Some say too many transgender kids are given hormones. Data finds otherwise.
Despite public uproar over teenagers and children changing their genders, transgender teenagers and children rarely get prescribed gender-affirming medications, according to a new study.
Just .1% of children ages 8 to 17 who identify as transgender or gender-diverse were prescribed gender-affirming hormones or puberty blockers, according to a study by researchers at Harvard University and FOLX Health, a healthcare provider for the LGBTQ+ community.
The report, published Monday in JAMA Pediatrics, looked at five million private insurance claims filed between 2018 and 2022.
“The politicization of gender-affirming care for transgender youth has been driven by a narrative that millions of children are using hormones and that this type of care is too freely given. Our findings reveal that is not the case,” said the Harvard study’s lead author Landon Hughes, a postdoctoral fellow at the university’s school of public health.
The findings also showed that no patients under 12 received gender-affirming hormones and higher rates of puberty blockers were prescribed for patients assigned female at birth, whom study authors note typically experience an earlier onset of puberty than patients assigned male at birth.
The years studied predate most of the effort to block health care for transgender youth in some states, said Dr. Joshua Safer, an endocrinologist and executive director of the Mount Sinai Center for Transgender Medicine and Surgery in New York.
While the study may have missed some Medicaid patients or those who paid in cash, most patients would have gone through the private insurance system, he said.
About 3.3% of U.S. high school students identify as transgender and an additional 2.2% have questioned if they were at some point, according to the latest annual Youth Risk Behavior Survey by the Centers for Disease Control and Prevention.
Puberty blockers, originally approved for children whose sexual development occurs too early, are prescribed to delay the onset of puberty or pause it in its tracks. These medications, called GnRH agonists, stop the body from making sex hormones, such as testosterone and estrogen.
In people assigned male at birth, such treatment slows down the growth of facial and body hair, prevents voice deepening and limits the growth of sex organs, according to the Mayo Clinic. In people assigned female at birth, it limits breast development and stops menstruation.
Experts say delaying puberty gives transgender patients more time to explore and integrate their identity before coming off the puberty blockers. When they do, they may proceed to gender-affirming hormone therapy or resume puberty of their sex assigned at birth.
However, the rate at which these teens receive hormone therapy is "surprisingly low," said the study's senior author Jae Corman, head of analytics and research at FOLX Health.
"Our study found that, overall, very few (transgender and gender-diverse) youth access gender-affirming care," he said. "Among those that do, the timing of care aligns with the standards outlined by the World Professional Association for Transgender Health, the Endocrine Society, and the American Academy of Pediatrics.”
Adrianna Rodriguez can be reached at adrodriguez@usatoday.com.
(This study has been updated to add new information.)