Care, Understanding, Agreement: Seeking a Path Forward in Sexual and Gender Minority Health

Symposium will examine challenges in health care and well-being for sexual and gender minority communities

This 2021 update to the Pride Progress flag includes stripes and symbols to represent the intersex and transgender communities and people of color.
This 2021 update to the Pride Progress flag includes stripes and symbols to represent the intersex and transgender communities and people of color.

Sexual and gender minorities fighting to get basic health care also face life-threatening knowledge deficits – even if they have a doctor.

“We've got people who are fighting for their lives, fighting for the ability to access health care at all, fighting to be seen, and we’re realizing we don't even understand what lab values a physician is supposed to reference for diabetes screenings, or for medications for transgender and other gender diverse patients,” Professor Kate Whetten said.

Whetten, a population health scientist at Duke, is among the organizers of a two-day symposium designed in part to identify the necessary research for better informed medical care and policies for these underserved communities.

The event, which takes place online March 21 & 22, is hosted by the Duke Sexual And Gender Minority Health Program, of which Whetten is a co-director along with Professor Sara LeGrand and Professor Sarah “Sadie” Wilson. Topics include the interactions between race, aging and neurodivergence in gender and sexual minority health care, health and wellbeing.

The speaker lineup is headed by Admiral Rachel Levine, a pediatrician and – as U.S. Assistant Secretary for Health – the first openly transgender holder of an office requiring Senate confirmation. The roster also includes multiple physicians, researchers and activists from across the spectrums of sexual and gender identities – many of whom disagree fundamentally about the paths forward.

“Even within the communities who support transgender and gender-diverse people, there is incredible disagreement about what we should be doing,” Whetten said.

“We're creating a space where people who have quite different beliefs can come together and express their differences, why they have them and what would convince them to believe differently.”

Among the knottiest of these issues is whether too many teens are trying to transition and how gender-diverse athletes can fairly participate in sports historically divided along traditional binary sex lines.

For sports participation, “We're going to ask what leveling the playing field would actually look like biologically and whether being transgender has a place in that discussion at all,” Whetten said. "For teen transitions, we are going to ask what we need to learn and research so that we are comfortable that the best care possible is being provided."

The scale of the disagreements is such that convening the event at all was tough.

“People have been trying to put this kind of conference together for the last two years and haven't been able to do it,” Whetten said. “I was told we wouldn't be able to do it, because the folks wouldn't sit in the same room. And I just felt really confident that we could, in part because my home base is in the Sanford School of Public Policy, where we're really good at having difficult discussions.”

The event is open to the public. For more information, and to register, click here. The inaugural Pauli Murray Sexual and Gender Diversity Awards will be presented at the symposium by Rosita Stevens-Holsey. The awards, created in partnership with The Pauli Murray Center and Family, will go to recipients “who embody traits of the Durham legend, who will keep their indefatigable spirit alive, and are, through their work, making the world a place in which Pauli Murray would have thrived today,” Whetten said. “We will also be awarding the inaugural ‘Promising SGM Researcher Award’.”

The Duke Sexual And Gender Minority Health Program launched in 2020. Its work includes a Duke effort to build the first national prospective registry of transgender and gender-diverse patients in the U.S., which will provide clinical data needed to answer outstanding questions about the risks and benefits of gender-affirming hormone and surgical interventions. Duke also plans to open an additional clinic to combine gender-related services.

“We want to become the training hub for, at a minimum, academic institutions and hospitals in the South and Global South,” Whetten said. “We can be the place where we can have these difficult policy and care discussions."