The Need for Gender-Affirming Care

Written by Vaishnavi Peyyety, Red & Black Current Events Staff Writer

The Student Health Center provides both physical checkups and counseling for students as well as partnering with Central Outreach to provide STD testing to students on campus. (Courtesy Regan Carlson)

MAR. 21 – The World Health Organization defines gender affirming care as social, behavioral, psychological and medical interventions that support an individual whose gender identity conflicts with their gender assigned at birth. Gender identity can be fluid, ranging from man to woman to a combination of the two to neither according to the American Psychiatric Association (APA). Most transgender children seek out this therapy after thinking about it for a long time and potentially experiencing gender dysphoria, psychological distress due to differences between gender assignment and identity.

A 2017 study out of the University of Minnesota titled “Risk and Protective Factors in the Lives of Transgender/Gender Non-Conforming Adolescents” found that nearly 61 percent of transgender youth in the state reported suicidal ideation. The Minnesota-based Mayo Clinic also reports that gender dysphoric youth experience “pressure to dress in a way that’s associated with their sex assigned at birth” and “accessing health services and mental health services can be difficult due to fear of stigma and a lack of experienced care providers.”

"Gender identity can be fluid, ranging from man to woman to a combination of the two to neither according to the American Psychiatric Association (APA)."

These interventions can include counseling, hormone therapy and/or changes to social expression. As with all sensitive health decisions, medical providers encourage they be made in a safe environment where children can voice concerns, though the most appropriate therapies are determined based on an individual’s physical and psychological development. Counseling can include guidance on how to come out as transgender to family and peers. Healthcare professionals may guide children on hair removal or other resources to modify outward appearances in ways that match gender identity. These interventions are reversible and can be continued until young people are satisfied.

Other interventions may involve biological changes to one’s body. Puberty blockers suppress release of sex hormones for youth that have not completed puberty. This effectively creates a buffer period for youth to determine their gender identity. Additionally, hormone therapy, typically given to older youth, allows development of sex characteristics including body hair or change of pitch in voice that align with their gender identity.

Over the years, several states have debated prohibiting certain gender-affirming treatments such as hormone therapies in youth. Some legislators are considering penalizing healthcare professionals who provide this care. According to legislators, the potential risks of therapies, including infertility and cardiovascular disease, violate child abuse laws and therefore should be stopped.

W&J's Gender and Sexuality Alliance (GSA) meets to educate members on Coming Out Day in October and promotes awareness of issues affecting LGBTQ plus individuals. (Courtesy Regan Carlson)

"Genital removal surgeries, chemical castration, puberty blockers and other sex change therapies [are] child abuse," says Republican state representative Bryan Slaton.

However, several studies actually link a decrease in depression and harmful behaviors with increased access to gender-affirming care. Stanford University School of Medicine found that youth who began hormone therapy in early adolescence experienced a decreased number of mental health struggles and substance use issues compared to those who began therapy later. Moreover, providers are noting the positive effects of this care, including Deanna Adkins, director of the Duke Child and Adolescent Gender Care Clinic in Durham, N.C.

"several studies actually link a decrease in depression and harmful behaviors with increased access to gender-affirming care."

“Most of them are happier, less depressed and less anxious,” Adkins says of children who have undergone gender-affirming care. “Their schoolwork often improves, their safety often improves.”

But Adkins is not the only expert praising the benefits of this care. Jason Rafferty, a pediatrician and child psychiatrist who provides gender-affirming care at the Gender and Sexuality Clinic at Hasbro Children’s Hospital in Providence, R.I. shares his thoughts.

“Saving the lives [of transgender youth] is a big deal...support has to take place within a clinic. It’s not something that can be legislated,” Dr. Rafferty says.

It is clear legislators must think about the repercussions of banning gender affirming care, given how many lives this action could change.