A recent study published in JAMA Pediatrics has found that less than 0.1% of U.S. adolescents with private insurance receive gender-affirming medications, such as puberty blockers or hormones, challenging the common perception that these treatments are widely accessible to minors. The study, which analyzed insurance claims from over 5.1 million young patients between the ages of 8 and 17 from 2018 to 2022, highlights the limited scope of transition-related care in the U.S.
The study’s lead author, Landon Hughes, a fellow at Harvard University’s T.H. Chan School of Public Health, emphasized the importance of understanding that gender-affirming care is not as prevalent as some may believe. “It’s really important for the public to understand that not everyone is getting access to gender-affirming care when they go to the doctor,” Hughes stated. “It is certainly a minuscule group of people who are getting access to this care, and it’s certainly taken up a lot of the public discourse in the recent political and legal climate.”
Key findings of the study reveal that no transgender patients under the age of 12 were prescribed gender-affirming hormones. Additionally, the use of puberty blockers and hormones was found to be more common among transgender minors who were assigned female at birth compared to those assigned male at birth, likely due to the earlier onset of puberty in those assigned female.
Puberty blockers are a form of medication designed to delay or pause puberty, providing children experiencing gender dysphoria additional time to explore their gender identity before making permanent decisions about transitioning. Once the medication is discontinued, puberty resumes. Gender-affirming hormones, on the other hand, are prescribed to align a person’s hormone levels with their gender identity.
Despite the limited usage of gender-affirming medications, the American Medical Association and other major medical organizations continue to support access to these treatments as medically necessary. Dr. Alex S. Keuroghlian, Director of Education and Training at Fenway Health, expressed no surprise at the study’s findings. He noted that access to transition-related care is often hindered by biases and barriers within both families and healthcare practices, even in communities with private insurance.
The issue of gender-affirming care for minors has become a focal point of political and legal debates in the U.S. The Supreme Court is currently considering the constitutionality of state laws, such as Tennessee’s ban on puberty blockers and other transition-related care. Meanwhile, international discussions are also shaping policies, with the United Kingdom recently banning new prescriptions of puberty blockers for minors.
This study provides valuable insight into the current landscape of gender-affirming care for minors in the U.S., underscoring the need for continued dialogue about access to transition-related treatments in a rapidly evolving political and healthcare environment.
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