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American Medical Ass'n adopts policies on LGBTQ health issues, racial pay equity
2019-11-19

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SAN DIEGO — The American Medical Association ( AMA ) gathered physician and medical student leaders from all corners of medicine at its Interim Meeting to shape guiding policies on emerging health care topics.

The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.

The policies adopted by the House of Delegates today include:

AMA Supports State and Federal Bans on Conversion Therapy

The AMA will develop model state legislation and advocate for federal legislation to ban so-called reparative or conversion therapy for sexual orientation or gender identity. The support for legislative bans strengthens AMA's long-standing opposition to this unscientific practice.

The AMA heard testimony, including first-hand accounts, regarding the significant harms triggered by conversion therapy, including depression, post-traumatic stress disorder, and suicidal thoughts and attempts.

"It is clear to the AMA that the conversion therapy needs to end in the United States given the risk of deliberate harm to LGBTQ people," said AMA Board Member William E. Kobler, M.D. "Conversion therapy has no foundation as scientifically valid medical care and lacks credible evidence to support its efficacy or safety."

Only 18 U.S. states and the District of Columbia have banned conversion therapy for people younger than 18, and no states have banned conversion therapy for adults. The AMA agrees with medical experts that the lack of regulation on conversion therapy opens the door to fraud, harm and trauma for many adults and children in the U.S.

AMA Wants Fully Inclusive EHRs for Transgender Patients

Failure of electronic health records to promote inclusive medical documentation is a major barrier to providing quality care to transgender patients. To fill the gap in needed information on transgender patients, the AMA today strengthened its existing policy promoting inclusive gender, sex and sexual orientation options in medical documentation for LGBTQ patients.

To create EHRs that are fully inclusive of transgender patients, the newly amended policy now supports the voluntary inclusion of a transgender patient's preferred name and clinically relevant sex specific anatomy in medical documentation.

"The newly amended policy reinforces the importance of EHRs that contain inclusive information on transgender patients," said AMA Board Member William E. Kobler, M.D. "Without this information, transgender patients and their specific health care needs cannot be identified or documented, the health disparities they experience cannot be addressed, and the provision of important health care services may not be delivered."

The amended AMA policy aligns with the recommendations of the World Professional Association for Transgender Health that medical documentation include a patient's preferred name, gender identity, and pronoun preference, along with a means to maintain an inventory of a patient's medical transition history and current anatomy.

Ensuring Medical Training on Health Issues Related to Sexual Orientation and Gender Identity

Continuing its efforts to improve health equity, the AMA today adopted policy aimed at ensuring medical students and residents have a better understanding of the health issues related to sexual orientation and gender identity. Specifically, the new policy encourages medical education accreditation bodies to both continue to encourage and periodically reassess education on health issues related to sexual orientation and gender identity in the basic science, clinical care, and cultural competency curricula in medical school and residency programs.

"With research showing significant disparities among patients facing health issues related to sexual orientation and gender identity, it is important that our future physicians have the training they need to recognize these health issues and better treat their patients," said AMA Board Member Grayson W. Armstrong, M.D., M.P.H.

AMA Advancing Racial Pay Equity in Medicine

Recognizing a racial wage gap exists between physicians of color and their white peers, the AMA adopted policy today in support of measures to eliminate racial pay disparity in medicine. Studies show that a racial imbalance in wages has been a pervasive issue that exists among physicians in the same medical specialty, conducting the same work with the same education and experience.

"The statistics on racial pay disparities in medicine are jarring, and more must be done to spur change and eliminate the imbalance and bias that adversely affect members of our profession," said AMA Board Member Michael Suk, M.D., J.D., M.P.H., M.B.A. "The new policy is a step in the right direction for bringing positive change to physicians of color and strengthening the AMA's commitment to improving equity in medicine."

The new AMA policy recognizes the specific challenges that minority physicians face with equal pay. The AMA will work with appropriate stakeholders to study effective and appropriate measures to increase the transparency and accountability of physician earnings through established transparency measures, in which physicians can access information including but not limited to the salaries, race and ethnicity of physicians.

—From a press release


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