On Thursday, Dr. Kade Goepferd, the founder of the Children's Minnesota Gender Health Program, expressed his deep sadness and frustration as the Trump administration announced plans to ban gender-affirming care for transgender youth. Goepferd emphasized that the medical community continues to support the evidence backing gender-affirming care, indicating that the government's actions lack a scientific basis and seem to be driven by a campaign of propaganda targeting a vulnerable population.
During the announcement, federal health officials claimed their actions were based on science and evidence, distancing their approach from politics or ideology. They referenced a report from the Department of Health and Human Services published in November, which criticized clinicians for failing their patients and advocated for psychotherapy as a viable alternative. Acting CDC Director Jim O'Neill went as far as to assert that the distinctions between genders are absolute, stating, “Men are men. Women are women,” which has raised concerns about the implications of such statements on societal understanding of gender identity.
In stark contrast, the American Academy of Pediatrics (AAP), representing over 67,000 pediatricians, rebuked these claims. President Dr. Susan J. Kressly emphasized that the proposed policies misrepresent the current medical consensus, stating that they do not address the healthcare needs of children and families and only serve to stigmatize an already marginalized group. The AAP maintains that gender-affirming care is both safe and effective for those in need, a position also supported by the American Medical Association and the Endocrine Society.
The American Psychological Association has voiced its apprehensions regarding the federal actions, stating that they undermine scientific understanding of gender identity and could jeopardize the psychological health and rights of transgender and nonbinary individuals. A significant aspect of the proposed regulations from the HHS would involve withholding Medicare and Medicaid funding from hospitals providing gender-affirming care to individuals under 18, a move described by the Children's Hospital Association as a dangerous precedent that could restrict access to essential health services for millions of families.
Following a 60-day comment period, these regulations could be finalized, prompting legal battles from various states. Attorneys General from New York and California have pledged to challenge these rules, affirming their commitment to protecting the rights of transgender individuals to access necessary healthcare. The ACLU has also announced plans to initiate lawsuits, suggesting that more legal challenges are imminent.
A recent CDC survey indicates that around 3% of teenagers aged 13-17 identify as transgender, amounting to approximately 700,000 individuals in the U.S. However, a poll from the KFF health research organization revealed that less than a third of transgender individuals have sought medication related to their identity, and only 16% have undergone surgery. For many young people, medical interventions typically include puberty blockers and hormone therapies, while surgical procedures remain exceedingly rare for minors.
Dr. Goepferd highlighted the personalized nature of gender-affirming healthcare, which evolves over time and is tailored to the specific needs of each patient. A 15-year-old transgender boy from California shared his experience with NPR, expressing concern over the government's perception that his feelings might merely be a phase. He articulated the profound impact of not receiving gender-affirming care, stating that the decision to delay such treatment can feel as permanent as starting it. After six months on testosterone, he feels more aligned with his identity, yet fears losing access to his medication due to the proposed federal restrictions.
Since 2021, over half of U.S. states have enacted laws banning gender-affirming care for minors, driven largely by Republican-led initiatives. Recently, House Republicans have attempted to pass two federal bills aimed at further restricting access to such care, including severe penalties for healthcare providers. While the future of these bills in the Senate remains uncertain, the ongoing national discourse has left doctors and health systems in states where gender-affirming care is still legal bracing for potential closures and additional obstacles in providing necessary care.