On Thursday, two of President Joe Biden’s administration departments released a seemingly coordinated series of documents that endorsed gender reassignment surgery and hormone treatments for children.
The Department of Health and Human Services’ Office of Population Affairs released a two-page document titled, “Gender-Affirming Care and Young People.”
“Gender-affirming care is a supportive form of healthcare. It consists of an array of services that may include medical, surgical, mental health, and non-medical services for transgender and nonbinary people,” the document explained. “For transgender and nonbinary children and adolescents, early gender-affirming care is crucial to overall health and well-being as it allows the child or adolescent to focus on social transitions and can increase their confidence while navigating the healthcare system.”
The document then argued that “gender-affirming care improves the mental health and overall well-being of gender diverse children and adolescents.”
Forms of affirming care listed by the document include “puberty blockers” to “pause pubertal development” (which the department claims to be reversible), “hormone therapy” (which the department claims to be partially reversible), and forms of “gender-affirming surgeries.” These include “top surgery” to “create male-typical chest shape or enhance breasts,” “bottom surgery,” which is “surgery on genitals or reproductive organs,” as well as “facial feminization or other procedures.”
However, as discussed by The Heritage Foundation, “The largest dataset on sex-reassignment procedures — both hormonal and surgical — reveals that such procedures do not bring the promised mental health benefits.”
The Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration’s National Child Traumatic Stress Network (NCTSN) also released a document, titled, “Gender-Affirming Care Is Trauma-Informed Care.”
“Major medical associations recognize gender-affirming care as the standard of care for transgender, gender diverse, and intersex (TGI) youth. Gender-affirming care broadly refers to creating an environment that facilitates youth to move through the world safely as the gender they know themselves to be,” the five-page document begins. “This includes developmentally appropriate, evidence-based care provided by medical and mental health experts in partnership with youth, parents, and caregivers. It may include evidence-based interventions such as puberty blockers and gender-affirming hormones. Gender-affirming care also includes access to opportunities that all children should have, such as playing team sports, safely using bathrooms in their schools and other public places, and positive relationships with supportive adults.”
The NCTSN then asserted that “There is no scientifically sound research showing negative impacts from providing gender-affirming care.”
However, in the correction to the previously-referenced study discussed by The Heritage Foundation, patients who had reassignment surgeries had worse outcomes regarding anxiety disorders than those who did not:
…individuals diagnosed with gender incongruence who had received gender-affirming surgery were more likely to be treated for anxiety disorders compared with individuals diagnosed with gender incongruence who had not received gender-affirming surgery.
Later in the NCTSN document, readers are then directed to “help keep TGI youth safe by expressing your support and acceptance and finding ways to partner with others to create affirming and supportive environments,” with a list of “practical suggestions.” These include:
- Take responsibility for your own knowledge and understanding of gender diversity by staying up-to-date on evidence-based research and best practice, attending trainings, and reading work by transgender and gender diverse writers to understand more about the language and experiences of TGI youth.
- Believe and validate youth when they share their gender identities with you, by always using and validating the names, pronouns, and identities that youth share with you, even if those change while they are exploring their identities.
- Prioritize using resources created by transgender and gender diverse experts by identifying and connecting with transgender and gender diverse providers and organizations- nationally and in your community as partners and trainers.
- Create space for youth to explore the fullness of their gender and other cultural identities without fear of judgment or harm.