Attorneys General Call on AMA to Ensure Reproductive Health Care and Gender-Affirming Care Providers Can Get Board-Certified Without Unnecessary Risk
New York Attorney General Letitia James led a coalition of 19 other attorneys general in urging the American Medical Association (AMA) to take stronger action to protect health care providers from potentially dangerous medical board certification requirements. In testimony submitted to AMA, Attorney General James and the coalition argue that requiring abortion and gender-affirming care providers to travel to states that restrict those forms of care in order to get board-certified puts them at legal and physical risk. The attorneys general warn that mandating in-person testing in states that have aggressively criminalized or penalized reproductive and gender-affirming health care endangers providers, especially those who are pregnant or transgender, and threatens access to essential care nationwide.
“As states weaponize their legal systems to punish doctors for providing essential health care, the American Medical Association must stand strong in defense of providers,” said Attorney General James. “Reproductive health care and gender-affirming care providers should not have to risk their safety or freedom just to advance in their medical careers. Forcing providers to travel to states that have declared war on reproductive freedom and LGBTQ+ rights is as unnecessary as it is dangerous. I urge AMA to act swiftly to prevent these requirements from becoming a tool for harassment and intimidation.”
Earlier this year, AMA acknowledged the risks posed to health care providers by state laws that restrict abortion and gender-affirming care, adopting a policy encouraging medical boards to provide alternative testing options in states with such restrictions. However, Attorney General James and the coalition assert that AMA’s current stance does not go far enough to protect examinees because it lacks sufficient urgency and fails to provide policy guidance to the specialty boards on concrete steps they should take to protect candidates. The attorneys general call for AMA to go further by recommending such steps, including:
- Relocating testing sites to non-restrictive states;
- Shifting to remote testing to eliminate the need for travel to hostile environments; or
- Granting individual exemptions from in-person exams in restrictive states for those facing heightened legal or physical risks.
The attorneys general’s testimony highlights the increasingly hostile legal landscape for health care providers in the aftermath of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. Following the decision, several states implemented draconian restrictions on abortion and have since taken steps to criminalize patients and providers. Many of the same states have followed by passing a wave of restrictions on gender-affirming care. The attorneys general argue that officials in these anti-choice states have made it clear their goal is to intimidate and punish reproductive health and gender-affirming care providers, no matter where the care was provided.
Attorney General James and the coalition warn that mandating in-person board certification testing in states that penalize these forms of health care could have far-reaching and harmful consequences. In particular, the attorneys general highlight the American Board of Obstetricians and Gynecologists (ABOG), which requires OB/GYNs seeking board certification to travel to Texas for in-person testing. Texas has implemented some of the most severe anti-abortion legislation in the country – criminalizing abortion at all stages of pregnancy, classifying it as a first-degree felony punishable by life imprisonment, and allowing private citizens to sue providers for up to $10,000 per abortion performed after six weeks into the pregnancy.
Despite these restrictions, ABOG – which oversees all gynecologists and obstetricians, and even evaluates doctors’ ability to perform abortions as part of the certification process – continues to require in-person certification exams in Texas. The attorneys general assert that ABOG’s refusal to provide accommodations for candidates who fear prosecution or physical harm in Texas places providers at needless risk and endangers access to essential care nationwide. Attorney General James and the coalition note that their offices have engaged with ABOG to identify safer testing alternatives, but ABOG has refused to grant exemptions for candidates who are pregnant or who provide reproductive health care to patients from hostile states, including for the upcoming testing cycle beginning in October.
Attorney General James and the coalition warn that anti-abortion state officials have publicly stated their intent to prosecute providers who assist patients from Texas in obtaining abortion care in other states. Additionally, Texas recently classified gender-affirming care as “child abuse,” opening the door to additional investigations and potential criminal charges against providers. The attorneys general assert that requiring reproductive health providers to travel to anti-abortion states for certification could result in them being targeted under these laws, even if they are legally providing care in other states.
The attorneys general emphasize that ensuring the safety of health care providers is essential to maintaining access to reproductive and gender-affirming care in states like New York. The attorneys general are urging AMA to act urgently and forcefully to ensure medical specialty boards adopt concrete, actionable policies that protect providers, warning that failure to act could exacerbate the national health care crisis.
Joining Attorney General James in submitting this testimony are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia.
