What To Know About Gender-Affirming Care

People who create barriers and laws that restrict care, education, and extracurricular activities to transgender children are trying to remove them from society—not protect them. Gender-affirming care is safe and saves lives.

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Bills continue to be introduced that are intended to classify gender-affirming care as child abuse and would put parents of transgender children at risk for serving a lifetime prison sentence if found guilty. Threats to parents and transgender children are coming from several states while other states have either restricted care or made it a felony to provide medical and mental health care. No status or celebrity is immune either. Dwane Wade’s ex-wife filed a lawsuit against him to stop their daughter from legally changing her gender and name. 

She, like so many other willfully ill-informed people, have created false scenarios to scare those who don’t understand what gender-affirming care is. While parents and politicians say they are trying to protect children, what they are doing is creating mass hysteria around a threat that doesn’t exist. Policies are passed that do more harm than the good they promote. 

The people who create barriers and laws that restrict care, education, and extracurricular activities to transgender children are trying to remove transgender children from society—either because they don’t believe transgender people are real or because they acknowledge that we are and don’t want us to thrive. 

What Is Gender-Affirming Care?

The phrase gender-affirming care is often used to describe the compassion and medical needs nonbinary and transgender folks need to live their most authentic and successful lives. However, gender is something most of us have and identify with. In that gender identity is the desire to express ourselves through clothing, pronouns, hair, and names or nicknames. 

Sam Ames, Trevor Project's director of advocacy and government affairs, explains it this way: “Gender-affirming care is a broad term that encompasses a range of social, psychological, behavioral, and medical interventions designed to support and affirm an individual as they explore their gender identity.” 

For example, on the way to school today my son expressed how good he felt in his blue hoodie. After a run-in with homemade slime it had been in the wash and he had been without it for a few days. “The stain is my favorite color and I just feel like me again,” he said from the backseat. 

The slime is gone but a deep purple mark was left in its place. My son’s hair touches his shoulders and is often in his eyes. His pants are always some sort of athletic gear. And his stained hoodie is his go-to comfort and jacket until it gets below zero. All kids experience—or should be allowed to—this sense of affirmed gender identity and expression. 

I affirm him by letting him be his most comfortable self and that includes calling him by a shortened version of his birth name. My son is cisgender, but I offer the same care and consideration to my transgender child too. 

I would never tell my cis son to be a girl when he is not, nor would I tell my trans daughter or any other child to be a gender they know they are not.

Gender-affirming care for transgender youth is not about surgery.

For nonbinary and transgender kids, affirming their gender can be done through social means (hair, makeup, names, clothing), legal changes (correcting a name or gender marker on a birth certificate or drivers license), and medical assistance (puberty blockers or hormone therapy).

It’s best to follow a child’s lead when it comes to expressing a gender identity different from the one they were assigned at birth. When they show signs of exploration, let them—especially when they are consistent, persistent, and insistent about not being the gender you assume them to be. 

Supportive caregivers will seek guidance from trans-competent doctors, therapists, and other medical professionals who are also able to support a gender diverse or transgender child. In some cases medical intervention is not only desired, but necessary for the health of the child. 

Puberty blockers are one of the most productive, safe, and reversible forms of gender-affirming care that many transgender children need. Cisgender children are also offered this form of affirming care when they experience precocious puberty. The results are the same: happier kids who are allowed to live in a body they accept and love while avoiding ostracization from peers. 

As transgender kids get older, they may want to take hormones that will push their bodies into a puberty that aligns with their gender identity. 

Underage children are not having surgeries, nor would a medical professional perform the surgeries people claim are being forced onto children. 

Sadly, intersex children are still subjected to genital and reproductive surgeries without their consent in order to force them into a gender box. And while it’s not uncommon for teenage, cisgender males to have gender affirming surgery when they have a condition called gynecomastia, transgender males are not given the same respect or clearance to have their breast tissue removed for the same reasons. 

Are There Risks to Medical Gender-Affirming Care?

Like any medical treatment, medical affirming care can have potential side effects. “However, every case is different and the people who are best equipped to make these highly individual medical decisions are patients, their families, and their doctors,” says Ames.

Jamie Bruesehoff, writer, advocate, and parent to a 15-year-old transgender daughter, echos this. “My child works with her father and myself and an entire team of healthcare professionals to ensure she's making the medically-necessary, evidence-based health care decisions that are most appropriate for her as an individual. There are so many layers of support; I can't imagine a more thorough system.”

Health care choices are difficult and shouldn’t be left to politicians or religious beliefs. Access to safe and reversible puberty blockers and then hormone therapy not only improves a child’s mental health, education, and overall quality of life but can sometimes eliminate the need or desire to have any other type of medical or surgical intervention when a transgender child reaches adulthood. 

“The blanket bans we’re seeing introduced in states across the U.S. don’t prevent irreversible changes—they prohibit the very medications that could allow trans youth to delay permanent decisions until they and their families feel they’re old enough to make them,” says Ames. 

Studies have also shown that transgender youth who access gender-affirming care go on to continue to this care into adulthood. 

What Are the Risks of Denying Medical Affirming Care?

“Research has found that gender-affirming care, such as hormone therapy, is associated with positive mental health outcomes—including showing promise for reducing suicide risk,” says Ames.

 The Trevor Project, which focuses on suicide prevention amoung LGBTQIA+ youth, published research in January 2020 that reviewed the empirical evidence on psychosocial outcomes related to gender affirming care for youth. The results showed that access to transgender medical care has improved mental health and reduced risk of self-harm and suicide. 

 In December 2021, The Trevor Project published the first large-scale study to examine gender-affirming hormone therapy among a sample of more than 9,000 transgender and nonbinary youth. Again, the results showed that access to gender-affirming hormone therapy was directly related to lower rates of self-harm, depression, and suicide attempts and ideation. 

“Denying young people from receiving this type of best-practice medical care could mean stripping them of a potentially life-saving intervention,” says Ames.

Bruesehoff can’t overstate the risks of denying medical care. “My 15-year-old is able to be who she is and live the life she does because she's had access to the evidence-based medical care she requires. She is an honors student who contributes to her school and local community in a million different ways—theater, student government, field hockey, and more. She can do that because she's thriving, and she's thriving because she's had access to the appropriate medical care.” 

When we deny medical care to children, we are setting them up for preventable struggles while also taking away their chance to feel better. This is true for transgender kids too who are simply trying to live as their true selves. No human should be forced to live a life within parameters someone else decides is best for them when those parameters are based on social constructs and myths. 

What Can Parents and Allies Do to Help Transgender Kids?

One of the most important steps caregivers and allies can do is to listen to transgender people and kids. And then educate yourselves about transgender and nonbinary topics and experiences without asking transgender youth you know to do that work for you. While there are amazing transgender youth activists who are happy to help you on your educational journey, don’t make the assumption that the transgender youth in your life are willing or able to adequately do that work for you. The Trevor Project offers a guide to being an ally to transgender and nonbinary youth

Your local library or Pride center and online resources like Human Rights Campaign and The National Center for Transgender Equality are all great places to find the information you need to learn and support transgender youth. 

It’s also important to acknowledge that you may not have all of the answers, but you're willing to learn while providing unconditional love.

How Do We Stop Bills That Target Transgender Youth and Their Families?

 Show up at school board meetings. Get to know your state representatives and call legislators to let them know you support transgender and nonbinary youth. Vote for people who support transgender youth and their access to care. Ames adds, “Connect with the organizers in your state who are fighting these anti-trans laws every day—even when they are not making headlines.”

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