During the 2016 National Conference of Constituency Leaders (NCCL) held here May 5-7, AAFP members from the five constituency groups -- women; minorities; new physicians; international medical graduates (IMGs); and gay, lesbian, bisexual and transgender (GLBT) physicians and those who support GLBT issues -- acted on resolutions considered by the Reference Committee on Health of the Public and Science (HOPS).
Kevin Wang, M.D., (left) a gay, lesbian, bisexual and transgender delegate from Seattle, testifies before the Reference Committee on Health of the Public and Science about a resolution he co-authored that opposes transphobic legislation regarding the use of public facilities such as public restrooms and locker rooms.
Delegates adopted three substitute resolutions during the May 7 business session that sought to safeguard the rights of transgender and gender-nonconforming people.
The first measure focused on opposing transphobic legislation regarding the use of public facilities. The reference committee heard a large amount of supportive testimony and stated that it is current AAFP policy to oppose discrimination in any form but also agreed that a substitute resolution would be beneficial "to ensure that eliminating discrimination against transgender people is not excluded from future efforts to advocate for changes to federal, state or other laws."
The reference committee's substitute resolution called for the AAFP to endorse laws protecting people from discrimination based on gender expression and also identify and oppose laws that compromise the safety and health of transgender people. The measure also said the Academy should support work to include sex, gender identity and sexual orientation in federal anti-discrimination legislation in "public accommodations, housing, (and) employment in public and private workplaces."
- Delegates adopted three substitute resolutions during the May 7 business session of the 2016 National Conference of Constituency Leaders (NCCL) that addressed the support of transgender and gender-nonconforming people.
- Another substitute resolution adopted addressed increasing education, research and access for opioid addiction treatment.
- NCCL delegates also adopted a resolution asking the Academy to advocate to insurers that anti-hepatitis C medications be covered regardless of the prescribing physician's specialty.
Kevin Wang, M.D., a GLBT delegate from Seattle and co-author of the resolution, said it was written in response to legislation introduced in multiple states this year requiring people to use public restrooms and locker rooms that correspond to their biological sex identified at birth and/or chromosomes instead of their gender identity.
"Knowing that these transgender and gender-nonconforming patient populations have already faced some significant discrimination issues and also are known to have significant health ramifications -- this is why we are bringing this issue to the attention of the AAFP," he said.
Benjamin Simmons, M.D., a GLBT delegate from Concord, N.C., also offered support for the resolution, explaining that in his state, this topic remains a popular point of discussion. Simmons explained that North Carolina's legislation on this issue originally stemmed from a city ordinance in Charlotte that the state government then used to create a discriminatory bill during a late-night session.
"But I'm proud to say our state chapter is working with the legislators under the leadership of Dr. Rhett Brown to have positive conversations about what this legislation means now," he said. "Some individuals didn't know the difference between someone who is transgendered or a cross-dresser. So there is a lot of education that is needed behind the scenes."
Another substitute resolution delegates adopted focused specifically on the care and support of transgender and gender-nonconforming youth. The measure called on the AAFP to develop educational programs for clinicians on the care of transgender and gender-nonconforming youth, as well as incorporating youth-specific information into the general online transgender health resources. The substitute resolution also asked the Academy to strongly recommend state chapters consider working with school systems to lobby for supportive environments for these children and adolescents in schools, including in restrooms, locker rooms and extracurricular programs.
KrisEmily McCrory, M.D., a women's delegate from Rensselaer, N.Y., brought a unique perspective to this discussion when she spoke in support of this resolution as the mother of a transgender son.
"I greatly appreciate the challenges of finding care for him and people who understand how to take care of him," she said. "I think there are a lot of family physicians who would like to provide supportive care for trans people in the medical home but we just don't know how. So I strongly recommend we pass this resolution to give family docs the tools to take care of these patients."
The third substitute resolution delegates adopted on this issue sought to promote parity in insurance coverage for transition-related transgender care. The measure directed the AAFP to send letters to appropriate parties recommending that preventive medical services covered for the general population should be covered for transgender patients regardless of the gender noted on their insurance card.
It also called for letters to be sent to appropriate parties to oppose and remove any transgender exclusion clauses from insurance policies concerning medically appropriate transition-related care. And a third resolved clause recommended the Academy create a toolkit for chapters to use when lobbying state legislatures to advocate for policies related to transgender health equity and removal of medically appropriate transgender exclusion clauses.
More Education on Opioids
Lisa Winkler, M.D., a women's delegate from Thornton, Colo., testifies on a resolution she co-authored that asks the Academy to increase CME offerings on treating opioid abuse.
Another substitute resolution delegates adopted addressed education about, research on and access to opioid addiction treatment. Specifically, the measure called on the Academy to increase the availability of CME opportunities specific to identifying and treating addiction to opioids. The resolution also called for the AAFP to advocate for improved reimbursement for addiction services and for continued research and development of evidence-based addiction treatment options related to opioid abuse.
Lisa Winkler, M.D., a women's delegate from Thornton, Colo., and co-author of this resolution, said family physicians are in the unique position to identify and treat addiction to opioids, but many times, they aren't best equipped to do so.
"I would like this resolution to help us get more education and training opportunities for family physicians to identify and treat (opioid) addiction in the family practice setting," she said. "And also to negotiate with insurance carriers and addiction centers to get more advanced services covered for our patients as we face this large epidemic in our country."
Among other measures considered by the reference committee, NCCL delegates adopted recommendations that asked the Academy to
- advocate to insurers that anti-hepatitis C medications be covered regardless of the prescribing physician's specialty.
- explore how FPs can best address social determinants of health in clinical practice using an evidence-based approach and develop CME explaining how to do so; and
- modify its current reproductive decisions policy to state "the AAFP endorses the concept that abortion should be performed in conformance with the standards of good medical practice as determined by evidence-based outcomes."
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