Gender Affirming Care & Minors
Gender-affirming care is riddled with ethical dilemmas that have spilled over into an explosive political situation. The changing landscape of transgender health care, debates about puberty blockers and detransition are all low-hanging fruit - Kinnon R. MacKinnon and Pablo Expósito-Campos
image by: Family Pride Initiative
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Why Is the U.S. Still Pretending We Know Gender-Affirming Care Works?
Imagine a comprehensive review of research on a treatment for children found “remarkably weak evidence” that it was effective. Now imagine the medical establishment shrugged off the conclusions and continued providing the same unproven and life-altering treatment to its young patients. This is where we are with gender medicine in the United States. It’s been three months since the release of the Cass Review, an independent assessment of gender treatment for youths commissioned by England’s National Health Service. The four-year review of research, led by Dr. Hilary Cass, one of Britain’s top pediatricians, found no definitive proof that gender dysphoria in children or teenagers was resolved…
Resources
U.S. Study on Puberty Blockers Goes Unpublished Because of Politics, Doctor Says
The leader of the long-running study said that the drugs did not improve mental health in children with gender distress and that the finding might be weaponized by opponents of the care.
Conservative justices lean toward allowing Tennessee’s ban on gender affirming care
A conservative U.S. Supreme Court appeared ready to side with Tennessee Wednesday in upholding the state’s ban on gender affirming care for minors, a case likely to set legal precedent on equal protection for transgender children. A decision from the court isn’t expected until June 2025, but Republican-appointed justices such as Samuel Alito, Clarence Thomas and Brett Kavanaugh tipped their hands on how they would rule during three hours of oral arguments in Washington, D.C.
“Wait Until You’re Older”
Last year, a staggering 22 states across the U.S. banned gender-affirming care for minors. The conservative politicians behind this wave of legislation didn’t care that it went against the near-unanimous medical consensus that parents and doctors ought to be able to decide, on a case-by-case basis, whether puberty blockers, hormones, or other interventions are what’s needed for a given teen to flourish and live their life authentically. These lawmakers felt the consensus was wrong, that the government should take medical transition entirely off the table, at least until the kids grow up and can make “informed,” adult decisions.
'It helps me be myself': trans kids on the healthcare Republicans want to deny them
Proponents of the healthcare bans argue that kids are too young to consentto treatments like hormone therapy and puberty blockers and that the bills aim to prevent “medical experimentation” on children. Some bills claim that trans kids “will outgrow” their identities.
A Rare Reversal on Gender Transition Policy
The ‘vast majority of children’ receiving care shouldn’t be treated with hormones or surgery, says the American Academy of Pediatrics
Gender Affirmation For Minors Is Child Abuse, Not Treatment
Interviewing therapists, academics, and transgender people in pursuit of the elusive answer to the question, “What is a woman?” Walsh uncovers a number of professionals whose objections to the trans party line have resulted in being cut out of the discussion altogether.
Hm, No One Had a Problem With Puberty Blockers When Only Cis Kids Took Them
“Puberty blockers have been used for decades in cisgender kids who either are going through puberty too early, or, in some instances, kids who are going through puberty very quickly,” Jason Klein, a pediatric endocrinologist and Assistant Director of the Transgender Youth Health Program at Hassenfeld Children’s Hospital at NYU Langone, told VICE. “Their use has been FDA approved, well-studied, well-documented, and well-tolerated for a long time now. And it’s the exact same medication that we use in trans or nonbinary children to basically put a pause on pubertal development. Exactly the same medications, at exactly the same doses.”
In just a few years, half of all states passed bans on trans health care for kids
Transgender people under 18 face laws that bar them from accessing gender-affirming health care in 25 states — just a few years ago, not a single state had such a law. The Supreme Court has agreed to consider a case from Tennessee in its next term that challenges that state’s gender-affirming care ban for young people. “Pressure had been mounting for the Supreme Court to weigh in here,” says Lindsey Dawson, director for LGBTQ Health Policy at the health research organization KFF.
It’s okay to let your transgender kid transition — even if they might change their mind in the future
It’s possible that many prepubescent transgender children will, in fact, change their minds about transitioning medically. We don’t have great research to know. Luckily, the interventions that doctors would recommend for kids this young are completely safe and reversible. Medical guidelines advise that prepubescent children not be offered any hormonal interventions. What a psychologist or psychiatrist might recommend is allowing the child to “socially transition” if the child so desires.
Medical Group Backs Youth Gender Treatments, but Calls for Research Review
The American Academy of Pediatrics renewed its support of gender care for minors while commissioning a fresh look at the evidence.
Puberty blockers: why some young people need help exploring their gender identity
Young trans people face numerous challenges in life. These can include social discrimination, bullying, harassment and family rejection. It’s maybe not surprising then that trans youth are also at much higher risk of self-harm and suicide attempts than their peers. Research shows that for some young trans people, puberty blocking drugs can help while they explore their gender identity. Puberty blockers are medications that temporarily cause the body to stop producing sex hormones and so delay puberty.
States are banning gender-affirming care for minors. What does that mean for patients and providers?
More than 20 U.S. states have banned or severely limited treatment to align a young person’s body with their gender identity. That leaves some doctors caught between breaking the law and providing what they say can be lifesaving medical care.
The real threat to gender-diverse children is the politicization of care issues like puberty blockers and detransition
Gender-affirming care is riddled with ethical dilemmas that have spilled over into an explosive political situation. The changing landscape of transgender health care, debates about puberty blockers and detransition are all low-hanging fruit for opportunistic politicians like Poilievre.
U.K. Study Criticizes Puberty Blockers for Gender Dysphoria in Minors
Four-year study says there is no good evidence for giving transitioning drugs, adding to growing caution in U.S. and Europe.
Why Is the U.S. Still Pretending We Know Gender-Affirming Care Works?
“The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” Cass concluded. Instead, she wrote, mental health providers and pediatricians should provide holistic psychological care and psychosocial support for young people without defaulting to gender reassignment treatments until further research is conducted.
4 out of 5 kids who question gender ‘grow out of it’: Transgender expert
A psychiatrist who has presided over youth gender transition treatments for more than a decade says “four out of five” gender-questioning children eventually accept their bodies if no medical interventions are carried out.
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