Fewer than 1 in 1,000 US adolescents receive gender-affirming
medications, researchers find
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[January 07, 2025]
By CARLA K. JOHNSON
As U.S. lawmakers debate issues around health care for transgender
youth, it’s been difficult to determine the number of young people
receiving gender-affirming medications, leaving room for exaggerated and
false claims.
Now, a medical journal has published the most reliable estimate yet and
the numbers are low, reflecting more clearly on medical practices now
being weighed by the U.S. Supreme Court.
Fewer than 1 in 1,000 U.S. adolescents with commercial insurance
received gender-affirming medications — puberty blockers or hormones —
during a recent five-year period, according to the study released
Monday.
At least 26 states have adopted laws restricting or banning
gender-affirming medical care for transgender minors, and most of those
states face lawsuits. A decision by the Supreme Court in a Tennessee
case is expected later this year. President-elect Donald Trump has
promised to roll back protections for transgender people.
“We are not seeing inappropriate use of this sort of care," said lead
author Landon Hughes, a Harvard University public health researcher.
“And it’s certainly not happening at the rate at which people often
think it is.”
The researchers analyzed a large insurance claims database covering more
than 5 million patients ages 8 to 17.
Only 926 adolescents with a gender-related diagnosis received puberty
blockers from 2018 through 2022. During that time, 1,927 received
hormones. The findings, published in JAMA Pediatrics, suggest that fewer
than 0.1% of all youth in the database received these medications.
The researchers found that no patients under age 12 were prescribed
hormones, an indication that doctors are appropriately cautious about
when to start such treatments, Hughes said.
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A vial of testosterone is prepared for injection at a home in
Florida, on May 29, 2023. (AP Photo/Laura Bargfeld)
“I hope that our paper cools heads
on this issue and ensures that the public is getting a true sense of
the number of people who are accessing this care,” he said.
The database included insurance plans in all 50 states, but did not
include youth covered by Medicaid, the federal-state health
insurance program for low-income people.
The study did not look at surgeries among transgender adolescents.
Other researchers have found those procedures are extremely rare
among young people.
Not all transgender youth proceed with medical treatments, said Dr.
Scott Leibowitz, co-lead author of the adolescent standards of care
for the World Professional Association for Transgender Health, a
leading transgender health group.
Transgender adolescents “come to understand their gender at
different times and in different ways,” he said, noting that the
best care should include experts in adolescent identity development
who can work with families to help figure out what’s appropriate for
each young person.
Leibowitz, who has worked in gender clinics in several U.S. cities,
said the study “adds to the growing evidence base about best
practices when serving transgender and gender diverse youth.”
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