Report from USPATH 2023 in Denver, Colorado

We’re happy to say that the United States Professional Association for Transgender Health (USPATH) biennial conference, held from November 1-5 in Denver Colorado, was a smashing success. TPATH held a dinner for transgender conference participants and local activists that was generously sponsored by One Colorado and attended by more than 50 people, including Colorado’s first out trans legislator, Brianna Titone. I attended on behalf of TPATH to organize the dinner and report back on the conference (see conference schedule and program). Here’s what I found.

November 3

TPATH’s Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Plenary: A Closer Look at Body Mass Index Requirements for Gender-Affirming Surgeries
This session was an in-depth discussion of problems with using the Body Mass Index (BMI) as an indicator in general, and for trans surgical approval specifically. Evidence was given that the practice is racist, reinforces and/or causes eating disorders, and is otherwise harmful to clients. One presenter discussed how the use of the BMI is in the process of being de-emphasized in certain sectors and institutions due to these problems (see). Others discussed the neurobiological underpinnings of weight and the specifics of surgical weight loss. It was noted that the FedUp Collective provides a searchable database of surgeon BMI limits.

Fandom Culture and TGD Community Engagement: What Clinicians Need to Know
Presenters for this session discussed the role of fandom culture in trans communities and how this knowledge can help practitioners connect with them.

Interdisciplinary Approaches to Capacity Assessment for Medical Decision Making in Gender-Affirming Care
This session discussed the process of assessing applicants for trans healthcare and determining whether they had the capacity to consent to it. The focus seemed to be on how clinicians become confident to affirm consent, rather than on clients experience of and autonomy in this process. One of the interesting points made was that many existing patient charts contain “chart lore,” which are historical diagnoses based on oral reports from prior clinicians that cannot be traced to an actual origin and/or diagnosis. This ‘lore’ can have extremely detrimental impacts on client’s access to services and on the healthcare they receive.

November 4

Plenary: In The Spirit of Care: Affirming and Supporting Our Two-Spirit, Trans and Non-Binary Relatives
The presenters in this session talked about the experiences of two-spirit trans and non-binary folks. Both the Paths (Re)Membered Project and the Trans & Gender Affirming Care ECHO Program were mentioned. The latter provides training in working with indigenous two-spirit, trans, and non-binary folks.

Mental Health Across the Lifespan Nonbinary and Genderqueer Identities
This session dealt with suicidality, social anxiety, and how nonbinary and genderqueer folks access transgender healthcare that is structured to serve binary individuals. One of the key takeaways was that often nonbinary people must ‘pass’ as binary to receive surgical care.

November 5

Plenary: Legislative Perspectives on Gender Affirming Care
Brianna Titone (Colorado House Representative for District 27/Jefferson County) ended the conference with a talk on her experiences as Colorado’s first out trans legislator.

Other Information

• USPATH offered a very useful media training presentation several times during the conference (slides). My only addition would be that folks who are contacted by the media – or even prior to contacting media – should check in with the trans community regarding prior experiences with that outlet/reporter. Often other people have already had experiences with them that can help you. Also consider signing up for Help A Reporter Out (HARO), which lets reporters reach out to folks who have a particular expertise.
• Earlier in the conference a report was given on the history and present state of anti-trans legislative bills in the US. They reported that there are 152 proposed bills in 2023. These include those that criminalize supportive parents and providers, limit insurance, and outright bans healthcare. While most deal with youth, they are increasingly targeting adults. It is expected that 2024 will be worse, as this is an election year. The discussion included how many of these bills and their proponents use misinformation and outright disinformation and that it is very important to connect with candidates around these issues, especially in local elections. Please see the Instagram post from ava.stays.strong for more details on this session.
• (Handout) How to Respond to Misinformation about Care for Transgender Youth

You can find more reports on the conference from the USPATH Rapporteurs
Caleb LoSchiavo (1, 2, 3, 4)
Elias Lawliet (1, 2, 3, 4)
Elijah Castle (1, 2, 3, 4)

TPATH’s Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.