ACP offers ways to support equity for LGBTQ+ health care

New challenges have surfaced that harm the health and well-being of lesbian, gay, bisexual, transgender, queer, and other sexual or gender minority (LGBTQ+) populations, according to ACP, which offered a new position paper that reaffirms and updates the College's policies on LGBTQ+ health.

The paper offers recommendations about how to improve health care equity and reduce social stigma, following new research and greater understanding of LGBTQ+ health issues, which have evolved since ACP's last position paper. For example, the U.S. Supreme Court overturned same-sex marriage prohibitions in 2015, the FDA removed restrictions on men who have sex with men from its blood donation policy in 2023, and insurance coverage for LGBTQ+ people increased from 75.9% to 91.2% in recent years. However, these and other advances came amid rising rates of bullying of youth and mental health issues, as well as many policies that particularly target transgender and gender-diverse (TGD) people's ability to access necessary health care services and otherwise openly participate in public life and use public facilities in a way that is consistent with their gender identity, the paper said.

The position paper was published June 25 by Annals of Internal Medicine.

While most of the recommendations are minor updates to previous positions, new positions include the following:

• ACP supports additional research and scientific inquiry into gender-affirming care to improve care for TGD people.
• ACP asserts that all people should be able to live openly in a manner consistent with their sexual orientation and/or gender identity without discrimination or harassment. ACP affirms that public policies should protect the civil rights of LGBTQ+ people and uphold the ability to participate in public life consistent with one's gender identity, including in athletics, access to public facilities, government services, and other basic human services and activities.
• ACP opposes explicit restrictions on educational content that includes sexual orientation and gender identity. ACP encourages efforts to incorporate evidence-informed gender identity and sexual orientation education within society.

The recommendations also call for incorporating LGBTQ+ health into medical education and supporting programs to help recruit this population into the practice of medicine.

"As the research and medical understanding of LGBTQ+ health issues improve and evolve, so too must public policy on these issues," the position paper concluded. "ACP is gravely concerned about the implications that recent policies targeting TGD populations have on access to care and the physical and mental well-being of this population as well as the precedent they set in permitting political interference in the practice of medicine and the provision of evidence-based, clinically indicated health care services. ACP stands firmly against these attacks and supports inclusive public policies that seek to affirm the diverse spectrum of sexual orientation and gender identity."