Sex and Gender Identification and Implications for Disability Evaluation
A National Academies committee will review medical standards for sex/gender identification, gender-affirming care, and their impact on disability evaluations, focusing on physiological changes.
Funder: National Academies of Sciences, Engineering, and Medicine
Due Dates: No current due dates (ad hoc committee review)
Funding Amounts: Not specified; committee-based review project
Summary: A National Academies committee will review medical standards for sex/gender identification, gender-affirming care, and their impact on disability evaluations, focusing on physiological changes.
Key Information: The report will provide findings and conclusions but no formal recommendations; focuses on transgender, intersex, and gender diverse populations in disability evaluation contexts.
Description
This National Academies of Sciences, Engineering, and Medicine ad hoc committee is tasked with reviewing the current state of medical knowledge and clinical practice regarding sex and gender identification, particularly as it relates to disability evaluation. The focus is on understanding the latest standards of care, treatment modalities, and scientific evidence concerning individuals undergoing or having undergone gender-affirming therapies, treatments, or care, and the physiological changes resulting from these interventions.
The committee will:
- Describe how sex and gender are medically defined, including preferred nomenclature for transgender individuals and those with intersex traits or identities.
- Identify recognized categories of intersex traits and their prevalence in the U.S. population.
- Examine how the medical community manages care and evaluation for intersex, transgender, and transitioning patients, including trends in conceptualizing physiological sex differences.
- Review how sex and gender information is collected and used in clinical practice and by large health organizations (e.g., Veterans Health Administration, Medicaid, HMOs).
- Detail usual physiological differences between male and female sexes, how these change over development, and how gender-affirming therapies affect these differences.
- Describe common gender-affirming therapies, their mechanisms, expected effects, prerequisites, treatment courses, side effects, and associated comorbidities.
- Evaluate the appropriateness of current Social Security Administration (SSA) disability listing criteria that consider sex or gender, including whether criteria should vary by birth sex or affirmed sex.
- Explore alternative tests or evaluations that could better assess functional capability in transgender and intersex individuals.
- Assess how other national health organizations evaluate impairments and eligibility for individuals with gender-affirming care or intersex traits.
- Investigate listings related to conditions generally associated with one sex and how these apply to transgender and intersex individuals.
The committee’s final report will present findings and conclusions but will not include formal recommendations.
