A wave of misinformation about health care for transgender and gender-diverse young people is circulating in the news and on social media. It uses inflammatory language to cause fear and create controversy. It is designed to make headlines. It is not rooted in truth.
At the center of all this is a group of children, trans and gender-diverse children, who have the same rights as all other children to get their health care needs met. Here are six important things you need to know about essential health care for transgender and gender-diverse youth.
Gender health care is not new.
The first gender clinic in the United States opened more than 50 years ago at Johns Hopkins Hospital, and the first pediatric multispecialty clinic was established at Boston Children’s nearly 20 years ago. Today’s medications and interventions are largely the same as they were decades ago, and they still adhere to care guidelines set by both the Pediatric Endocrine Society and the World Professional Association for Transgender Health.
Gender health care is not experimental.
Health care for transgender youth is backed by decades of research and follows clinical guidelines and protocols. Major medical associations support this care, ensuring it is safe and evidence based. Engaging in gender health care is a thoughtful, lengthy process that includes parents, patients and their clinical care teams.
At the Children’s Minnesota Gender Health program, the care we provide is based in peer-reviewed research and is backed by every major medical and mental health organization in the United States. We take a slow, conservative, methodical and developmentally appropriate approach to our care that integrates mental health care and medical care.
Parents are involved every step of the way.
Parents know best how to protect and support their kids. They play a primary role in their child’s gender health care. Nothing happens without their support and consent. Our Gender Health program is a safe and accepting space for parents and kids to ask questions, seek support and access evidence-based mental health and medical care. Parents are an indispensable part of a holistic care team that includes mental health providers and medical doctors. We’re all working for the same goal: optimal mental and physical health for children and teenagers.
Gender health care is individualized and age appropriate.
Contrary to myths you may have heard, surgery is not a part of the care we provide at Children’s Minnesota and is never part of gender health care for young children and young adolescents. It’s important to understand the facts about the basics of gender health care, while understanding this care is individualized for each patient and family. Over half of the patients in our Gender Health program do not take any medications and most families come to us seeking resources, information and support.
Before puberty
For children who have not yet reached puberty, no medical interventions are needed or available. Visits focus on educating parents about their child’s gender exploration and ensuring that the child has a safe and supportive environment at home and at school.
Onset of puberty
Some transgender adolescents don’t feel distressed by changes in their body and don’t need to consider medical intervention. Those who do experience distress or dysphoria about changes during puberty may consider using reversible medical interventions that pause puberty. These medications are safe and have been used for decades. They are also the same medications we use to treat children who are not transgender but who have conditions like precocious puberty.
Older adolescents
For young people who are in mid to late adolescence, gender-affirming hormone treatment may be appropriate. These treatments are partially reversible and slowly create changes in the body to align pubertal changes with the patient’s gender identity. Whether to move forward with this treatment is a decision made with careful consideration by patients and their parents, with the guidance of medical gender health experts and mental health professionals.
Medical interventions are well studied and reversible.
Medications used to pause puberty are reversible and do not have long-term negative side effects on physical health, including bone density. Decades of research show that after pausing puberty, bones will mineralize and harden at the same rate as someone not using this treatment. Just as with puberty for all adolescents, some pubertal changes induced by hormones aligned with an older adolescent’s gender identity are reversible and some are irreversible. As with all medications, the risks and benefits are explained at length to patients and their parents prior to making decisions. Patients receiving either puberty suppression or pubertal hormones are monitored closely while in treatment.
Not only does hormone therapy not harm physical health, but it can also improve a patient’s mental health. When transgender and gender-diverse young people have timely access to medical care during adolescence, their chances of feeling severe psychological distress are greatly reduced.
Gender health care is life-saving care.
It is not an overstatement to say that gender health care is life-saving care. When transgender and gender-diverse young people have access to gender health care, they are less likely to attempt suicide.
Just like any child with a specific health care need, transgender and gender-diverse young people deserve health care tailored for their needs. They, and their families, deserve a safe and accepting place to have their questions answered by gender health experts.
That’s why it’s crucial that we don’t stay silent in the face of misinformation. That we continue to speak up and provide accurate information so transgender and gender-diverse youth can receive the care and support they deserve.
Dr. Kade Goepferd, (they/them)
Chief education officer and pediatrician in the Gender Health program
Dr. Kade Goepferd, (they/them), is a pediatrician, chief education officer and founder of the Gender Health program at Children’s Minnesota. Dr. Goepferd is an advocate for advancing equitable health care for all children – including trans and gender-diverse youth. They have been named a Top Doctor by both Minneapolis/St. Paul Magazine and Minnesota Monthly for the last several years and gave their first TED talk, “The Revolutionary Truth about Kids and Gender Identity” at TEDx Minneapolis in 2020.
