US deviates from European approach to transgender care

Thursday, June 22nd, 2023

The United States finds itself at odds with several Western nations over transgender care and the treatment of children grappling with gender identity concerns.

While American healthcare institutions have long supported medical interventions for transgender minors, including the use of puberty blockers to delay the physical changes of adolescence, the European medical community is displaying scepticism towards this approach.

Five countries— the United Kingdom, Sweden, Finland, Norway, and France—have now begun urging caution and limiting the use of puberty blockers for minors, citing a lack of evidence on the benefits outweighing the risks.

The UK’s National Health Service recently restricted the use of puberty blockers to clinical trials, effectively making them inaccessible to most children.

“These countries have done systematic reviews of evidence,” said Leor Sapir, a fellow who studies transgender care at the conservative-leaning Manhattan Institute think tank. “They’ve found that the studies cited to support these medical interventions are too unreliable and the risks are too serious.”

While some nations, including Canada, Spain and Australia, still permit puberty blockers as a clinical option, there are increasing calls for restrictions in these countries as well.

For example in Italy, the president of the Italian Psychoanalytic Society expressed “serious concerns” in a public letter to the prime minister about the use of puberty blockers..

During a recent congressional hearing, Republican politicians highlighted European examples of growing caution and criticised Democrats and the US medical community for making treatments readily available for minors. They lauded the European countries’ reassessment and portrayed the issue of transgender care as a pivotal one for the 2024 campaign.

Transgender youth used as political pawns

Conversely, Democrats accused Republicans of using transgender youth as political pawns and argued that bans and restrictions on treatments would harm children.

“They are telling parents that Republican politicians know better than they do what is best for their child,” said Rep Frank Pallone Jr at the hearing last week. “This is the height of hypocrisy from a group that supposedly believes in limited government.”

A Washington Post and KFF poll conducted late last year revealed that 68% of respondents opposed the use of puberty blockers in children aged 10 to 14.

Since then, over a dozen Republican-led states have implemented restrictions on medical interventions as part of transgender care. For example, a Texas law scheduled to take effect in September threatens healthcare providers with the loss of their medical licences if they offer puberty blockers, surgeries or hormone treatments to most transgender minors.

While Republicans push for increased parental involvement, some Democrat-led states are embracing transgender minors seeking treatments.

New York, for instance, introduced public school guidance allowing teachers to protect the privacy of students undergoing social transitions without parental knowledge due to safety concerns or lack of acceptance at home.