Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Transgender health care in the United States: legal, ethical and practical concerns for gastroenterologists in a changing landscape

Transgender and gender-diverse patients in the United States can have difficulty finding providers who are knowledgeable about their unique health-care needs. In many states, legislation limits the ability of physicians to provide gender-affirming and supportive care. Further awareness, advocacy and research is needed to help mitigate the discrimination and stigma endured by the transgender community.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Challenges in transgender health care in the United States.


  1. Redfield, E., Conron, K. J., Tentindo, W. & Browning, E. Prohibiting Gender-Affirming Medical Care for Youth (The Williams Institute, 2023).

  2. Paul, S. Overcoming the challenges and mitigating the disparities in our LGBTQI+ patients. Am. J. Gastroenterol. 116, 1815–1818 (2021).

    Article  PubMed  Google Scholar 

  3. Vélez, C., Casimiro, I., Pitts, R., Streed, C. Jr & Paul, S. Digestive health in sexual and gender minority populations. Am. J. Gastroenterol. 117, 865–875 (2022).

    Article  PubMed  Google Scholar 

  4. Newman, K. L. et al. Research considerations in digestive and liver disease in transgender and gender-diverse populations. Gastroenterology 165, 523–528.e1 (2023).

    Article  PubMed  Google Scholar 

  5. American College of Physicians. Attacks on gender-affirming and transgender health care. ACP (2023).

  6. Abramovich, A. et al. Assessment of health conditions and health service use among transgender patients in Canada. JAMA Netw. Open 3, e2015036 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Schenker, R. B. et al. Recommendations for transgender and gender nonconforming adolescents and young adults with inflammatory bowel disease. J. Pediatr. Gastroenterol. Nutr. 72, 752–755 (2021).

    Article  PubMed  Google Scholar 

  8. Lee, J. L. et al. “I don’t want to spend the rest of my life only going to a gender wellness clinic”: healthcare experiences of patients of a comprehensive transgender clinic. J. Gen. Intern. Med. 37, 3396–3403 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Schweikart, S. J. What’s wrong with criminalizing gender-affirming care of transgender adolescents? AMA J. Ethics 25, E414–E420 (2023).

    Article  PubMed  Google Scholar 

  10. Kiran, T. et al. Cancer screening rates among transgender adults: cross-sectional analysis of primary care data. Can. Fam. Physician 65, e30–e37 (2019).

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Sarah Singh.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Singh, S., Duong, N., Targownik, L. et al. Transgender health care in the United States: legal, ethical and practical concerns for gastroenterologists in a changing landscape. Nat Rev Gastroenterol Hepatol 21, 370–371 (2024).

Download citation

  • Published:

  • Issue Date:

  • DOI:


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing