• Posted September 19, 2023

Doctors Working With Trans Kids Oppose 'Unsafe' State Bans

A new survey of U.S. doctors specializing in the care of transgender kids finds they're alarmed by pressure to limit patient care, threats to personal and patient safety, and the possibility of legal action.

"The increasing number of bans on gender-affirming care in the U.S. and the negative impact on pediatric endocrinologists may lead to areas in the country without access to pediatric endocrine care,"said study author Dr. Stephanie Roberts, a pediatric endocrinologist at Boston Children's Hospital and Harvard Medical School.

This could limit "access to treatment of other disorders we have expertise in besides gender-affirming care, such as type 1 diabetes or adrenal insufficiency, both of which can be life-threatening conditions,"Roberts said in a news release from the Endocrine Society.

Gender-affirming care is considered the standard of care by all major medical organizations, the society notes. This care has been shown to improve mental health and lower the risk of suicide in transgender youth.

Yet legislation aiming to ban or seriously restrict gender-affirming care has been proposed in 28 states and passed in 20 states, the society points out.

In Florida, a law signed by Gov. Ron DeSantis, a Republican presidential candidate, prohibits gender-affirming care for minors, but it also makes it hard for transgender adults to get treatment.

Health care providers there are forbidden to administer puberty blockers, hormone therapy and surgeries to transgender minors. Practitioners who violate the law could end up in prison for committing a felony.

For now, the legislation is tied up in the courts, with a trial scheduled for November.

For the new paper, researchers surveyed more than 220 U.S. pediatric endocrinologists to assess the impact of transgender health bans on their practices and to identify their top concerns. These doctors care for children and teens with disorders related to hormones and the glands that produce them. Some also provide gender-affirming care.

About 56% of those surveyed were providing gender-affirming care, and 46% practiced in a state where anti-transgender legislation had been proposed or passed between January 2021 and June 2022.

The major themes of their worries were on safety and the impact of laws on medical practice.

"Our work reinforces why efforts to limit access to medically necessary care for transgender youth need to be opposed,"Roberts said.

About 1.4% of Americans ages 13 to 17 identify as transgender. The Endocrine Society's Clinical Practice Guideline recommends mental health treatment as the first course of action and the use of puberty-delaying medications and gender-affirming hormone therapy, when appropriate, in teens who are transgender or gender diverse.

Efforts to ban gender-affirming care have led to politicizing medical care, widespread misinformation, online harassment and bomb threats targeting hospitals and physicians, according to a Human Rights Campaign report.

The American Medical Association, American Academy of Pediatrics and the Children's Hospital Association have asked the U.S. Department of Justice to investigate these threats.

The survey results were published in the Journal of the Endocrine Society. The study received funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

More information

The Association of American Medical Colleges has more on gender-affirming care.

SOURCE: The Endocrine Society, news release, Sept. 19, 2023