Myths of Gender Affirming Care

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Expanded Pamphlet Text and Sources

Gender dysphoria is a condition in which a person feels incongruent with their biological sex, causing extreme psychological distress.[1]

“Gender Affirming Care” is promoted as a lifesaving treatment. It involves social and medical transition: the patient dressing as the opposite sex while taking puberty blockers and/or cross-sex hormones to alter their physical features.

Studies have shown that 43-75% of adolescents with gender dysphoria have at least one type of psychiatric comorbidity.[2] “Gender Affirming Care” ignores many of these contributing factors to gender dysphoria [3], such as:

  • Anxiety disorders

  • Mood disorders

  • Depression

  • Eating disorders

  • Autism spectrum disorders

  • Dissociative identity disorders

  • Substance abuse

  • Childhood trauma

Affirmative Care Harms Children and Teens

Comprehensive studies show “affirmative care” is not safe and effective despite being seen by proponents as a cure to gender dysphoria.[4][5]

Many homosexual or gender nonconforming teens may confuse their anxiety disorders, eating disorders, autism spectrum disorders, or childhood trauma with gender incongruity and dysphoria.

The “affirmative care” model prescribes puberty blockers and cross-sex hormones to pre-pubertal children and teenagers who are distressed about their bodies or have sex-atypical interests.[6] 98% of adolescents on blockers will go on to take cross-sex hormones.[7]

Puberty blockers and cross-sex hormones can compromise bone health [8], prevent maturation of the brain [9], cause infertility [10], deteriorate genitalia [11], and triple the risk of cardiovascular disease.[12]

Puberty blockers like Lupron are the same drugs used in cancer treatment and the castration of sex offenders.[13] Many of the effects can be permanent in children and adults.[14]

An International Crisis

Countries across the world have seen massive spikes in referrals to gender clinics. England saw a 1460% increase in boys and a 5337% increase in girls being referred to gender clinics in under a decade.[15][16][17]

The harmful effects of childhood transition have caused countries like Finland, Sweden, and Norway to halt pediatric transition.[18][19][20]. And England’s Tavistock gender clinic (set to close in 2023) gave blockers and cross-sex hormones to thousands of children and teens under “affirmative care” without considering mental health comorbidities.[21]

Myth of a Trans Child or a Dead Child

A common argument for childhood transition says, "Would you rather have a dead child, or a trans child?"[22] No data has shown that children with gender dysphoria will take their own lives if they do not have access to medical or social transition.[23]

Studies have shown anywhere from 61-98% of trans-identifying children and adolescents "outgrow" their gender dysphoria when reaching an older age.[24][25][26]

The most truthful and compassionate approach toward a child questioning their gender is two-fold:

  • Allow them to explore their interests without expectations of how a boy or girl should express themselves.

  • Provide them with adequate psychological care surrounding other mental health concerns. 


Authors

Lead graphic design: Zach Elliott

Writing & graphic design: Cynthia Breheny

Editing: Talia Nava


Click below for an ink-friendly version. Size remains 8.5x14.


References

  1. Frew, T., et al. (2021). Gender dysphoria and psychiatric comorbidities in childhood: a systematic review. Australian Journal of Psychology, 73(3), 255-271.

  2. Kaltiala-Heino, R. (2015). Two years of gender identity service for minors: Overrepresentation of natal girls with severe problems in adolescent development. Child Adolesc Psychiatry Ment Health, 9, 1-9.

  3. Otero-Paz, M., et al. (2021). A 2020 review of mental health comorbidity in gender dysphoric and gender non-conforming people. Journal of Psychiatry Treatment and Research, 3(1).

  4. National Institute for Health and Care Excellence (2020). Evidence review: gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria.

  5. National Institute for Health and Care Excellence (2020). Evidence review: gender-affirming hormones for children and adolescents with gender dysphoria.

  6. Respaut, R., Terhune, C. (2022). Putting numbers on the rise in children seeking gender care. Reuters.

  7. Carmichael, P., et al. (2021). Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One, 16(2).

  8. Biggs, M. (2021). Revisiting the effect of GnRH analogue treatment on bone mineral density in young adolescents with gender dysphoria. Journal of Pediatric Endocrinology and Metabolism 34 (7): 937-939.

  9. Cass, H. (2022). Independent review of gender identity services for children and young people. The Cass Review. ; Sisk, C. (2017). Development: pubertal hormones meet the adolescent brain. Current Biology 27(14).

  10. Cheng, P.J., Pastuszak, A.W., Myers, J.B., Goodwin, I.A. & Hotaling, J.M. (2019). Fertility concerns of the transgender patient. Transl Androl Urol, 8(3): 209-218.

  11. A. Baldassarre, M., et al. (2013). Effects of long-term high dose testosterone administration on vaginal epithelium structure and estrogen receptor-a and -b expression of young women. International Journal of Impotence Research, 25, 172-177; B. Irving, A. & Lehault, W. (2017). Clinical pearls of gender-affirming hormone therapy in transgender patients. Mental Health Clinician, 7(4), 164-167.

  12. Alzahrani, T., et al. (2019). Cardiovascular disease risk factors and myocardial infarction in transgender population. Circulation: Cardiovascular Quality and Outcomes, 12.

  13. Gallo, A., et al. (2018). The use of leuprolide acetate in the management of high-risk sex offenders. Sexual Abuse, 31(8), 930–951.

  14. Schmidt, L., Levine, R. (2015). Psychological outcomes and reproductive issues among gender dysphoric individuals. Endocrinology Metabolism Clinics of North America, 44, 773-785.

  15. Transgender Trend. (2019). The surge in referral rates of girls to the Tavistock continues to rise.

  16. Tavistock and Portman NHS Foundation Trust. (2020). Gender identity development service referrals in 2019–20 same as 2018–19.

  17. de Graaf, N. M., Giovanardi, G., Zitz, C., & Carmichael, P. (2018). Sex ratio in children and adolescents referred to the gender identity development service in the UK (2009–2016)). Archives of Sexual Behavior, 47(5), 1301–1304.

  18. Medical treatment methods for dysphoria related to gender variance in minors. (2020). Recommendation of the Council for Choices in Healthcare in Finland (PALKO / COHERE Finland).

  19. Linden, T. (2022). Updated recommendations for hormone therapy for gender dysphoria in young people. National Board of Health and Welfare (Sweden).

  20. (2023). Patient safety for children and young people with gender incongruence. Norwegian Healthcare Investigation Board.

  21. Barnes, H. (2023). Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children. Swift Press.

  22. Levine, S., Abbruzzese, E., & Mason, J. (2022). Reconsidering informed consent for trans-identified children, adolescents, and young adults. Journal of Sex & Marital Therapy, 48(7), 706-727.

  23. Biggs, M. (2020). Puberty blockers and suicidality in adolescents suffering from gender dysphoria. Archives of Sexual Behavior, 49, 2227-2229.

  24. Drummond, K. D., Bradley, S. J., Peterson-Badali, M., & Zucker, K. J. (2008). A follow-up study of girls with gender identity disorder. Developmental Psychology, 44(1), 34–45.

  25. Ristori, J., Steensma, TD. (2016). Gender dysphoria in childhood. Int Rev Psychiatry, 28(1), 13–20.

  26. Singh, D., et al. (2021). A follow-up study of boys with gender identity disorder. Frontiers in Psychiatry, 12.