(Reuters) – In the United States, as more transgender youth identify as a different gender than they were born with, they seek more medical gender reassignment care. Reuters recently worked with medical technology company Komodo Health to calculate the number of cases, which until now have been estimates.
The survey revealed that an increasing number of families are facing serious questions about what type of medical care their children should receive. These families are at the center of the political debate over the protection of transgender youth in the United States.
About 42,000 American children and teenagers will be diagnosed with “gender dysphoria” in 2021, nearly triple the number in 2017, according to data compiled by Comodo for Reuters. Gender dysphoria is defined as the distress caused by gender identity and the sex assigned at birth.
Between 2017 and 2021, at least 121,882 Americans aged 6 to 17 were diagnosed with gender dysphoria.
There are many types of gender reassignment care for young people, from being socially recognized by a name or pronoun of their choice, to hormone therapy, to surgery. A small but growing number of American children and youth with gender dysphoria are seeking medical intervention. Treatment is only available after puberty (secondary sexual characteristics) begins, usually between the ages of 10 and 11.
At this age, administration of secondary sex control agents becomes an option. These inhibitors, called “GnRH agonists,” inhibit the expression of the sex hormones testosterone and estrogen.
The US Food and Drug Administration (FDA) has approved GnRH agonists for the treatment of prostate cancer, endometriosis, and central precocious puberty, but not for gender dysphoria. Although it is legal for use in unintentional gender reassignment care, there is no clinical trial support to establish the safety of such treatments.
At least 4,780 young people in the United States were diagnosed with gender dysphoria and started on secondary anti-sexual drugs in the past five years.
None of Komodo’s surveys, including this one, include treatments that are not covered by insurance, and are limited to pediatric patients diagnosed with gender dysphoria, which may be a high understatement.
Administration of a secondary anti-sexual agent prevents typical sexual physical changes. For many transgender children, these changes can be very distressing. Secondary sexual characteristics resume when the treatment ends.
After stopping secondary sex characteristics, the child can progress to hormone therapy to initiate secondary sex characteristics that are consistent with the gender they identify with. Young people who miss out or choose not to use secondary sex control agents can also be treated with hormones.
Komodo’s analysis found that at least 14,726 minors in the US were diagnosed with gender dysphoria and started hormone therapy between 2017 and 2021.
Hormone therapy can lead to infertility, especially among young people who were also taking secondary sex control drugs early on. Experts say this and other possible side effects have not been well studied.
＜ Surgery ＞
The ultimate gender reassignment treatment is surgery, but it is unusual for a patient under the age of 18 to undergo surgery. Some pediatric clinics and sex clinics do not operate on minors.
An analysis of insurance claims by Comodo found that there were 56 gender reassignment surgeries for patients aged 13 to 17 diagnosed with gender dysphoria between 2019 and 2021.
(Reporting by Robin Respaut and Chad Terhune)