A invoice filed final week would bar medical professionals from offering hormones or conducting medical procedures that facilitate a “minor’s need to current or seem in a fashion that’s inconsistent with the minor’s intercourse.”
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Last week, a group of N.C. Republicans filed a bill that would ban gender-affirming care for transgender kids.
If signed into law, the legislation would make it illegal for doctors to provide hormone treatments, puberty blockers or any other procedure that facilitates a “minor’s desire to present or appear in a manner that is inconsistent with the minor’s sex.”
The bill carries a $1,000 fine and a license revocation for doctors who provide this care for people younger than 18.
Medical experts in this field say this bill departs from consensus in the medical community about the benefits of gender-affirming care for minors.
Here is what we know about gender-affirming care:
Gender affirming care is based on large body of research
Transgender children seeking treatment are typically offered a number of options — both medical and therapy based — that are rooted in rigorous scientific research.
Children who have not yet hit puberty are not usually prescribed any medications. Instead their treatment largely centers around strategies to ease their social transition and present themselves in ways that improve their mental health, said Dr. Deanna Adkins, a Duke pediatric endocrinologist.
Once they hit puberty or have completed puberty, Adkins said they could be eligible for gender-affirming hormone treatment.
A small percentage of her patients, about 1.7%, may qualify for medications that delay puberty if they are at high risk for self-harm. Adkins said this delay is “completely reversible.”
Transgender patients may also choose to undergo gender-affirming surgeries, like facial reconstructive surgery, surgery to remove breast tissue or surgery to transform genitalia. These procedures are typically done on adult patients, not children, Adkins said.
“We have a very rigorous process of assessment both with the child, the parents as well as their mental health provider,” Adkins said, “before we would consider moving ahead with that treatment or any gender-affirming hormone treatment.”
She said gender-affirming care can be life-saving, due to the high rates of self-harm and suicide in transgender kids.
The country’s largest medical organizations, including the American Academy of Pediatrics, the American Medical Association, and the Endocrine Society have emphasized the importance of this treatment for the health and safety of LGBTQ youth.
This guidance is based on a large body of research that shows this care supports healthy relationships with parents and peers, reduces depression and anxiety, and prevents harmful self-prescribed hormones.
“Every major medical association in the United States recognizes the medical necessity of transition-related care for improving the physical and mental health of transgender people,” the CEO of the American Medical Association wrote.
Adkins said the law proposed last week not only puts LGBTQ kids at risk, but also infringes on her ability to provide the best care to her patients.
“You wouldn’t ask me to not do what the American Diabetes Association recommends is the best care for my patients with diabetes,” she said. “I don’t think it’s right that you’re asking me to do that for my transgender patients.”
Potential impacts of limiting access to care
Recent surveys have found alarming rates of mental health challenges among transgender youth, Adkins said.
Two-thirds reported symptoms of major depression. Sixty percent reported that they engaged in self-harm. One in five said they attempted suicide in the last year.
The best tool medical professionals have to combat this distress is offering gender-affirming care like hormone therapy.
One study that followed 104 transgender kids found that those who had access to gender-affirming care were 60% less likely to report depression and 73% less likely to consider suicide.
Dane Whicker, a Duke psychologist who specializes in conducting therapy for LGBTQ+ adolescents, said he worries a broad bill like the one proposed could prevent adults from receiving timely care as well.
He said the language in the bill would block him from talking about and planning gender-affirming procedures after the patient turns 18, potentially delaying the transition.
“That causes immense distress because it increases gender dysphoria,” he said.
Teddy Rosenbluth covers science and health care for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.
This story was initially revealed February 9, 2023, 9:30 AM.
Teddy Rosenbluth covers science for The Information & Observer ready funded by Duke Well being and the Burroughs Wellcome Fund. She has coated science and well being look after Los Angeles Journal, the Santa Monica Each day Press, and the Harmony Monitor. Her investigative reporting has introduced her all over the place from the streets of Los Angeles to the hospitals of New Delhi. She graduated from UCLA with a bachelor’s diploma in psychobiology.