Advocating for Gender Affirming Care for Minors

Annually, Osteopathic Health Policy Fellowship (OHPF) participants are tasked with producing two "Health Policy Briefs" to showcase their program-related skills. Tim Kowalski, DO, a member of the OPHF Class of 2022 and vice president for professional and public relations at Edward Via College of Osteopathic Medicine Carolinas Campus, undertook one of the most formidable assignments to date.

In 2022, there was a flurry of activity in fifteen states prohibiting, and in some cases criminalizing, the provision of gender-affirming care health services to minors. Dr. Kowalski, a board-certified child psychiatrist, was assigned the task of developing a critical review of the issue, an objective policy recommendation and a brief “testimony” as if presenting to a state legislative committee at a hearing on such a bill. He took on the task willingly, stating, “I was grateful that I was allowed to write on a topic that was within my specialty of child psychiatry, but one that I was completely unfamiliar with.”

As some states had already passed legislation criminalizing physicians for providing medical gender affirming care to youth with gender dysphoria, the topic was already a touchstone. The policy and political climate made this a front-page topic again, leading to a new wave of state-level policy efforts. “Given that history of states already criminalizing conversion therapy, and the resurgence of interest in the issue, it was clear that a brief on this topic would be timely,” Dr. Kowalski said.

Since completing the OHPF, Dr. Kowalski has continued to follow and be involved with the topic, including testifying several times before both the South Carolina Medical Association’s House of Delegates as well as before the American Osteopathic Association House of Delegates over the past two years. “The opportunity to address a controversial topic and exploring both sides of the issue has been contributory to the deliberations of both Houses. I appreciate having the opportunity to expand my knowledge in how to approach and comment on such an important issue through the participation in the Osteopathic Health Policy Fellowship,” stated Dr. Kowalski.