Medical evidence, not politics, should inform treatment decisions
The Endocrine Society opposes legislative efforts that do not conform to medical evidence and clinical practice to prevent transgender and gender diverse adolescents from accessing gender-affirming medical care.
Arkansas passed a law April 6 prohibiting gender-affirming care for minors, the first law of its kind in the U.S. Seventeen other states have introduced or are considering similar legislation. The proposals reflect widespread misinformation about the nature of gender-affirming medical care.
These policies criminalize physicians’ efforts to provide needed medical care and disregard widely accepted medical evidence and clinical practice guidelines.
“The treatment of transgender and gender diverse youth should be governed by the best available medical evidence, not politics,” says Joshua D. Safer, MD, FACP, co-author of the Society’s Clinical Practice Guideline and position statement on transgender medicine. “When caring for transgender and gender diverse youth, physicians and mental health professionals must be able to freely practice and choose the best available treatment options in consultation with the patients and their parents, as they would when treating any other condition.”
Scientific evidence shows that there is a durable biological underpinning to our gender identity, and external forces have little impact on that identity.
When young children experience feelings that their gender identity does not match the sex recorded at birth, the first course of action is to support the child in living in their affirmed gender identity and to provide mental health support, as needed.
After transgender and gender diverse minors start puberty, prescribing treatment to suppress puberty is the recommended strategy if desired and if diagnostic and treatment criteria are met. Pubertal suppression is commonly used in children who experience early puberty. This treatment, which is reversible, gives adolescents more time to explore their options. Pubertal suppression helps transgender adolescents avoid distressing and even traumatic experiences in life, and may help some avoid undergoing surgical procedures later in life.
“When caring for transgender and gender diverse youth, physicians and mental health professionals must be able to freely practice and choose the best available treatment options in consultation with the patients and their parents, as they would when treating any other condition.”
Eliminating access to medical care will harm transgender and gender diverse individuals, who already face a disproportionately high rate of suicide. A study published in the journal Pediatrics last year found transgender and gender diverse youth who wanted access to pubertal suppression and could not access the treatment had higher rates of suicidal thoughts over their lifetimes than those who wanted the treatment and received it.
“Legislation should not interfere with physicians’ efforts to provide their patients evidence-based medical care in line with the recommendations of the Endocrine Society and other respected international medical organizations,” Safer says.
While the Society focuses its advocacy efforts at the federal level, it offers a toolkit for members and other advocates who are calling for evidence-based legislation at the state level.