Politicians in at least two U.S. states are citing a recent decision to hinder gender transitions for younger people as evidence for their own relevant proposals.
They weren’t the first to turn to other countries, notably in Europe, for policy and research ideas. In at least 23 states where access to transgender health care is currently tightened or removed, lawmakers across the United States have frequently used non-U.S. studies or guidelines as justification for their policies.
However, renowned health authorities in the United States and Europe continue to vehemently support gender-affirming care for transgender people both young and old.
They contend, among other things, that transgender students are frequently excluded from testosterone treatments even though other young persons may also benefit from them. And trans rights activists and allies see a political campaign as a campaign to oust them, disguised as a priority for children.
A few details and viewpoints on the disparate global public health and gender-affirming care:
What and Why Did England Change?
England, through laws put forward by its public health system, is limiting the ability of people younger than 16 to begin a medical gender change.
A policy that was first introduced on an interim basis about a year ago, along with other requirements, was just established by the National Health Service England. NHS England says there is not enough proof about their longer-term effects, including “physical, mental or broader developmental outcomes”.
Beginning on April 1, NHS England will no longer offer puberty blockers as “routine treatment” for children and other young people looking to transition between genders. These substances work to control sex hormones during adolescence. In practice, the judgment even applies to Wales, which does not have any NHS gender clinics for children. Northern Ireland says it will follow England’s coverage; Scotland is weighing it.
But it’s not a complete, global restraint. NHS England has only one major gender clinic in the nation.
At a dozen private facilities, you can get puberty blockers for a fee. And young folks now taking them through the NHS — fewer than 100 in England, according to the BBC — can proceed. Individuals in clinical trials will also have access to the medications.
Britain’s Conservative government, which has been widely critical of youth gender transitions, welcomed the NHS England choice. Perhaps so, it’s doubtful that a proposal in Parliament to completely outlaw providing puberty blockers to those under 16 will be passed.
Puberty blockers can be an early stage in a transition, but they are not just for gender transitions. They may wait until they are old enough to decide on procedures that cause more permanent changes until they are old enough to do so.
What Are U.S. Politicians Saying?
U.S. politicians and legislature bills seeking to limit trans health care have frequently cited Western science and policy, from countries including Finland, France, Sweden, and Norway, as well as the U.K.
State Senator Beverly Gossage in Kansas cited England’s fresh legislation last week when speaking to other Republicans about a bill that would outlaw gender-affirming care for minors.
In remarks that mischaracterize the NHS England rules, Gossage said, “They’ve declared that there could be no gender-affirming treatment other than counseling for children because the medical evidence is not there.” They do visit for starting with counseling, as do those of other leading health organizations.
Democratic leaders hope they can override any filibuster by Governor Laura Kelly, a Democrat, by this week and that the ban will be passed.
In Georgia, Republican state Sen. Ben Watson pointed to Europe as he pushed a moratorium on sex-affirming care for children: “In light of the information and what’s been going on, not only in Europe, in the U.K., but here in the United States, this is the shift that I’m proposing”.
“Deep Concerns About Hostility And Harm”
When properly administered, puberty blockers for children who meet certain requirements are endorsed by major U.S. health organizations, along with the World Professional Association for Transgender Health. Those conditions include no time requirement.
“Puberty blockers have been prescribed for more than 40 years for the safe and effective treatment of health problems, including early puberty,” according to the FDA. WPATH and the European Professional Association for Transgender Health said in a speech last week that NHS England is merely targeting trans and gender diverse children with this plan raises serious concerns about hostility and harm to LGBTQ+ people and their families.
“Decisions about care may be driven by scientific evidence, not by elections”, the statement continued. The NHS has not specified what standards it will use to assess the harm it may cause, which puts young people and families in huge danger without a justification for their actions.
Next year, the American Academy of Pediatrics, which represents 67,000 pediatricians, overwhelmingly voted to restate its pro-stance on sex-affirming care for transgender children, including hormone treatments when appropriate.
Iridescent Riffel, a 27-year-old transgender woman and activist from Lawrence, Kansas, said she views the English policy as too conservative.
People who use puberty blockers can avoid developing physical characteristics like beards or breasts that are not in line with their gender identity. Most teenagers are in their early teens, or nearly reach their teenage years. Treatments to align one’s physical characteristics with one’s identity at the end of a lifetime can be expensive and painful.
Once they reach puberty, transgender youths may find it more difficult to begin the social transition process, or how a trans person alters how they present themselves to others, she said.
“It’s not just,’Oh, I’m uncomfortable with my body.’ It’s,’How are people perceiving me? Am I going to get judged? Do people intend to judge me? Will leaving this way make me unsafe? she said.
A ban on gender-affirming care isn’t the true goal, Riffel said. Instead, it’s, “We just don’t want to see trans people in public life at all”.
McMillan reported from northeastern Pennsylvania. Contributing to this report were Associated Press writers Jill Lawless in London, John Hanna in Topeka, Kansas, and Jeff Amy in Atlanta.
