Countering the Mischaracterization of Trans Healthcare
A recent study published in JAMA Pediatrics reveals an important yet often overlooked fact about transgender healthcare in the United States: a “very, very small number” of teens receive gender-affirming medical care. This finding underscores the reality that much of the rhetoric surrounding transgender youth is rooted not in evidence but in sensationalism. Despite claims to the contrary, doctors and mental health professionals who follow the World Professional Association for Transgender Health (WPATH) standards are not “grooming” children. Instead, they are providing thoughtful, evidence-based care that often involves slowing down the decision-making process and exploring various options.
What the Study Tells Us
The study, which analyzed private insurance claims for over 5 million adolescents from 2018 to 2022, found that fewer than 18,000 teens were diagnosed with gender dysphoria during this period. Even more strikingly, fewer than 1,000 accessed puberty blockers, and fewer than 2,000 received hormone therapy. In total, this represents less than 0.1% of teenagers with private insurance.
These numbers stand in stark contrast to the political narrative that frames gender-affirming care as a widespread and reckless phenomenon. Instead, the data reveals that such care is exceedingly rare and highly specialized. Moreover, many transgender youth do not pursue medical interventions at all, opting instead for non-medical changes like adopting a new name or altering their clothing and hairstyle.
A Thoughtful and Cautious Process
The standards of care set forth by WPATH emphasize a thorough, patient-centered approach to gender-affirming care. This process often begins with mental health evaluations and discussions aimed at helping young people explore their gender identity in a safe and supportive environment. Puberty blockers, for instance, are reversible treatments that give adolescents more time to consider their options before making permanent decisions.
Contrary to the inflammatory claims of critics, these interventions are not rushed or taken lightly. Decisions about puberty blockers and hormones are typically made after careful consideration, involving not just the patient but also their family and healthcare team. This aligns with WPATH guidelines, which prioritize the well-being of the individual and recommend age-appropriate care based on robust scientific evidence.
Mischaracterizing Trans Healthcare
Despite the thoughtful nature of gender-affirming care, it has been severely mischaracterized in public discourse. Opponents often portray it as experimental or dangerous, ignoring endorsements from major medical organizations like the American Academy of Pediatrics and the American Medical Association. These groups recognize that access to gender-affirming care can significantly improve mental health outcomes for transgender youth, including reducing rates of depression, anxiety, and suicidal ideation.
The political weaponization of trans healthcare has also led to widespread misinformation. For example, opponents frequently conflate gender-affirming care with irreversible surgeries on minors—a practice that is exceedingly rare and not recommended under WPATH standards for adolescents. Instead, the focus is on non-invasive or reversible treatments designed to provide support during a critical developmental period.
The Disproportionate Focus on Trans Youth
The study’s findings also highlight the disproportionate attention given to transgender youth in political and media discourse. While fewer than 0.1% of teens with private insurance receive gender-related medical care, this small group has become the target of legislative efforts in half of U.S. states. These efforts often ignore the lived experiences of transgender individuals and the consensus of medical professionals in favor of divisive political messaging.
This focus is not only unwarranted but also harmful. Transgender youth already face significant challenges, including higher rates of bullying, discrimination, and mental health struggles. The stigmatization of gender-affirming care exacerbates these issues, creating barriers to accessing supportive and life-affirming treatment.
Slowing Down to Support
Far from “pushing” children into irreversible decisions, providers who adhere to WPATH standards often help young people slow down and consider their options. This approach reflects the core principles of medical ethics: autonomy, beneficence, non-maleficence, and justice. By creating a space for open dialogue and careful deliberation, healthcare professionals empower patients and their families to make informed decisions based on their unique needs and circumstances.
Moreover, delaying or banning access to gender-affirming care does not eliminate the need for support—it merely shifts the burden onto already vulnerable populations. Denying care increases the risk of negative mental health outcomes, as individuals are forced to navigate their identities without the tools and resources they need to thrive.
The Path Forward
As debates about transgender healthcare continue, it is essential to center evidence and compassion over fear and misinformation. The findings from the JAMA Pediatrics study remind us that gender-affirming care is not a widespread or reckless practice—it is a rare, carefully considered intervention that helps young people navigate their identities with dignity and support.
Rather than demonizing healthcare providers and transgender youth, policymakers and the public should strive to understand the realities of gender-affirming care. This means listening to medical experts, uplifting the voices of transgender individuals, and rejecting the harmful narratives that misrepresent their experiences.
By doing so, we can move toward a more inclusive and compassionate society—one that recognizes the humanity of all its members and ensures that everyone has access to the care they need to live authentically.
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:), Susan Reimers, JD/LICSW
TRANSCENDENT MENTAL HEALTH 