Community Member Spotlight Caroline Davidge-Pitts, MBBCH, Fellowship Class of 2024 and Associate Chair, Practice, Endocrinology, Diabetes and Metabolism, Mayo Clinic

By Douglas Riddle, PhD, DMin, FAPA, Carol Emmott Foundation Curriculum Director

In 2022, the Health and Human Services Administration of the federal government proposed a regulation intended to protect transgender and gender diverse (TGD) people from discrimination in accessing healthcare. (NCTE) While the announcement noted that denials of healthcare based on gender identity are illegal, the reality shown in a 2015 survey was that one in four TGD people had been denied care by insurance companies. Much of this came to the forefront of political attention because the prior administration eliminated federal protections for transgender people in June of 2020, which according to experts (The Dose Podcast The Commonwealth Fund, July 10, 2020) meant that transgender people could be denied access to health coverage and care simply because they were trans. As recently as April 2024, Admiral Rachel Levine, Assistant Secretary of Health and Policy, noted that “because of state laws targeting transgender people, the political and legal context of where people live has become a social determinant of health.”

It’s already hard for TGD people to navigate healthcare in a society that is polarized about their very existence. There are an estimated 1.6 million Americans who are transgender (Williams Institute), and of those about 300,000 are under the age of 18. Seventeen states in their most recent legislative sessions passed restrictions on medical care for TGD people, added to the three states that already had such bans. That’s the social and political context for caregivers who provide hormone therapy to TGD people.

While there has been significant improvement in insurance coverage for gender care over the last 10 years, there has also been a significant increase in anti LGBTQ+ legislative bills. Many of these are focused on transgender youth, limiting their access to bathrooms and ability to participate in sports. More recently, there are more bills targeting transgender adults. The consequence is gender care clinics have very long waiting lists because there aren’t enough gender care experts in restricted states. Providers can often find themselves subject to online threats. “This is a difficult time for transgender health.”

Fortunately, there are major healthcare systems, including some that are associated with The Carol Emmott Foundation, which are working to ensure that quality healthcare is available to all Americans. Health systems associated with Johns Hopkins University, University of Iowa, University of California at San Francisco, Oregon Health Science University School of Medicine, and Mayo Clinic are a few examples of such systems.

At the Mayo Clinic, Dr. Davidge-Pitts, a Fellow of the Carol Emmott Fellowship Class of 2024, is active in countering misinformation and prejudice through her advocacy and education. She works closely with the LGBTQ+ employee resource group at Mayo to provide more visibility to transgender people within Mayo. Also, because TGD people come to all parts of the health system, not just the transgender clinic, everyone needs to know how to sensitively provide care to this population at all levels. As part of these efforts, she led the development of a 10-minute module available to everyone at Mayo to help with updated terminology around gender diverse health.

She is the Medical Director for the Transgender and Intersex Specialty Care Clinic at the Rochester campus of the Mayo Clinic. They provide multi-disciplinary care for patients and have seen over 2,000 patients since the clinic started in 2015.

She says, “It’s an amazing privilege to take care of this community. I will do everything I can to ensure they receive the medically necessary care that they need!”

 

References

AAMC (2024). https://www.aamc.org/news/meeting-demand-better-transgender-care

Commonwealth Fund (2020, July 10). The Dose: Podcast

Harvard School of Public Health. https://www.hsph.harvard.edu/news/features/building-a-better-system-for-transgender-health-care/

Johns Hopkins Center for Transgender and Gender Expansive Health  https://www.hopkinsmedicine.org/center-transgender-health/

National Center for Transgender Equality (2022). 85 Organizations Launch Nationwide Campaign to Protect Trans Health by Supporting Biden Healthcare Regulation.

OHSU (Oregon Health & Science University School of Medicine) Transgender Health Program

Oregon Health Sciences. https://www.ohsu.edu/transgender-health/transgender-health-program-health-care-professionals

Texas Tribune (2023). https://www.texastribune.org/2023/03/24/texas-transgender-kids-transition-related-health-care/

The American College of Obstetricians and Gynecologists (2021, reaffirmed 2024). Health Care for Transgender and Gender Diverse Individuals (https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/03/health-care-for-transgender-and-gender-diverse-individuals)

UCSF Gender Affirming Health Program  https://transcare.ucsf.edu

Vanderbilt University (2024, April 15) U.S. Cabinet official leads seminar on transgender health and policy. https://news.vanderbilt.edu/2024/04/15/u-s-cabinet-official-leads-seminar-on-transgender-health-and-policy/

Williams Institute (UCLA School of Law) (2024) https://williamsinstitute.law.ucla.edu/subpopulations/transgender-people/