In recent years, policy across the nation has concentrated on providing medical care for transgender children.
At least 23 states have passed restrictions on transgender youth’s exposure to gender-affirming healthcare, many of which have faced legal difficulties claiming that these restrictions violate the rights of the children, their families, and their health professionals.
Healthcare professionals who focus on gender-affirming treatment claim that misinformation has distorted public perceptions of what transgender minors and their families can expect.
In order to explore the most hotly debated issues relating to gender-affirming treatment, ABC News spoke with doctors and researchers.
What does gender-affirming treatment for adolescents entail in the United States?
According to Joshua Safer, an oncologist and executive director of the Mount Sinai Center for Transgender Medicine and Surgery, gender-affirming maintenance appears differently for each individual.
Not every patient will get any or every type of gender-affirming clinical care option, according to him, who claims that patients, their doctors, and their families work together to create a personalized and specialized approach to attention.
According to Kellan Baker, executive director of the Whitman-Walker Institute, an LGBTQ research firm and care service, there is no one-size-fits-all approach to treating transgender people or gender dysphoria.
According to Baker, teams of health professionals and mental health professionals who work with families to discuss their boy’s experience, needs, choices, and other factors are frequently involved in the long process of deciding to pursue gender-affirming care.
Minnesotans hold a rally in St. Paul, Minnesota, on March 6, 2022, to help transgender children across the nation.
Getty Images, FILE, Michael Siluk/UCG/ Universal Images Group
We’re discussing months ‘ worth of consultations with mental health professionals. In an exam, Baker said,” We’re talking a lot of conversations between providers, relatives, and boys.” ” We are talking about long waitlists because this is n’t something that happens quickly in terms of being able to access these clinicians who actually have experience working with trans people.”
According to treatment recommendations from the health organizations Endocrine Society and World Professional Association for Transgender Health, there is no medical treatment available for toddlers who have not reached adolescence.
There are currently no hormonal changes or improvements that may call for medical attention, according to Safer.
Health professionals are usually focused on teaching parents about sex and working to ensure that the children have a healthy and inclusive setting to discover their sex at this stage, according to Jack Turban, professor of Child and Adolescent Psychiatry at the University of California, San Francisco.
Prepubescent children may be interested in a cultural transition, according to Turban in an interview.
It might entail trying a fresh name, fresh word, unique clothes, or different cut, he continued. And the general discussion in the field for these prepubertal children is that we should allow them to explore any of those points while making sure they are doing so in a secure, encouraging setting.
To ensure that families and people have given their informed consent, the World Professional Association for Transgender Health standards of care outline a protracted and in-depth review process.
There are some transgender people who suffer from natural sex distress and are extremely upset by menstruation. Turban remarked,” There are other trans people who do n’t and are OK with their bodies. Therefore, we always make sure that children are aware that none of these health interventions are necessary.
Hormone treatment, puberty blockers, and surgery
Puberty filters, which Safer claimed are a centuries-old process to postpone the emergence of stereotyped characteristics, such as the development of breasts and facial locks as well as voice changes, may be used by patients and their caregivers when children enter pubertY.
According to Safer, this method is not dangerous and has been frequently used on kids who go through puberty earlier than usual.
Health experts claim that when blockers are stopped, puberty continues with few to no known side effects.
According to Safer, this delay in puberty gives transgender or questioning children the opportunity to explore their gender” so that we have time to be more meticulous in reviewing the situation with those specific youth, as well as with their parents, and ascertain what the appropriate course of action may be.”
Doctors have been employing this strategy for roughly 40 times, he claimed, and “have not seen any negative effects from doing so.”
On February 3, 2024, hundreds of people gathered in Edmonton, Alberta, Canada, to oppose Premier Danielle Smith’s suggested LGBTQ2S+ policy and the proposed regulations affecting transgender and non-binary youth. An activist is holding a poster.
via Getty Images, Artur Widak/NurPhoto
Safer, the author of the Endocrine Society’s trans treatment guidelines, stated that” this is a well-established, traditional maneuver.”
Hormone treatments can be used on older minors and has been used for years in a variety of cases.
Prior to beginning hormone therapy, the WPATH recommendations call for a complete psychological assessment, which should include an educated consent from the parents in accordance with federal laws, and an in-depth discussion of the risks and benefits with both patients and parents.
Depending on their gender identity, estrogen therapy individuals may take testosterone or estrogen. According to authorities, changes brought on by hormone therapy, like changes in tone and body hair, happen gradually and are only partially reversible.
According to experts, it’s common for patients to stop receiving hormone therapy after a while and choose they’ve made the desired transition.
Surgery, such as a surgery, for children under the age of 18 is uncommon and only performed on children, according to the American Academy of Pediatrics. One skilled expert told ABC News that while there is some risk involved, it can be a significant source of relief for people who are physically in excruciating pain.
What dangers do gender-affirming treatments have for reproduction? How widespread is repent?
One of the objections raised by conservative lawmakers to gender-affirming health care is that it might make transgender children sterile.
Express Rep. Gary Click stated on the House floor in favor of a gender-affirming treatment restrictions in Ohio,” We also look to fertility as another problem that comes up with this.” Because of these medications and the hormones they are taking, we observe children who are unable to experience the pleasures of sexual later in life.
People who briefly use puberty blockers do not appear to have fertility problems, according to experts.
Hormone therapy does not completely sterilize transgender people, according to Safer, who wrote the Endocrine Society’s rules, but it does lower fertility.
If we’re talking about a transgender boy, so female to male, or someone who has ovaries, testosterone wo n’t make them procreate. That’s actually a part of the objective. However, there is n’t any proof that those ovaries are harmed, according to Safer.
This indicates that it is still possible for transgender kids to become pregnant.
According to Safer,” For trans girls, female to female, if you lower your testosterone levels, that may cut spermatogenesis, which is the growth of the feces, and it will actually reduce fertility.” However, even that is not a guarantee.
Before administering testosterone treatment, doctors should fully inform people about the possibility of reduced fertility, according to the gender-affirming treatment recommendations from the World Professional Association for Transgender Health and the Endocrine Society.
A baby is seen holding the Transgender Pride flag in this document pictures from July 9, 2022, during the pride march in Madrid.
Luis Soto/SOPA Images/LightRocket via Getty Images, FILE
According to Safer, patients receiving both procedures are also advised to exercise caution when engaging in sexual activity due to the ongoing risk of becoming pregnant or causing conception.
Legislators who supported the ban on gender-affirming attention also voiced concerns about potential side effects, such as negative effects on cardiovascular health and bone mass, among others.
According to studies, gender-affirming treatment may have some potential to affect different aspects of a patient’s health.
According to a study published in The Journal of Clinical Endocrinology &, Metabolism, those receiving hormone treatment have been shown to have fewer bone mineral density levels.
According to preliminary JAMA Pediatrics study, hormone therapy may raise cholesterol levels. The American Heart Association’s research, however, found no proof of an increase in cardiovascular risk. Additionally, dental hormone has been shown to raise the risk of blood clotting, according to Thrombosis Research book research.
However, doctors have informed ABC News that all drugs, procedures, and vaccines come with some level of risk. People you make an informed choice by being aware of both the risks and benefits of therapy as well as the consequences of not treating a problem.
Politicians have also expressed worry about individuals who regret receiving gender-affirming maintenance.
We have several teenagers who have begun making this improvement, Click argued. How did people letting me make this decision? they ask themselves as they get older.
Although some people have subsequently “detransitioned” or regretted their attention, medical professionals do not dispute this. But, study indicates that dread costs for gender affirmation surgery are extremely small, hovering around 1 %.
Studies indicate that regret rates for knee and hip surgeries are significantly higher at 17.1 % and 4.8 %, respectively.
Gender-affirming care bans are the exact opposite of that, according to Baker.” That does n’t mean it’s not important to make sure that everyone can get the care they need and that they’re getting it in safe, high quality care environments.
Are methods for gender-affirming treatment “experimental”?
According to doctors and psychologists questioned by ABC News, gender-affirming attention is hardly experimental.
According to new studies published by the American College of Physicians, the first-of-its-kind female care doctor at Johns Hopkins Hospital in Maryland opened in the 1960s and continues to use related procedures immediately.
Gender-affirming attention is safe, effective, useful, and medically necessary, according to a number of major national health organizations, including the American Academy of Pediatrics, America Medical Association, the Americas Association for Child and Adolescent Psychiatry and more than 20 people.
Which states have outlawed gender-affirming medical treatment?
According to the Human Rights Campaign, the following 23 state have limited access to gender-affirming healthcare: Montana, Idaho, North Dakota, South Dakota; Nebraska, Iowa; Utah; Arizona; Texas; Oklahoma; Louisiana; Mississippi; Alabama; Florida; North Carolina; West Virginia; Kentucky; Indiana; Ohio; Arkansas; and Tennessee.
However, a number of states have had their plans thwarted by legal disputes.
Restrictions on transgender maintenance have an impact
The effects of such restrictions on transgender youth’s mental and physical well-being are a concern for some doctors and Transgender advocates.
According to the Centers for Disease Control and Prevention, trans children are more likely to experience stress, sad mood, and suicidal ideation and attempts frequently as a result of gender-related discrimination and gender dysphoria.
According to a recent study published in the New England Journal of Medicine, hormone treatment can enhance the mental wellbeing of transgender children and adolescents.
The 33-year-old Ash Orr of the National Center for Transgender Equality claimed to have personally experienced this progress, describing feeling” trapped in my own physique” and feeling more liberated thanks to gender-affirming treatment.
Orr stated in an interview,” I’ve already noticed such a significant change in my mental health because I am now in the brain that was meant to be mine.” ” I’m content to be in this figure,” she said. Although I know it sounds a little cliche, I’m glad to be able to present myself as more muscular, but for me, having access to female was life-saving.
Mary Kekatos of ABC News contributed to this article.
