Gender Affirming Care - McNamara vs Grossman & Crenshaw - Health Subcommittee Hearing (6/14/2023)

The US Committee on Energy and Commerce held hearings on 14 June, 2023 which included debate over a proposed amendment which would restrict graduate medical education funding to pediatric hospitals that performed certain gender affirmative care. The bill was sponsored by Texas rep Dan Crenshaw and a lively debate over the issue took place in the hearing.

Testimony given and questions taken by:
Dr. Meredithe McNamara, MD, MS, FAAP, Assistant Professor, Yale School of Medicine
Dr. Miriam Grossman, MD, Child, Adolescent, and Adult Psychiatrist

Key Moments - Chapters:
00:00 Master Edit
00:00 McNamara Testimony
00:09 Professional Background
00:57 Medical Political Issue
02:05 5 Categories of Misinformation
02:33 Gender Dysphoria Medical Condition
03:13 Medical Trainees
04:00 Banning Transgender Kids
04:32 Trans Teen Example
05:15 Grossman Testimony
05:31 Professional Background
05:47 Sex Assigned at Birth
06:31 European Halt on Intervention
08:05 Suicide
08:32 Psychotherapy
08:54 Debate Over Standards of Care
09:59 Experimental Care
10:38 Question to Dr McNamara
12:36 Misinformation
13:01 Conversion Therapy
13:28 Suicidality
14:12 Correction regarding precocious puberty
14:20 Growth of Affirmative Care Clinics
14:37 Q: Is the US an outlier?
14:59 Clarification on Precocious Puberty
17:30 Q: What are the long term impacts?
17:35 New Population
18:24 Q: Shifting Population and Long Term Outcomes
18:42 ROGD Population
19:13 Parental Rights and Privacy
19:42 Question Dr McNamara
20:22 Q: What would be the impact on Care?
22:14 Q: Impact on Training?
23:19 Q: Impact on Pediatric Workforce?
24:16 Question McNamara
24:16 Q: Importance of Pediatric and Mental Health care
26:02 Question Dr. McNamara
26:07 Statement on Politicization
27:36 Statement on Suicide
29:07 Q: How does Affirmative Care improve outcomes?
31:12 Question McNamara
31:12 Q: What impact will bill have on Trans Youth and Peds Workforce?
34:04 Question Dr. Grossman
35:40 Q: What treatments for dysphoria are backed by data?
39:42 Question McNamara
39:46 Statement on Government Role in Healthcare
42:46 Q: Please Explain Informed Consent in Affirmative Care
45:21 Statement from Vice Chair
45:58 Statement on Partisan politics
47:03 Q: What is age appropriate gender affirming care?
48:19 Q: Do Professional Associations Support Affirmative care?
48:33 Q: Is the US an outlier?
50:52 Question McNamara
50:58 Statement about partisan politics
53:06 Q: Anything to add or correct?
54:48 Statement Crenshaw
59:35 Statement on Politicization
01:01:04 Q: What type of care would be disrupted?
01:01:54 Statement regarding Boston Children's Hospital and Surgery
01:02:45 Q: What of the dangers to healthcare workers?
01:04:05 Statement
01:05:59 Crenshaw Statement about Culture War
01:06:35 Q: Concern for unknown long-term effects of affirmative care?
01:07:00 Q: What do you mean by cherry-picked data?
01:07:41 Q: Wouldn't you want strong evidence of benefits for therapy?
01:08:18 Q: Is there any strong evidence of benefit at all?
01:08:51 Question McNamara and Grossman
01:09:24 Q: Is an XY Chromosome Assigned at Birth?
01:10:26 Q: Have there been controlled trials of the benefit of affirmative care?
01:12:06 Crenshaw Statement on Affirmation
01:14:16 Q: What of the lack of evidence?
01:15:01 Q: How have professional associations been affected by activists?
01:16:11 Question McNamara
01:17:15 Q: What of Low Quality evidence for Standards of Care ?
01:19:12 Q: What is the process that patients and families go through to get care?
01:19:58 Q: What is the importance of having both medical and mental care?

Sources:

- https://energycommerce.house.gov/events/health-subcommittee-legislative-hearing-examining-proposals-that-provide-access-to-care-for-patients-and-support-research-for-rare-diseases
- Bill text: https://crenshaw.house.gov/_cache/files/7/3/7394a6ec-0490-4e34-a160-cc485e4628c1/99A1262D6DC8161B24BCD8C7C684784C.chgme-reauth-02-xml-35-.pdf