Gender-affirming care for children – how do we best protect our kids?

Gender-affirming care for children – how do we best protect our kids?

Many Republicans in the state of Wisconsin believe that kids should be kids, focusing on algebra and playing with their friends, rather than dwelling on their gender identity. 

In a way, Kat Grant (they/them), an equal justice work fellow with the Freedom from Religion Foundation, agrees. 

Grant recently testified against Senate Bill 480, which aims to prohibit gender transition medical intervention for individuals under 18. Democratic Gov. Tony Evers has vowed to veto the bill. Opponents of the bill say children should have the freedom to explore who they are. While lawmakers consider the legislation, supporters of transgender youth remain concerned with the moral and mental health ramifications the debate may pose. 

“When I testified against the Wisconsin bill, I sat there and listened to kids, 10, 11, 12 years old, begging people in power for their lives,” Grant said.

This broke Grant’s heart. They believe that children should be worried about Pokemon cards and math homework, not worrying about the Legislature telling them that they are broken, unworthy or that there’s something wrong with them, Grant said.

The bill proposes that children must wait until they are adults in order to receive gender-affirming care. According to the American Academy of Child and Adolescent Psychiatry, legislators supporting the bill noted, adolescents are less likely to think before they act, pause to consider the consequences of their actions or change their dangerous behaviors. 

“They are not allowed to vote, join the military, get a tattoo, sign a contract, buy alcohol, tobacco or nicotine products until they are an adult. They should not be put into a position to make permanent, life-changing decisions about altering their otherwise healthy bodies for non-medically necessary reasons,” argued  a co-sponsorship memo from the office of Sen. Duey Stroebel (R-Cedarburg) and Rep. Scott Allen (R-Waukesha). 

Furthermore, research from the American College of Clinical Pharmacy indicates that up to 98% of children presenting with gender dysphoria will reconcile their gender identity with their biological sex during puberty, the bill's supporters also noted.

“Our children are not experiments and parents should not be scared or pressured into having their children receive non-medically necessary drugs or irreversible procedures before their brains are fully developed,” the memo said. Republican legislators who sponsored the bill declined to comment further on the issue. 

According to Grant, gender affirming care for children prior to puberty usually looks like haircuts, therapy, clothing and experimenting with different names. At the beginning of puberty is when the family, child and doctor may decide to start puberty blockers. Puberty blockers are essentially a pause button. While they are technically considered off-label use by the FDA, they have been prescribed for more than 30 years and are completely safe, according to Grant. 

However, not all trans children use puberty blockers, as not everyone realizes they’re trans at the  window of opportunity to pause puberty. In the teenage years, gender-affirming care may look like hormone replacement therapy. According to Healthline, most changes will last until you stop hormone replacement therapy; however, certain changes, such as breast growth, are irreversible.

Based on the research available to them, Grant thinks that allowing people to exert their gender identity consistently with how they feel internally is the best way to address gender dysphoria.  

Grant said that they believe trans kids should be able to have access to gender-affirming care with the help of a team of medical experts and their families, and that they made it clear that choosing this medical care is not a decision that is made on a whim. However, they also do believe that it amounts to medical neglect when a family does not seek out gender-affirming care for their child.

This medical neglect can manifest in mental health struggles, according to Grant. And the risk of suicide is higher among transgender youth than any other youth group: according data from the National Library of Medicine, 82% of transgender individuals have considered killing themselves, and 40% have attempted suicide. 

“You’re sending a message that trans kids aren’t welcome in our society… Even when these bills are brought up, there’s an increased phone call to a hotline,” said Marc Herstand, executive director of the National Association of Social Workers Wisconsin Chapter.

“This is an attempt to eradicate trans people,” Grant said. “The word genocide is a heavy one, but we are currently in the stages of a trans genocide,” adding that we have entered a phase where trans children are facing “dehumanization and erasing from legal structures. The goal of these laws is to make it seem like trans people are trying to harm children instead of letting kids be who they are.”

Not only is access to gender-affirming care important for Grant, but so is the idea that transgender individuals are treated well and accepted by society. 

“I think we have a responsibility as human beings to each other to alleviate suffering. To stop and pause and ask, are we treating people in a way that respects who they are?” Grant said. 

Kat Grant speaking at an event in September about LGBTQIA+ rights. Photo provided by Kat Grant.

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