In February, President Donald Trump issued an executive order prohibiting the provision of gender-affirming care to youth. The order has since been paused by federal courts.
There are a lot of myths and misconceptions when it comes to gender-affirming care for youth. The youth that receive this type of healthcare have self-identified as a gender different from the one they were assigned based on the appearance of their genitals at birth. For many children, this incongruence between their biological sex and the way they perceive their own gender can cause serious distress.
In this case, parents and caregivers may bring their child to see a gender specialist. First, the child will receive supportive mental healthcare. They may make changes in how they dress or style their hair, and choose a name and pronouns that better suit them. Until puberty, that is the extent of transition.
Once they begin puberty, youth who identify as transgender may decide, with their parents and doctors, to begin puberty blocking drugs. This is where the myths start. Opponents of gender-affirming care for youth will tell you that puberty blockers are dangerous and permanent. This is simply untrue. Puberty blocking drugs have been used since at least the 80s for various medical conditions in children, and are considered safe and reversible under medical supervision.
Children using puberty blockers may stop their use at any time to resume puberty and develop as their biological sex would dictate. They may also choose to take them until age 16, at which point they may be given gender affirming hormones to begin developing the secondary sex characteristics in line with their gender identities.
To be extremely clear: In the state of Connecticut, minors legally cannot undergo gender-affirming surgeries, like breast removal or vaginoplasty. Nationally, teens only very rarely undergo chest surgeries and only in very extenuating circumstances; a review by Harvard in 2019 found that no surgeries were performed in the U.S. on children under age 12. These surgeries are reserved for adults, and even among trans adults, most do not pursue surgery of any kind (in large part due to cost).
Here’s the thing about gender affirming care for youth: it makes them less likely to experience suicidal ideation or attempt suicide. It makes them feel more comfortable in their bodies. It is considered best practice by all major medical authorities. The benefits continue into adulthood.
Adults who received gender-affirming care as youth have better mental health outcomes than adults who did not. And, by the way, the regret rate for medical transition is less than 1%. Compare that to the rate of regret for knee replacement surgery (10%) or the rate of nose job regret ( 15%).
My point in all this is that youth gender-affirming care involves a relatively small amount of medical intervention and a lot of mental and social support. It leads to a significant reduction in suicidality and other mental distress.
The idea of banning it is not rooted in science, but discomfort with diversity. The moral panic about “saving the children” is simply a cover for intolerance. Laws should be based on evidence and outcomes – not on how we personally feel or moral judgments.
Kim Adamski is a sex educator in West Hartford.