Gender diversity is part of the human experience and as such is not a medical condition. However, in the United States, the inadequate education and training that medical providers
often receive renders them ill-prepared to offer culturally sensitive care to transgender/gender diverse (TGD) persons including law enforcement officers (LEOs).
In response, the ACOEM Public Safety Medicine Task Group has added a new LEO chapter on Gender Diversity to its online Guidance for the Medical Evaluation of Public Safety Employees. The goal of this document is to provide an overview of gender health, increase the competency of public safety medical providers, and promote a gender-affirming approach to the assessment of TGD LEOs.
The chapter espouses a gender-affirming model of care that recognizes that gender expression and identity exist along a wide spectrum and may be fluid within an individual over time. Rather than viewing identities and expressions that transgress cultural norms as pathologic, a gender-affirming philosophy views the diversity of the gender spectrum as an expected part of the human experience. Unlike a corrective approach which redirects gender-nonconforming behaviors or expressions with the goal of reducing them, the gender-affirming model promotes a person’s right to explore gender in a way that is safe and comfortable for them, without assuming a fixed trajectory regarding gender identity.
Extensive information related to the health, well-being, and lived experience of TGD LEOs, which may aid providers in assessment, can be found in the appendices which cover medical and behavioral health issues, and include policy statements from other organizations. Appendix G is unique as it consists of inappropriate and/or rude questions or statements made by co-workers to TGD LEOs who transitioned while on the job.
ACOEM’s Guidance for the Medical Evaluation of Public Safety Employees is the first national consensus guidance for developing a comprehensive occupational health and safety program for police officers, etc. Lead by Drs. Daniel Samo and Fabrice Czarnecki, the diverse Task Group (physicians, police officers and executives, and municipal managers) also seeks input from content experts and advocacy groups related to topic areas. These collaborations have produced state-of-the-art chapters on more than 25 medical conditions.