Exemptions and Exceptionalism in Transgender and Intersex Healthcare

This panel explores how health policies have treated transgender and intersex people as exceptional cases and exempt from other domains of healthcare. Such policies have exacerbated disparities in access to care and produced bodily harm. Presenter 1, a health policy researcher, reviews the recent slate of state legislation restricting access to gender-affirming healthcare, analyzing how these bills have cleaved pediatric and adult care from one another. Presenter 2 and panel moderator, a historian and gender studies scholar, examines legislation that seeks to curtail gender-affirming healthcare for trans people while making exceptions for surgery and hormones for children born with intersex traits. Ironically, these are the same medical interventions denied to transgender children. Presenter 3, a feminist and queer studies philosopher, explores exceptionalism in sexual and reproductive healthcare access. Youth generally permitted to make their own decisions regarding sexual and reproductive health (e.g. contraception, STI screening) are required to obtain parental permission for gender-affirming care and fertility preservation—two treatments that disproportionately affect transgender and intersex youth. Presenter 4, a historian of medicine and science & technology studies scholar, considers how exceptional standards of evidence have been demanded for gender-affirming care for transgender people. Across successive iterations of standards of care guidelines, transgender health researchers have responded by hewing more closely to the precepts of evidence-based medicine in an effort to de-exceptionalize transgender healthcare. The session will invite attendees to share how exemptions and exceptionalism in LGBTQI health policy have affected their clinical practice.