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AMA is trying to remove gender designation from public birth certificates

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Healio Primary Care was unable to confirm Fryhofer’s relevant financial information at the time of publication.

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The AMA announced that it recently passed a policy to support the removal of a person’s gender designation from the public part of birth certificates.

The AMA House of Delegates said it builds on an existing policy that recognizes that “everyone has the right to determine their gender identity and gender designation in government documents”.

A 2015 population-based study in Belgium published in the Archives of Sexual Behavior found that 2.2% of adults assigned male at birth and 1.9% of adults had gender ambivalence adults who identified themselves equally with the opposite sex as with the sex assigned at birth and who were female at birth. In addition, 0.7% of men and 0.6% of women were found to have sex incongruence – a “strong” identification with the opposite sex than the sex assigned at birth.

The authors of a 2020 review in The Lancet Child & Adolescent Health wrote that a “significant proportion” of young people who identify as transgender or gendered “do not conform to traditional binary notions of gender (male vs. female) and instead conform to one non-binary gender identity. ”

The authors also found that young people with a non-binary gender identity “experience lower levels of support and are at greater risk of experiencing abuse and victimization than young people with cis sex”. Compared to transgender and binary individuals, individuals who identify as non-binary have less access to trans-specific health care and have “similar, if not higher” rates of depression, anxiety, and suicidal ideation.

According to a press release, the new AMA guideline aims to protect a person from invasion of privacy and stop discrimination. It would also allow information about a person’s gender designation to be collected at birth and provided on the US standard live birth form – information used only for medical, public health and statistical purposes.

“The indication of gender in birth certificates as male or female and the provision of this information in the public part perpetuates the view that the gender designation is permanent and does not recognize the medical spectrum of gender identity.” Sandra Adamson Fryhofer, MD, AMA board chairman elected, said in the press release. “This type of categorization system also risks stifling a person’s self-expression and self-identification and contributes to marginalization and minorization.”

References:

AMA. AMA announced the guidelines adopted on the last day of the special session. Available at: https://www.ama-assn.org/press-center/press-releases/ama-announced-policies-adopted-final-day-special-meeting. Accessed June 23, 2021.

Chew D, et al. Lancet Child Adolesc Health. 2020; doi: 10.1016 / S2352-4642 (19) 30403-1.

Van CaenegemE, et al. Arch sex behavior. 2015; doi: 10.1007 / s10508-014-0452-6.

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Morissa Ladinsky, MD)

Morissa Ladinsky, MD

This AMA guideline is a really positive, creative way to confirm, include, and clarify a critical component of what is currently reported on birth certificates: the gender of an infant, represented by a letter that identifies the gender assigned at birth .

There is some difficulty for people of different sexes to change their driver’s license, passport, social security and other important documents. This process is different in all 50 states; with some it’s super easy and with some super difficult. I am not a member of the AMA, but this policy seems to suggest that the association recognizes that our population includes individuals whose gender identity does not fully match their gender assigned at birth. And for roughly 1.5 to 2% of our population, as they grow and continue to evolve, let’s make a few things easier.

It is important to note that when this policy goes into effect it will be made incredibly clear to the public about what it means. Those who work with vital statistics, social security and agencies with similar purposes need to know that they are not losing any critical data. This policy simply removes the gender tag on that glossy document that families receive about a month after their child is born.

Reference:

Tanner, L. According to surveys, more US teenagers identify as transgender. USA today. https://www.usatoday.com/story/news/nation/2018/02/05/more-us-teens-identify-transgender-survey-finds/306357002/. Accessed June 23, 2021.

Morissa Ladinsky, MD

Associate Professor, Department of Academic General Pediatrics, University of Alabama at Birminghamama

Member, AAP Section for LGBTQ Health and Wellness

Disclosure: Ladinsky does not report any relevant financial information.

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Stephanie Tran, MD)

Stephanie Tran, MD

There is a wide range of gender-specific identities for gender-nonconforming individuals who may or may not match the formal Western binary gender designations “male” and “female”.

This AMA guideline supports an individual’s ability to determine gender identification in any way they deem appropriate, which is unique to each individual. The policy also confirms that the gender assigned at birth may or may not be the same as one’s gender identity, which may also evolve over time and be either congruent or incongruent with the gender assigned at birth.

The effects of this policy promote equality and inclusion in multifactorial areas (sociopolitical, psychological, physiological and cultural). Omitting a person’s gender from public records provides a level of anonymity that does not hinder a health care provider’s ability to promote excellent patient-centered care and facilitates improved communication between patient (s) and care provider (s) to get a Gaining mutual understanding of one’s own gender identity, sexuality, gender expression and gender designation and how this can affect general well-being and health.

In a broader sense, these policies will serve to mitigate prejudice, assumptions, and explicit discrimination based on previous sociological constructs by creating new meanings and a dynamic understanding that is representative of the time and cultural labels to which language assigns meaning.

Stephanie Tran, MD

General Practitioner, Cedars-Sinai Medical Center, Los Angeles

Disclosure: Tran does not report any relevant financial information.

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Francisco Sánchez, PhD

The AMA recently passed a policy to remove gender designation from public birth certificates – part of a growing movement seen in several countries and in several states. However, the AMA’s position supports the continued collection of “gender at birth” only for the use of vital statistics.

Since birth certificates are primarily used to verify a person’s legal identity, the elimination of gender would have no real practical implications for the vast majority of the population. People don’t go around with their certificate often to authenticate their gender (or gender identity) to others, and such information would be incorporated into proprietary health information for medical care from birth.

Instead, this move would help remove barriers, stigma and discrimination for those of us who develop gender dysphoria and seek transition. In addition, this step could reduce the burden on parents whose children are born with a different / disordered sex development (sometimes referred to as an “intersex state”), who often feel pressured to choose a gender long before their children are to themselves speak for yourself.

Overall, removing this information from the public part of the certificate will not harm anyone.

Francisco Sánchez, PhD

Associate Professor of Counseling Psychology
University of Missouri College of Education

Disclosure: Healio Primary Care was unable to confirm Sánchez’s relevant financial statements at the time of publication.

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