Res. No. 774

Resolution calling on the New York State Department of Health to implement regulations requiring hospitals in New York City to adhere to the World Professional Association for Transgender Health’s Standards of Care 8, to ensure medical professionals can provide high-quality and ethical treatment for individuals with gender dysphoria.

By Council Members Hudson, Cabán, Ossé, Hanif, Bottcher and Louis

                     Whereas, The World Professional Association for Transgender Health (WPATH) is a 501(c)(3) non-profit, interdisciplinary, professional, and educational organization devoted to transgender health, whose members engage in academic research to develop evidence-based medicine and strive to promote a high quality of care for transgender, gender nonconforming, non-binary, and intersex (TGNCNBI) individuals internationally; and

                     Whereas, WPATH established the internationally accepted Standards of Care (SOC) for the treatment of individuals with gender dysphoria; and

                     Whereas, the SOC promotes the health and welfare of TGNCNBI individuals in all cultural settings; and

                     Whereas, WPATH updates and revises the SOC as new scientific information becomes available; and

                     Whereas, the Standards of Care 8 (SOC8) is the most recent version of the SOC; and

                     Whereas, According to the Human Rights Campaign, gender dysphoria is the distress that results from having one’s gender identity not match one’s sex assigned at birth; and

                     Whereas, According to the Human Rights Campaign, the age-appropriate care that is medically necessary for the well-being of many TGNCNBI individuals with gender dysphoria is called gender affirming care; and

                     Whereas, Every major medical and mental health organization, collectively representing more than 1.3 million doctors, and including organizations like the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association, recognizes that gender affirming care is medically necessary for TGNCNBI individuals, according to the Human Rights Campaign; and

                     Whereas, According to the Williams Institute of the University of California, Los Angeles School of Law (“Williams Institute”), the New York metropolitan area has the highest population of lesbian, gay, bisexual, and transgender (LGBT) adults of any American metropolitan area, at about 706,000 as of March 2021, and New York State, as of June 2022, has a population of 34,800 individuals aged 13-17 who identify as transgender and 81,800 adults who identify as transgender; and

                     Whereas, According to the most recent Behavioral Risk Factor Surveillance System survey on sexual orientation and gender identity, published in June 2022 and using data collected from 2019 and 2020, which is managed and published by New York State’s (“State”) Department of Health (DOH), about 0.6% of New York City’s (“City”) population identifies as transgender; and

                     Whereas, Some private hospitals in the city already adhere to the WPATH SOC8, such as NYU Langone Health, and others, such as Mount Sinai, require providers to be “informed by” WPATH SOC8; and

                     Whereas, Other hospitals in the city, including the public hospitals run by the Health and Hospitals Corporation (H+H), do not adhere to WPATH SOC8, despite H+H’s strong track record of meeting LGBT individuals’ needs, including being recognized by the Human Rights Campaign’s and Services and Advocacy for GLBT Elders’ Long-Term Care Equality Index; and

                     Whereas, The DOH is responsible for the development and administration of the State’s policy with respect to hospital and related services; and

                     Whereas, An official policy manual of the State’s Office on Mental Health (OMH) published in 2020 requires the delivery of medically managed hormone therapy (a form of gender affirming care) to adhere to the SOC set forth by WPATH; and

                     Whereas, A memorandum from the OMH’s Chief Medical Officer Thomas E. Smith required all UR Agents, defined in the memorandum as health maintenance organizations and insurers, and their contracted utilization review agents, to update their previously approved clinical review criteria, and associated policies and procedures regarding how such criteria are used, for all gender affirming treatments to be consistent with the updated recommendations in WPATH SOC8; and

                     Whereas, Despite these policies, the DOH has not made any broad call to require WPATH SOC in all hospitals in the state; and

                     Whereas, Gender affirming care is under attack in multiple states, including in 26 states that passed bans or restrictions on gender affirming care for youth; in Oklahoma, Texas, and South Carolina, which considered bans for gender affirming care for those up to 26 years of age; and in several states that prohibited public funds from being used to provide gender affirming care for anyone, meaning those under Medicaid cannot receive care; and

                     Whereas, The City and State should continue to strive to be a center for TGNCBI health in the face of these attacks; now, therefore, be it

                     Resolved, that the Council of the City of New York calls on the New York State Department of Health to implement regulations requiring hospitals in New York City to adhere to the World Professional Association for Transgender Health’s Standards of Care 8, to ensure medical professional can provide high-quality and ethical treatment for individuals with gender dysphoria.

LS 18679

2/21/2025

JN