignity crisis. That’s why Tamil Nadu’s move matters. Healthcare must go beyond curing bodies - it must respect identities. ✅ Training medical students before they enter practice. ✅ Re-educating doctors and faculty who are already shaping patient experiences. ✅ Creating an ecosystem where bias is called out and empathy is built in. Tamil Nadu has set the bar. Now the question is: will this remain a one-state initiative, or will the rest of India follow? Because dignity in healthcare shouldn’t depend on your pin code. #InclusiveIndia #InclusiveHealthcare

Gender Norms and Vulnerability This report summarizes a wealth of information from a variety of sources. Gender norms significantly shape our health and wellbeing by influencing behaviors, access to healthcare, and exposure to risks. These informal rules dictate what is considered appropriate for men and women, affecting everything from physical activity levels to healthcare seeking behaviors. Key Insights: Non-communicable Diseases: Gender norms contribute to different health outcomes such as obesity, tobacco, and alcohol use. For example, societal expectations that link masculinity with strength and risk-taking lead to higher rates of substance abuse and risky behaviors among men. Communicable Diseases: Norms about gender roles and exposure to infection significantly impact how diseases spread and how individuals seek treatment. Men often delay seeking healthcare due to norms that associate seeking help with weakness. Nutritional Status: Gender norms affect dietary habits and food distribution within households. In many cultures, women and girls may have less access to nutritious food, leading to poor health outcomes. Physical Integrity: Norms that justify male violence against women or promote risky behaviors among men lead to higher rates of violence and unintentional injuries. These norms also affect body image and practices like body modification. Sexual and Reproductive Health: Traditional gender roles often dictate sexual behaviors and access to reproductive health services, with women being pressured to conform to ideals of purity and modesty, while men are encouraged to take risks. Mental Health: Adherence to traditional gender norms can lead to poor mental health outcomes. For instance, men who conform to rigid masculine ideals are more likely to experience depression and suicidal thoughts but less likely to seek help. Health Systems: Health systems often reflect and reinforce gender norms, affecting service delivery and workforce composition. Addressing these norms is crucial for improving health outcomes and achieving gender equity. Interventions to Address Gender Norms: Community Mobilization: Engaging community leaders to disseminate gender-equitable messages has proven effective in changing norms and improving health outcomes. Educational Campaigns: Targeting specific groups, such as men in Zika virus prevention, can lead to better community health by promoting shared decision-making and responsibility. Gender-Transformative Programs: Interventions that challenge traditional gender norms, especially in small-group settings, have shown positive results in areas like HIV prevention and family planning. To foster healthier societies, it is imperative to continue addressing and challenging harmful gender norms through comprehensive and culturally sensitive interventions. #GenderNorms #HealthEquity #PublicHealth #Wellbeing #GenderEquality

Health should be centered on evidence and compassion (not exclusion). Policies that shape gender and reproductive health have profound impacts on access to care and health equity. An executive order seeks to redefine gender as purely biological and declare life begins at conception—moves that could have sweeping consequences for health rights. What’s at stake? ❌ Restricted access to abortion and reproductive care ❌ Barriers to in-vitro fertilization (IVF) for families trying to conceive ❌ Elimination of gender-affirming care for transgender individuals When policies ignore diverse identities and reproductive needs, they don’t just limit rights—they widen health inequities and restrict care for those who need it most. Equitable health care means respecting all identities and choices - not redefining them out of existence. #publichealth #genderhealth #reproductivehealth