LAWMAKERS IN more than half a dozen states are considering ways to block medical treatment for transgender teenagers. They cast their efforts as a crusade against forced sterilization, “mutilation” and child abuse. Yet the greatest harm to these adolescents may come from the rules purported to protect them.
South Dakota’s Republican-supermajority House of Representatives recently passed a bill that would ban medical professionals from providing hormones or gender confirmation surgery to children younger than 16, with a penalty of one year’s jail time and a fine as high as $2,000. Legislators in Florida, South Carolina, Colorado, Missouri, Oklahoma and Kentucky have filed similar proposals. Missouri’s bill would report consenting parents to child welfare officials.
The aim, supporters of these bills say, is to shield youths from making “life-altering changes” — from doing something irreversible, when there’s still a chance those experiencing gender dysphoria might change their minds. Those arguments would be more convincing if advocates weren’t pushing for something irreversible themselves. The initial medical step for a transgender adolescent, after parental consent and extensive counseling, is usually to take hormone blockers. These blockers give those on the cusp of puberty the opportunity to hit pause before estrogen or testosterone transforms their bodies.
This reprieve is helpful to those who end up transitioning. They never have to live in an adult body that clashes with their identity, and any further treatment may not need to be as extensive — which helps explain why research suggests puberty suppression results in better mental-health outcomes for patients. The pause is also helpful to those who ultimately decide against a change. In fact, blockers give children exactly what these lawmakers claim to be offering: a chance to wait until they’re older.
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The options that await transgender individuals, of course, can’t be turned back just by clicking the play button again, as with blockers. Further hormone therapy for those who wish to pursue a transition can make a female body more masculine or a male body more feminine — a process that experts classify as “partially reversible,” because some effects, such as hair growth, can be reversed while others, such as breast growth or voice-deepening, can’t so easily. Then there’s gender confirmation surgery itself, from mastectomies to genital reconstruction. These, professionals classify as irreversible.
Perhaps a state has an interest in keeping a minor who might change their mind from taking such a permanent step as genital reconstruction. But the reality is that children under 16 today aren’t taking those permanent steps except in exceedingly rare circumstances. The process of transitioning is deliberately slow, steady and methodical to guard against just the regrets lawmakers say they fear. Again, hormone blockers that forestall the need for more aggressive interventions until a teenager has reached the legal age of consent are one of those safeguards.
Lawmakers, it seems, have settled on a solution in search of a problem. Either that, or they are actually troubled not by premature treatments that threaten transgender children but by the existence of transgender people in the first place. The way to help these children is to listen to them and give them the time and space they need to find their way.
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