U.S. Hospitals Discontinuing Gender-Affirming Treatment for Minors: Possible Implications for Affected Youth

In a recent development, the Department of Health and Human Services (HHS) released a comprehensive review of transgender care for children and teens, calling for a broader use of psychotherapy for young people with gender dysphoria rather than gender-affirming care. This decision has sparked controversy and led to changes in several hospital systems across the US.

Dr. Kristopher Kaliebe, a child and adolescent psychiatrist and professor at the University of South Florida Morsani College of Medicine, supports the HHS's stance, expressing concerns about the evidence base for gender-affirming interventions in minors. He emphasizes the need for rigorous tracking of harms and a clearer study of psychotherapeutic approaches.

However, not everyone agrees with this view. Dr. Marci Bowers, a renowned gynecologic and reconstructive surgeon, dismisses the HHS review as derivative, stating that the team behind the report did not conduct its own review but rather "pirated" reviews conducted overseas. Bowers argues that while stronger research is welcome, cutting off services altogether harms real people and that there is decades of clinical experience showing that when care is affirming, young people are happier and healthier.

The controversy has led to significant changes in healthcare providers. At least 17 major hospital systems in at least nine states and the District of Columbia have paused, discontinued, canceled, or ended pediatric gender services since January. Among these is Kaiser Permanente, a health care company managing 40 hospitals across several states, which is pausing gender-related surgeries for patients under age 18 as of Aug 29. Similarly, Children's National Hospital in Washington, D.C. is stopping the prescription of gender-affirming medications on Aug 30.

Despite the controversy, it's important to note that gender-affirming care is supported by multiple major medical organizations, and studies have shown many of the treatment options to be generally safe and to have a positive impact on mental health. Dr. Marci Bowers also stated that gender-related health care is beneficial to patients and their families with very few instances of regret or disappointment in that care.

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As the debate continues, it's crucial to approach this issue with empathy and a commitment to the well-being of all individuals involved. The authors of the HHS review have not been named, and the paper has not yet been peer-reviewed by independent scientists. The ongoing dialogue and research will undoubtedly shape the future of transgender care for children and teens in the US.

U.S. Hospitals Discontinuing Gender-Affirming Treatment for Minors: Possible Implications for Affected Youth