The American Public Health Association recently published policy
9933,
which is titled "The Need for Acknowledging Transgendered
Individuals
within Research and Clinical Practice," which was adopted
in Nov. 1999.
The full text of the policy can be found within
http://www.apha.org/legislative/policy/99policy.pdf
Here is the heart of the policy (definitions and refs. are omitted):
Understanding that transgendered individuals vary by age, race,
culture,
income, education, residence, sexual orientation, marital status,
religion, ability/disability, immigration status, and interest
in medical
interventions; and
Noting that studies generally either do not identify the existence
of
transgendered individuals, or combine them into a single transgender
category and/or misconceptualized under other labels; and
Acknowledging that little is known about the long term health
risks
associated with the hormonal and/or surgical reassignment, some
of which
is conducted without a health care provider's participation, and
that
studies that do exist have small sample sizes and little generalizability;
and
Noting that medical procedures are conducted upon many children
and
adolescents with little understanding of their long-term outcome
often
resulting in pain and distress, and examples of this are that
(a) Gender
Identity Disorder within the DSM-IV is misused by some health
care
professionals to treat "pre-homosexual" and "pre-transsexual"
children and
adolescents so as to promote their development into nontranssexual,
heterosexual adults, and (b) genital surgery or sex reassignment
surgery
are sometimes conducted upon intersexed infants so that their
external
genitalia resembles that of normal infants; and
Noting a growing body of literature that finds many transgendered
individuals within the United States are at risk of experiencing
violence,
HIV infections, and many sexually transmitted diseases; and
Concluding that transgendered individuals are not receiving
adequate
health care, information, or inclusion within research studies
because of
discrimination by and/or lack of training of health care providers
and
researchers; therefore, (American Public Health Association)
1. Urges the National Institutes of Health and the Centers
for Disease
Control and Prevention (as well as individuals researchers and
health care-
workers) to categorize MtF and FtM transgendered individuals
as such and
not conflate them with gay men or lesbians (unless as appropriate
to an
individual's sexual orientation in their preferred gender) as
well as
acknowledging the variation that exists among transgendered individuals;
2. Urges researchers and health care workers to be sensitive
to the lives
of transgendered individuals and treat them with dignity and respect,
and
not to force them to fit within rigid gender norms. This includes
referring to them as the gender with which they identify;
3. Urges researchers, health care workers, the National Institutes
of
Health, and the Centers for Disease Control and Prevention to
be aware of
the distinct health care needs of transgendered individuals; and
4. Urges the National Institutes of Health and the Centers
for Disease
Control and Prevention to make available resources, including
funding for
research, that will enable a better understanding of the health
risks of
transgendered individuals, especially the barriers they experience
within
health care settings.