Gender-Affirming Care for Children — The Elephant in the House

Gender-affirming care for preteen and teenage children has become a subject of heated debate across the US, with proponents describing it as “medically necessary”, especially in the treatment of gender dysphoria, and allowing transgender children to choose the gender they feel happy to identify with instead of sticking to the gender they were assigned at birth.

Although pro-LGBTQ+ activists and legislators have been pushing for laws supporting gender-affirming care for youth and even pointing out evidence that gender-affirming care is clinically appropriate, conservatives and republican lawmakers terming gender-affirming care for minors a “child abuse” and vowing to protect transgender children against such medical procedures.

As a result, more than 19 states have passed bills either banning or restricting such controversial medical interventions, making 2023 the most anti-transgender year in the US, according to a CNN report citing ACLU data released on April 3.

Gillian Branstetter, communications strategist for the ACLU, told CNN that a record number of anti-LGBTQ+ bills had been presented for approval in various Houses.

At least 283 of the 417 anti-LGBTQ+ bills fronted by legislators as of April are education-related, with 60 of the education-focusing bills being “forced outing” bills, requiring teachers to inform parents when their children begin using different names or pronouns.

According to a CNN report, five states, Indiana, Alabama, North Dakota, Oklahoma, and Florida, have passed legislation making the provision of gender-affirming care a felony. At the same time, Utah banned surgical procedures and hormone treatment for minors seeking gender-affirming care.

Gender-affirming Care on Minors

Although adults can seek gender-affirming medical procedures, including surgeries, such options are not openly available to minors in most states across the US.

In May 2023, an investigation report by the Education First Alliance accused top medical schools in North Carolina of administering sex-change treatments to toddlers as early as two years old. The report alleged that East Carolina University, the University of North Carolina at Chapel Hill, and Duke University offered gender-transitioning treatments to toddlers despite the potential risks associated with such treatments.

According to the report, Duke University began offering sex change treatment for toddlers in 2015 under its “Child and Adolescent Gender Care” unit, with the Gender Care Director at the facility, Deanna Adkins, telling NBC 11 news that the clinic worked with “all kinds of kids” from infant to teen, and offered treatment for children having gender dysphoria from 2 years old.

The University of North Carolina (UNC) was also singled out in the report for offering a similar treatment for children aged 3 to 11, according to their intake form cited by the Alliance. UNC Department of Psychiatry’s Gender Equality Psychiatry Clinic was accused of offering such services for minors from 4 years old. East Carolina University was also accused of providing gender-transitioning care for children.

However, a fact-check by various media outlets, including the AP, revealed that the allegations were false. According to an article published by the AP regarding the claims, the institutions clarified that they do not offer gender affirmative or gender transitioning treatment to toddlers and minors.

Recently, North Carolina became the 22nd state in the US to enact laws banning or restricting gender-affirming treatments, as reported by AP on August 17, 2023. GOP supermajorities in the Senate and the House enacted a bill barring medical practitioners from administering puberty-blocking drugs, hormone therapy, and gender transition surgeries to anyone under 18.

However, the bill allows minors who began the treatment before August 1, 2023, to continue if their doctors deem it necessary and under their parents’ consent.

The Dilemma of ‘Irreversible Scars’

While sex change and gender transitioning treatment isn’t something new in the current era, a recent study cited by the Education First Alliance showed that nearly all transgender children who underwent early gender transition still identified themselves as transgender five years down the line, with only 2.5% re-identifying with their sex.

The transitions don’t always end in joy. In July 2023, a woman in North Carolina sued a medical team for financial damages following a botched gender transition that left her with irreversible lifetime damages.

According to a Daily Mail Online report, Prisha Mosley, now 25, said in a 53-page complaint filed at the Superior Court in Gaston County that she was just 17, confused and grappling with mental health issues when medical practitioners suggested to her a cross-sex hormone treatment and double breast removal would help solve her health problem.

READ NEXT: Is It Lawful For Religious Schools To Dismiss LGBTIQ+ Educators?

Now, she regrets the entire move, blaming the doctors for lying to her only to make more money and a good name for them. Mosley said the clinicians lied to her that testosterone jabs would help resolve her condition and “grow a p–nis.” Trusting the process, her breast was removed the following year.

According to her complaint, the entire procedure left her with irreversible scars and new challenges, including a hairy body, a deep voice, no breasts, a damaged vagina, and pain around her neck and shoulder. With such traumatizing complications, Mosley believes she cannot breastfeed and may be infertile.

Mosley blamed the clinicians for lying to her by omission and deliberately failing to let her know of the life-altering consequences of such procedures. She also accused the doctors of not advising her on other available alternative courses of treatment for her condition, with her lawyer stating that they wanted to “make money off her and bolster their credentials in the emerging field of so-called gender-affirming care.”

Mosley is among the latest victims of transgender transition treatment to sue her doctors in a legal battle that could prove pivotal in shaping the current debate about transgender rights and gender transition procedures, especially on children and teens.


Caitriona Maria is an education writer and founder of TPR Teaching, crafting inspiring pieces that promote the importance of developing new skills. For 7 years, she has been committed to providing students with the best learning opportunities possible, both domestically and abroad. Dedicated to unlocking students' potential, Caitriona has taught English in several countries and continues to explore new cultures through her travels.

Notify of
Inline Feedbacks
View all comments