While lawmakers around the world debate whether minors should have access to medications related to gender transition, a study published this Monday in the leading pediatric medical journal in the United States found that these drugs are rarely prescribed to younger people.
Less than 0.1% of privately insured adolescents in the United States are trans or gender diverse and are prescribed puberty blockers or gender-affirming hormones, according to findings published in the scientific journal JAMA Pediatrics.
The research, which analyzed the private insurance claims of more than 5.1 million young patients aged 8 to 17 between 2018 and 2022, also found that no trans patients under the age of 12 were prescribed gender-affirming hormones. Private insurers covered 65% of the country in 2023, according to the Census Bureau.
“It’s very important for the public to understand that not everyone has access to gender-affirming care when they go to the doctor,” said the study’s lead author, Landon Hughes, a member of the TH Chan School of Public Health at the University of California. Harvard. “It is not as common as some would have us believe, especially among young people.”
“There is not a massive wave of people accessing this type of care,” Hughes added. “It is certainly a tiny group of people who have access to this care, and it has certainly occupied much of the public discourse in the recent political and legal climate.”
The study found that the use of puberty blockers and hormones was more common among trans minors who were assigned female at birth than among those who were assigned male. The authors noted that this may occur because the onset of puberty occurs earlier in people who were assigned female at birth.
Puberty blockers are used to delay the onset of puberty or pause it while it is occurring. The medicine is designed to give children who experience gender dysphoria more time to decide if they want to take more permanent steps to make the gender transition. Puberty resumes when the medication is stopped.
Gender-affirming hormones are typically prescribed to replace hormones that a person’s body produces naturally, but that do not align with their gender identity.
Most major medical organizations in the United States support gender-affirming care for minors. The American Medical Association, which publishes the journal JAMA, has referred to the care as “medically necessary.”
Dr. Alex S. Keuroghlian, who is the director of education and training at the LGBTQ health care organization Fenway Health and was not involved in the study, said he is “not surprised” by the findings, because access to gender-related care The transition is limited.
“There is such a bias against providing this particular type of care that I suspect that not all trans or gender diverse youth who would have benefited from it in this data set necessarily received it,” he said. “I see that in practice in the communities we work with, even in privileged communities with private insurance. “There could be a lot of barriers at the family level, at the practice level for that child to receive gender-affirming care.”
In December, the Supreme Court heard oral arguments in a case involving state bans on puberty-suppressing drugs and other forms of transition-related care for minors. The court is weighing the constitutionality of a state law in Tennessee that prohibits gender-affirming care for minors, and the justices appeared leaning toward upholding the law. Tennessee is one of more than two dozen states that restrict such care in the United States.
Last month, the United Kingdom indefinitely banned new prescriptions for puberty blockers to treat minors for gender dysphoria. The indefinite ban came several months after an independent study commissioned by the National Health Service in England concluded that the medical evidence on transition-related care for minors was “remarkably weak.”
