• Care for the Transgender and Gender Nonbinary Patient

    The American Academy of Family Physicians (AAFP) recognizes that diversity in gender identity and expression is a normal part of the human existence and does not represent pathology.  The AAFP supports access to gender-affirming care for gender-diverse patients, including children and adolescents.  Gender-affirming health care is part of comprehensive primary care for many gender-diverse patients, and may include supportive behavioral health care, gender-affirming hormones, puberty blockade, medical procedures, and surgical interventions.

    Family physicians are uniquely suited to provide gender-affirming care because of their whole-person focus, ability to create care plans that meet the needs of diverse individuals, and longitudinal relationship with the patient across the entire lifespan.  Family physicians who do not provide this care should take steps to ensure that patients requiring gender-affirming services are appropriately referred.

    Transgender and gender nonbinary people often face social and economic marginalization, and experience a variety of barriers to healthcare, including overt discrimination, inadequate health insurance coverage, legislative interference in the physician-patient relationship, and poor physician knowledge of appropriate treatment. The AAFP supports gender-affirming care as an evidence-informed intervention that can promote health equity for gender-diverse individuals, although wider sociopolitical efforts are necessary to further mitigate these barriers and advance equity. (October 2020 BOD)