Texas Medical Association’s stance on gender-affirming care

Summary of Content on TMA’s Politicization and Gender Medicine Policy

The Texas Medical Association (TMA) has experienced increasing politicization regarding gender medicine, starting in 2016 with the introduction of a resolution opposing “Sexual Orientation Change Efforts in Minors.” This trend intensified with the establishment of the LGBTQ Health Section in 2020, which altered TMA’s bylaws to advocate for policies on gender identity to enhance healthcare access. This shift highlighted tensions between TMA’s aim for evidence-based practices and the growing influence of political motivations within the organization.

Concerns regarding conflicts of interest emerged as members from the LGBTQ Section participated in committees reviewing gender-affirming care resolutions. Data indicated a significant adoption rate of resolutions proposed by reference committees, raising alarms about the integrity of TMA’s policymaking process. Reports reveal that LGBTQ Section members discussed using strategic language to introduce controversial policies subtly, reflecting a deliberate effort to influence TMA’s House of Delegates without direct association.

By 2022 and 2023, TMA members voiced dissatisfaction with board members’ potential conflicts of interest and the association’s focus on social justice over core medical concerns that resonate with the majority of physicians. Internal surveys revealed that most members deemed gender-affirming care low on their priority list, challenging the legitimacy of TMA’s current trajectory. However, these grievances were largely ignored by TMA leadership, indicating a possible breach of fiduciary duty.

Despite a robust push from members for an ad hoc committee to evaluate gender-affirming care policies, internal politics prevailed. Testimony supporting a more in-depth review was significantly outnumbered by dissent from those in influential positions, leading to recommendations that upheld the organization’s support for gender-affirming care as essential and evidence-based. This episode showcased the difficulty faced by dissenting members in an increasingly politicized environment.

Ultimately, TMA’s evolution toward activist positions around gender medicine poses significant questions regarding its commitment to evidence-based practice and the representative nature of its governance. The report underscores an urgent need for open discourse and sound governance practices to mitigate the risk of institutional capture in medical associations. Joe Figliolia, the author, emphasizes that the politicization witnessed at TMA may reflect broader issues prevalent in other large organizations, further calling for accountability and a return to fundamental medical tenets.