Transgender care discussion should be based on reality
Supporters and opponents of transgender rights rally in front of the Supreme Court on Dec. 4, 2024, in Washington, where arguments were underway in the case of a Tennessee law banning gender-affirming medical care for transgender youth. Credit: AP/Jacquelyn Martin
The 2024 presidential election featured attacks on the care and treatment of transgender individuals, especially minors, lodged largely without any statistical support.
The strategy was effective and others seized on the messaging, using it in statewide and local debates and to support legislative proposals dealing with bathroom use, sports and medical care.
Thanks to a new study from Harvard University and FOLX Health, we now have a clearer picture of the actual situation, particularly when it comes to transgender children and teens.
A research letter published this week in JAMA Pediatrics found that less than 0.1% of adolescents — fewer than 1 in 1,000 — have received medical care related to gender transitioning, including puberty blockers and hormone treatments.
The researchers analyzed private insurance claims for more than 5 million adolescents, ages 8 to 17, and found that fewer than 18,000 of those young individuals had received a medical diagnosis of gender dysphoria. Among them, fewer than 1,000 accessed puberty blockers and fewer than 2,000 accessed hormones. No patient under the age of 12 was prescribed hormones, according to the research. Previous studies have found that surgeries, too, are extremely rare.
The percentage of teens who identify as transgender is far higher — about 3% of high school students, according to the Centers for Disease Control and Prevention, but many of them may express their gender identity in different ways, sometimes changing their dress, appearance, pronouns or names, without undergoing medical procedures.
Nonetheless, the issue of gender-affirming care for minors has morphed into a widespread issue in state houses across the country. The Supreme Court heard oral arguments last month regarding a Tennessee ban on gender-affirming care for transgender youth; its decision could reverberate, as 26 states have established similar bans or restrictions.
This is a complex issue, one that requires a more dispassionate discussion that recognizes the real concerns regarding our teens' mental health and their crucial efforts at self-discovery, while also addressing legitimate questions over the roles of school personnel and parental rights.
It's important that we get this right. Efforts to target transgender youth can have dangerous repercussions, even for the many teens who aren't undergoing surgery or taking medications. A study by The Trevor Project, an organization focused on the needs of LGBTQ+ youth, showed causation between state legislation targeting transgender individuals, whether regarding care, sports or other issues, and an increase in suicide attempts among transgender and nonbinary youth — in those states, the likelihood of a suicide attempt was 72% higher in the years after such a law took effect than before it was passed.
"I hope that our paper cools heads on this issue and ensures that the public is getting a true sense of the number of people who are accessing this care," Harvard University public health researcher Landon Hughes, the report's author, told The Associated Press.
Ideally, the research could serve as the starting point for a serious, thoughtful conversation, grounded in reality, so public officials can begin making policy decisions guided by facts, rather than fervor.
Only then will our vulnerable youth and teens be truly supported and embraced, rather than targeted and vilified.
Columnist Randi F. Marshall's opinions are her own.
Randi Marshall is a member of the Newsday editorial board.
