American healthcare just took a powerful step toward justice, safety, and compassionate medicine. The Centers for Disease Control and Prevention recently announced that it will recognize the patients who’ve suffered from so-called gender-affirming care. CDC is shining a light on those who resolve their confusion about their gender, as well as those who seek to reclaim their biological gender after a transition. Our country will become the first in the world to finally give them the attention they need–so they can finally get the medical care they deserve.
The CDC is righting a wrong that has long existed in healthcare. When patients get treatment—for gender dysphoria or any other medical issue—their doctors use diagnosis codes to document the visit. These codes assign a diagnosis in the medical record for whatever ailment a patient has, facilitating a tailored course of treatment. They also streamline billing to insurance companies and provide valuable data for real-world medical research.
Yet until now, there have been no diagnosis codes for patients who resolve their discomfort with their biological gender, or want to reverse an attempted sex change. By contrast, when these patients started a gender transition, the medical system documented every move. Since 2015, the CDC has adopted a slew of codes from the World Health Organization dealing with gender distress and even added a code for sex reassignment. But if these patients ever tried to go back — and restore the body they were born with — they were effectively invisible to medicine.
This injustice reflects the activist belief — which has unfortunately infected the medical establishment — that “detransitioning” doesn’t exist. The diagnosis system has codes for everything from “sucked into jet engine” and “struck by macaw.” With such specificity, you would expect there to be corresponding codes for “regrets cutting off breasts at age 15.” But activists don’t want to acknowledge that anyone would ever regret a sex-change, much less want to go back, because that threatens their dogma that sex-changes are all gain, no pain.
In reality, patients who undergo sex changes often experience tremendous suffering.
I’ve written about a patient in her twenties who had her ovaries removed in a sex-change surgery who subsequently tried to revert to her female biological identity. Yet because she was invisible in the eyes of the healthcare system, she couldn’t get the right treatment, and experienced menopause twenty-plus years earlier than normal. This young woman was seriously suffering and needed real medical help.
The lack of codes stifled doctors’ attempts to find a path forward, as her medical record indicated she was male. That young woman was eventually prescribed estrogen at a far greater dose than was appropriate — it was actually the dose prescribed to a biological man trying to become a female. Nor would medical insurance cover the treatment, because there were no codes indicating she had reclaimed her gender as a female.
In short, the medical system treated that woman as a man — a man who could not possibly try to become a woman again.
Stories like this are increasingly common. Well over 14,000 children have received sex-change treatments in recent years. As they get older, many will realize they have made a mistake and understandably want to go back. Some need hormone replacement for surgically removed sex organs. Others will need serious mental health treatment, given the pain and confusion they will have endured.
Bottom line, these patients deserve a medical system that recognizes them, because recognition is the first step to ensuring they get the right care.
The CDC deserves praise for bringing these detransitioners into the light. Its new codes — which will be formally issued in October and reflect my organization’s recommendations from earlier this year — will enable doctors to create effective treatment plans.
Medical researchers will also be able to study what has happened to these patients using real-world data, leading to advances in care over the long run. At the most basic level, these new codes will allow American medicine to tally the actual number of detransitioners. Right now, nobody knows how many people want to reclaim their true gender, because the system was originally designed to ignore them.
Transgender activists have fought this transparency tooth and nail. They have falsely portrayed detransitioners as a threat to patients’ health and well-being. But patients should never be stigmatized for a medical condition, especially patients who have already suffered from the rise of gender ideology.
These patients deserve all the compassion and ethical care that medicine can muster. Under the CDC’s guidance — which should serve as a model for the rest of the world — the U.S. healthcare system is bringing detransitioners out of the shadows and into the sunshine, to find the healing and hope they deserve.
Dr. Aida Cerundolo is an emergency medicine physician and senior fellow at Do No Harm.
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