The number of children with gender dysphoria has exploded in recent years, giving rise to the use of powerful puberty-blocking drugs.
About 300,000 children between the ages of 13 and 17 (1.4 percent) in the United States identify as transgender, according to the latest 2020 estimates.
That’s double the number estimated to have the condition in 2017 a previous report by the same researchers, although they used different estimates.
Children aged 13 to 17 are over four times more likely to identify as transgender (1.4 percent) than adults over 65 (0.3 percent).
Some say the rise is born out of increased awareness of gender dysphoria — that is, emotional distress due to a disconnect between gender identity and biological sex — and an increase in acceptance in society.
But many believe that children’s impressionable minds are easily swayed by ‘trends’ and ‘phases’ among peers, and that children are not ready to make irreversible decisions about their gender.
Although no official national estimates exist, many more children are receiving gender-affirming care at an increasingly younger age. Treatment often involves powerful and life-changing drugs that block puberty and the release of important developmental hormones.
So far, four states — Alabama, Arkansas, Texas and Arizona — have enacted bans to limit access to gender-affirming treatment, including hormone replacement therapy and surgery. Oklahoma signaled its intention to follow suit Tuesday after threatening to cut a hospital’s funding if it prescribes puberty blockers or hormone therapy.
There are an estimated 300,000 trans Americans between the ages of 13 and 17, a number that has increased severalfold in the past two decades.
Shown above are the states with a ban on puberty blockers (red), a partial ban (dark orange), a suspended ban due to litigation (orange), and a surgery-only ban (yellow).
Puberty blockers are marketed as a ‘pause button’ during puberty, giving a child breathing space to make an informed decision about whether to switch using hormone therapy or surgery.
They work by stopping the production of sex hormones – such as testosterone or estrogen – which trigger the physical changes that occur during puberty, such as a deeper voice in men and the start of the menstrual cycle in women.
They are approved for use in pre-pubescent teenagers and can be given on prescription to children as young as eight or nine years old. Girls tend to start puberty when they are around 11 years old, while boys start around 12 years old.
The medicine is given as an injection every one, three or six months. It can also be administered via an implant under the skin, which lasts for up to a year.
Puberty starts if a patient is taken off the pills.
Now Oklahoma ‘bans’ puberty blockers for trans kids
Oklahoma Gov. Kevin Stitt has signed a bill that effectively bans prescribing sex-change drugs to minors at the state’s largest children’s hospital.
The Republican is withholding Covid aid from Oklahoma Children’s Hospital at OU Health until it stops giving puberty blockers and hormone therapy to under-18s.
The state allocated $108 million to the University of Oklahoma-affiliated health system as part of the federal US bailout law passed in 2021 to help struggling businesses and hospitals.
Governor Stitt said Tuesday: ‘By signing this bill today, we are taking the first step to protect children from permanent gender reassignment surgeries and therapies.
‘It is wildly inappropriate for taxpayer dollars to be used to condone, promote or perform these types of controversial procedures on healthy children.’
Oklahoma Children’s Hospital currently offers life-changing medications to teens under 18 with parental consent. It is believed that around 100 minors are currently receiving treatment.
Stitt also called on the Republican-controlled Legislature to ban some of these gender-affirming treatments nationwide when it returns in February.
He said in a statement that he wanted a ban on “all irreversible sex-change operations and hormone treatments” on minors.
Hormone therapy, on the other hand, is used to trigger secondary sexual characteristics in a patient to make their body better match their gender identity.
They work by boosting the levels of either testosterone or estrogen while suppressing the other to create the physical changes.
If they start before puberty, doctors say they can help patients avoid secondary sexual characteristics that don’t match their gender.
Treatment usually begins around 16 years of age Mayo Clinic says, but other hospitals may offer it at an earlier age.
It can be given via injections, pills or by using a cream that is rubbed on the skin.
For patients undergoing feminizing hormone therapy, they begin with daily doses of spironolactone — sold under the brand name Aldactone — to suppress the male sex hormone testosterone.
Four to eight weeks later, they then start taking estrogen pills to trigger female characteristics.
Doctors say the treatment will trigger a loss of muscle mass, reduced hair growth, breast development and redistribution of body fat — among other changes — three to six months later.
Gender confirmation surgeries available to older youth and adults are non-reversible and can include top surgery to create male or female chests, bottom genital surgery, and even facial feminization surgery.
In February, Texas Governor Greg Abbott directed state authorities to begin investigating parents who allow their children to receive gender-affirming care, classifying it as a form of child abuse.
Abbott wrote a letter to the state Department of Family and Protective Services, saying state law imposes reporting requirements “on all licensed professionals who have direct contact with children who may be subject to such abuse.”
Doctors, nurses and teachers may be subject to criminal penalties if they fail to report such incidents.
A bill in Missouri would attempt to classify gender-affirming care as child abuse, not unlike the order recently issued in Texas.
The Williams Institute found this year that its estimate of the number of young people who identify as transgender has doubled from its previous estimate in 2017.
Children ages 13 to 17 make up about 18 percent of the transgender population in the United States, meaning that nearly one in five people who identify as transgender fall into that age group.
Since 2005, the number of young people referred to sex clinics has increased as much as tenfold in the United States, a review in the British Psych Bulletin said this year.
A Yale University study examined the use of puberty blocker implants in people going through precocious or precocious puberty, when puberty begins before age eight in girls and age nine in boys.
It found that in 2016, blockers were used in 512 cases for early puberty at an average of 8.9 years.
In trans youth, they were used in only 62 cases at an average of 14 years.
The researchers said this suggests that the age-based argument that trans youth are too young to access puberty blockers does not appear to apply to those who experience puberty early.
The same study found that between 2004 and 2016, the annual number of puberty-blocking implants given to transgender patients rose from 0 to 63.
The average age of the recipient was 14 years.