As policymakers around the world debate whether minors should have access to transition-related medications, a study published Monday in the country’s leading pediatric medical journal found that the medications are rarely prescribed to young people.
Less than 0.1% of privately insured adolescents in the United States are transgender or gender diverse and are prescribed puberty blockers or gender-affirming hormones, according to findings published in JAMA Pediatrics.
The research note, which analyzed the private insurance claims of more than 5.1 million young patients ages 8 to 17 between 2018 and 2022, also found that no transgender patients under the age of 12 were prescribed affirmation hormones. gender. Private insurers covered 65% of the country in 2023, according to the Census Bureau.
“It’s really important for the public to understand that not everyone has access to gender-affirming care when they go to the doctor,” said the report’s lead author, Landon Hughes, a fellow at the University of Massachusetts’s TH Chan School of Public Health. Harvard. “It’s not as ubiquitous as some would have us believe, especially among young people.”
“There’s not a massive wave of people accessing care,” Hughes added. “It is certainly a tiny group of people who have access to this care, and it has certainly consumed much of the public discourse in the recent political and legal climate.”
The study found that the use of hormones and puberty blockers was more common among trans minors who were assigned female at birth than those assigned male at birth. The authors noted that this may occur because the onset of puberty occurs earlier in people who are assigned female at birth.
Puberty blockers are used to delay the onset of puberty or pause it as it progresses. The medication is designed to give children experiencing gender dysphoria more time to decide if they want to take more permanent steps toward gender transition. Puberty resumes when medications are no longer taken. Gender-affirming hormones are typically prescribed to replace hormones that a person’s body produces naturally, but that do not align with their gender identity.
Most major U.S. medical organizations support gender-affirming health care for minors. The American Medical Association, which publishes JAMA, has referred to the care as “medically necessary.”
Dr. Alex S. Keuroghlian, director of education and training at the LGBTQ health care organization Fenway Health and not affiliated with the study, said he is “not surprised” by the findings, because access to transition-related care is limited.
“There is such a bias against providing this particular type of care, that I suspect that not all transgender or gender diverse youth who would have benefited from it in this data set necessarily received it,” he said. “I see it in practice in the communities we work with, even in privileged communities with private insurance. “There could be a lot of barriers at the family level, at the practice level, for that child to receive gender-affirming care.”
In December, the Supreme Court heard oral arguments in a case involving state bans on puberty-suppressing medications and other forms of transition-related care for minors. The court is weighing the constitutionality of a state law in Tennessee that prohibits gender-affirming child care, and the justices appeared inclined to uphold the law. Tennessee is one of more than two dozen states that restrict such care in the US.
Last month, the United Kingdom indefinitely banned new prescriptions for puberty blockers to treat minors with gender dysphoria. The indefinite ban came several months after an independent study commissioned by England’s National Health Service concluded that the medical evidence on transition-related child care was “remarkably weak.”