07-05-2025
Medical Experts Continue to Support Gender-Affirming Care for Trans Youth
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A new report from the U.S. Department of Health and Human Services (HHS) advises against gender-affirming care for trans youth.
However, the American Academy of Pediatrics (AAP) and other medical experts and organization continue to support gender-affirming care, emphasizing its role in the mental health and wellbeing of trans children and teens.
Evidence continues to show that gender-affirming care and supportive environments can help reduce rates of depression, anxiety, and suicidal ideation in trans youth.
The U.S. Department of Health and Human Services (HHS) recently released a review about gender dysphoria and gender-affirming care for youth in America. The review was written following President Trump's executive order that calls on the federal government to stop supporting gender transitioning for children under the age of 19.
It's important to note that major medical organizations in the U.S. continue to support gender-affirming care for minors, including the Academy of American Pediatrics (AAP), who released a statement saying they are 'deeply concerned' about this report and the impacts it may have on transgender kids.
Here, we'll take a closer look at this report, and what these policies mean for trans and gender-nonconforming kids and their families.
What Does This Statement Mean for Families?
The HHS explainer is a 409 page review titled 'Treatment for Pediatric Gender Dysphoria.' In a press release, HHS said the reviewers found the benefits of gender-affirming medical care for minors to be 'very weak' and that some gender affirming medical interventions posed 'significant risks' to children.
The Academy of American Pediatrics (AAP) questioned the integrity of the report and its conclusions in their recent statement. 'This report misrepresents the current medical consensus and fails to reflect the realities of pediatric care,' Susan Kressly, MD, president of the AAP, commented. 'AAP was not consulted in the development of this report, yet our policy and intentions behind our recommendations were cited throughout in inaccurate and misleading ways.'
Molly O'Shea, MD, a pediatrician with Birmingham Pediatrics + Wellness Center, who treats trans kids, shared that even though the report was described as evidenced-based by HHS, over 2,000 studies were screened for inclusion in the report, but 99% were rejected from consideration.
Dr. O'Shea emphasizes that the majority of pediatric and adolescent physicians across the world continue to support gender-affirming care for youth. 'The report's recommendations are based on a tiny sliver of the peer-reviewed literature in the field and as a result does a disservice to transgender children, their families, and the physicians who care for them,' she says.
Understanding Gender Dysphoria
The main topic of the HHS report is gender dysphoria, how it impacts youth, and what should be done about it. It's important to know that gender dysphoria is often misunderstood.
Gender dysphoria refers to the distress some individuals experience when their gender identity doesn't match their body or how others perceive them, explains Rebecca Minor, LICSW, gender specialist and author of Raising Trans Kids: What to Expect When You Weren't Expecting This. 'It's not the same thing as being trans—plenty of trans people don't experience dysphoria all the time—but for those who do, it can be intense and debilitating, especially during puberty,' she describes.
Importantly, gender dysphoria is not a mental illness or a sign that something is wrong. 'The distress doesn't come from being trans, but from being misunderstood, misgendered, or prevented from living as oneself,' Minor says. 'When kids are supported in expressing their gender and accessing appropriate care, dysphoria can significantly lessen—and in some cases, completely resolve.'
What Is Gender-Affirming Care?
Gender-affirming care is a broad umbrella term, and there's no one-size-fits-all, says Minor. Moreover, it typically begins with non-medical interventions, and doesn't necessarily ever include medical interventions at all. 'For kids and teens, it often starts with things like using the right name and pronouns, making social changes like clothing and hairstyle, and accessing affirming mental health support,' Minor describes.
If medical care is part of a gender-affirming care plan, it's typically introduced in a very careful and gradual manner, usually in collaboration with mental health providers, endocrinologists, and families, Minor emphasizes. 'In reality, gender-affirming care is thoughtful, thorough, and rooted in what's best for each individual,' she says.
Medical interventions aren't offered to young trans children, but may be offered closer to puberty. 'For adolescents, puberty blockers (which are known to be reversible) may be offered or necessary,' says Prerna Menon, LCSW, a queer psychotherapist at Boundless Therapy, who works with LGBTQ+ teens. Later, hormone replacement therapy may be offered to older teens or young adults. Surgery is rarely—if ever—part of a gender-affirming care plan for a minor, Menon says.
'The narrative that minors are undergoing routine surgery is a myth,' Menon says. 'Such procedures are wholly rare before adulthood and should only be done after extensive medical and psychological evaluation.'
What Doctors and Therapists Say About Gender-Affirming Care for Trans and Non-Binary Youth
Doctors and therapists who treat trans and non-binary youth know first-hand how impactful gender-affirming care can be.
Gender-affirming care can change lives, says Minor. 'I've seen kids go from anxious, withdrawn, and depressed to vibrant, engaged, and hopeful—just because they were finally given the space to be themselves,' she describes. 'For many of my clients, it's not about 'becoming' someone else—it's about shedding layers of shame, fear, or silence.
Dr. O'Shea agrees. 'I have a non-binary adult child and have cared for many transgender youth over the years,' says Dr. O'Shea. She says that when children receive care from a gender-affirming doctor, their life journey is much easier to navigate. Gender-affirming care is all about creating a loving, supporting environment that allows the child or teen to be their authentic self.
The positive impacts of this care can't be understated. 'Affirming who they are and supporting their journey, wherever it leads, with all the available support will ensure the best possible outcome,' says Dr. O'Shea.
How Gender-Affirming Care Supports the Mental Health of Trans People
Not only can gender-affirming care change lives, it can save them. 'Clients of mine have repeatedly stated that gender-affirming care saved their life,' says Rachel D. Miller, PhD, LMFT, founder at Hold The Vision Therapy and a therapist who works with transgender youth.
Consider the mental health impacts of untreated gender dysphoria. Gender dysphoria can create significant distress for kids who experience it. 'The distress can manifest as anxiety, depression, low self-worth, and suicidal ideation and impact their school, social, and home lives,' Dr. Miller describes.
Here's where the power of gender affirming care can be felt. As Trevor Project's 2023 Survey on the Mental Health of LBGTQ youth found, trans and non-binary youth who lived with people who affirmed them and respected their pronouns had lower rates of attempted suicide. Additionally, trans and non-binary youth who went to schools they described as gender-affirming had lower rates of attempted suicide.
Common Misconceptions About Trans Teens
One takeaway these experts want to impart is that there are a lot of myths out there about gender affirming care and trans teens in general.
'A primary misconception I see is that trans teens are being urged into irreversible medical choices,' says Menon. 'In the healthcare community I am in, and in my state of New York, this simply is not how the process works.' Evaluations of trans and non-binary youth are comprehensive and thorough, and there are multiple assessments made before any medical inventions happen, she says.
Dr. Miller says that another myth—and one shared in the HHS report—is that mental health providers are underutilized for trans and non-binary youth, and that therapy isn't an integral part of the medical decisions made for trans kids.
On the contrary, 'mental health professionals are typically the gatekeepers of medical interventions,' says Dr. Miller. 'Medical interventions, again when used, traditionally come after mental health assessments and psychotherapy for the child individually and with their family prior to any decisions about medical options.'
Lastly, there's a myth that being trans or non-binary is simply a cultural trend—one that scores of young people seem to be "latching onto." But this is untrue. 'One of the most dangerous misconceptions is that being trans is trendy, a phase, or the result of confusion or mental illness,' Minor says.
Minor wants families to know that being trans isn't a trend, and that trans kids should continue to be affirmed and cared for by experts with experience treating them. 'Being trans is simply one way of being human—and when teens are affirmed in their identities, we see improved mental health, not worse,' she says.
Read the original article on Parents
