Pediatricians object to Trump’s push to ban care for transgender kids : Shots

Dr. Kade Goepferd watched the Trump administration's move Thursday to ban gender-affirming care for transgender youth with “a combination of sadness and disappointment.”

Goepferdfounder of the Minnesota Children's Gender Health Program, says for the medical community, nothing has changed in the evidence supporting gender-affirming care that could justify government action.

“There is a massive propaganda and disinformation campaign selectively targeting this small group of already vulnerable children and their families,” Goepferd says.

“Men are men”

Federal health officials said numerous times in Thursday's statement that their actions were driven by science and evidence, not politics or ideology. They often praised report published by the Department of Health and Human Services in November. He concluded that doctors who provide medical care to help youth in transition have failed their patients, and emphasized the benefits of psychotherapy as an alternative.

Sometimes health officials question the idea that a person can be transgender at all.

“Men are men. Men can never become women. Women are women. Women will never be able to become men,” said CDC Acting Director Jim O'Neill. He added that the “blurring of boundaries between the sexes” represents “hatred of nature as God intended it to be.”

Secretary of Health Robert F. Kennedy Jr. said doctors and medical groups “promoted lies” that these treatments could be beneficial for children and that these youth were “trained to believe that gender can be changed.”

Doctors groups disagree

The American Academy of Pediatrics, a medical group that represents 67,000 pediatricians nationwide, has come out strongly against such characterizations.

“These policies and proposals misinterpret current medical consensus and do not reflect the realities of pediatric care and the needs of children and families,” said AAP President Dr. Susan J. Kressley. in the statement. “These rules help no one, do nothing to reduce health care costs, and unfairly stigmatize young people.”

The AAP's official position on this medical care is that it safe and effective for young people who need it. This view is shared by the American Medical Association, the Endocrine Society, and other medical organizations.

IN statement On Thursday, the American Psychological Association wrote: “APA is deeply concerned about recent federal actions that not only challenge scientific understanding of gender identity, but also potentially jeopardize the human rights, mental health, and well-being of transgender and nonbinary people.”

The most significant proposal released by HHS would stop funding the Medicare and Medicaid programs from hospitals (most of their budgets) if they provide gender-affirming care to people under 18 years of age.

The Children's Hospital Association said the rule — if adopted — would set a dangerous precedent. “The terms proposed today allow for the refusal of all types of specialized medical treatment based on the rules established by the government,” wrote CEO Matthew Cook. “Millions of families could lose access to the care they need.”

After a 60-day comment period, the rules can be finalized and then go into effect.

Attorneys General in New York And California said they would fight the rules and protect the rights of transgender people to receive health care in their states. The ACLU has vowed to sueand more legal challenges are expected.

“I don't want to get lost”

According to Center for Disease Control and Prevention (CDC) surveyabout 3% of 13-17 year olds identify as transgender, approximately 700,000 people. A survey from health research organization KFF found that less than a third of transgender people were taking identity-related medications, and 16% had undergone surgery.

For young people, medical options most often include puberty blockers and hormones. Surgery very rarely for minors. “This is healthcare that evolves over time, individualizing and adapting to the needs of the patient, often after years of collaboration with a proven medical team,” says Goepferd.

This week, NPR spoke with a 15-year-old transgender man in California about the steps Trump administration officials are taking to limit grooming. “They think what I'm feeling is a phase and that my family should just wait it out and that it's better if I'm miserable and never get help,” he says. NPR agreed not to name him due to concerns for his safety.

He says the experience may be difficult for those who are not transgender to understand, but as far as he can tell, these health officials “have no interest in understanding transgender people.”

He describes the long and deliberate process he went through with his parents and doctors before he started taking testosterone. “The decision not to start gender-affirming care is often as permanent as the decision to start it,” he says. “Won't start [hormone therapy]For some people, it's like destroying our body because there are certain changes that we will never have.”

Now, after six months of taking testosterone, he feels he's on the right track and is concerned about the prospect of losing access to his medications if HHS's efforts to end health care nationally succeed. “It feels like someone is throwing me into the bushes right off the road I'm walking on, and it's a little scary,” he says. “I don't want to get lost. I want to keep going where I’m going.”

“Deep moral shock”

More than half of states have already banned gender-affirming care for young people after madness of laws passed in 2021 in Republican-led states. This week, House Republicans led efforts to pass two federal bills that would limit access to health care, including legislation that could jail doctors who provide health care for up to ten years. It is unclear whether the bills will be voted on in the Senate.

While nothing has officially changed in states where medical care is still legal, these efforts to impose national restrictions have doctors and health systems in those states bracing for the possibility of their clinics closing.

“When you know that there is help you can give to young people that will measurably improve their health and their quality of life, you feel a deep moral concern and you are limited in doing so,” says Children's Minnesota's Goepferd. “And there is a moral concern that you—as a hospital or health system—must limit the care you provide to one population in order to remain financially viable to provide care to other children.”