Legislators in at least two US states are citing a recent decision in England to restrict gender transitions for young people in support of their proposal.
They were not the first to look to other countries, especially Europe, for policy and research ideas. In the US, where at least 23 states have tightened or eliminated access to transgender health care for minors, lawmakers routinely cited non-US research or policies as justification for their laws.
Nevertheless, leading health organizations in the US and Europe continue strongly confirms and gender-affirming care for both transgender youth and adults.
Among other things, they argue that restrictions on things like hormone therapy tend to isolate transgender youth, even though other youth can benefit from them. Transgender advocates and their allies, however, cloak the political effort to erase them as caring for children.
What has England changed and why?
England restricts the ability of people under the age of 16 to initiate a medical gender transition through rules put forward by the public health system.
England’s National Health Service recently consolidated a policy for the first time is given temporarily almost a year ago, it sets, among other requirements, the minimum age at which puberty blockers can start. NHS England says there is insufficient evidence about their long-term effects, including “sexual, cognitive or wider developmental outcomes”.
From April 1, NHS England will no longer prescribe puberty blockers – drugs that suppress sex hormones during puberty – as “regular treatment” for children and other young people who want to transition. In practice, the decision also applies to Wales, where there are no NHS gender clinics for children. Northern Ireland says it will accept British policy; Scotland measures it.
But this is not a nationwide restriction. NHS England, albeit a large one, is only one health provider in the country.
Puberty blockers are sold at cost in several private clinics. Young people who already receive them through the NHS – fewer than 100 in England, according to the BBC – can continue. Medicines will also be available to participants in clinical trials.
Britain’s Conservative government, which has widely criticized youth gender transitions, welcomed NHS England’s decision. Despite this, a proposal in Parliament to make it outright illegal to give puberty blockers to under-16s is unlikely to become law.
The use of puberty blockers is not limited to gender transitions, but they can be an early step in one. They can delay puberty for youth questioning their sexuality until they are old enough to decide on treatments that bring about more permanent changes, after discussions with families and health care providers.
What do US lawmakers say?
US lawmakers and bills seeking to limit transgender health often cite European science and policy from countries such as Finland, France, Sweden and Norway, as well as the United Kingdom.
In Kansas, state Sen. Beverly Gossach cited England’s new policy last week when she briefed Republicans on a bill that would ban sex-affirming care for minors.
“In England they have declared that there can be no gender-affirming care for children other than therapy because there is no scientific evidence,” Gossac said in comments that mischaracterized NHS England’s guidelines. They, like other leading health organizations, call for consultation to begin.
Republican leaders expect the ban to pass this week and hope to override any veto by Gov. Laura Kelly, a Democrat.
Republican state senator Ben Watson in Georgia He pointed to Europe when he banned gender-affirming care for children: “In light of the information and what’s happening, not only in Europe, in the UK, but also in the United States, that’s the change I’m proposing. .”
“Deep anxiety about hostility and harm”
Puberty blockers for adolescents who meet certain criteria are approved by major US medical groups, including the World Professional Association for Transgender Health, when administered correctly. These criteria do not include any age requirement.
“Puberty blockers have been prescribed for more than 40 years to safely and effectively treat medical conditions, including precocious puberty. “The fact that NHS England is targeting only trans and gender diverse young people with this policy is deeply worrying about the hostility and harm to LGTBQ+ people and their families,” WPATH and the European Association for Transgender Health said in a statement last week.
“Healthcare decisions should be informed by clinical evidence, not politics,” the statement said. “The NHS has given no guidance on what criteria it will use to monitor the harm its decision may cause, putting young people and families at great risk for legitimate medical purposes.”
Last year, the American Academy of Pediatrics, which represents its 67,000 pediatricians, voted unanimously to reaffirm its position on gender-affirming care for transgender children, including hormone therapy when appropriate.
Iridescent Riffel, a 27-year-old transgender woman and activist from Lawrence, Kansas, said she found British politics too conservative.
Puberty blockers prevent people from developing physical features that are inconsistent with their gender identity, such as beards or breasts. For most teenagers, puberty lasts or is almost complete by age 16. Treatments to alter physical features to match personality later in life can be expensive and painful.
Transgender youth may have a harder time starting the process of social transition after puberty — or how a trans person changes how they present themselves to other people — she said.
“It’s not just, ‘Oh, I’m worried about my body.’ It’s ‘How do people perceive me? Will I be judged? Will people judge me? Am I going to be dangerous to go this way?’ he said.
Banning gender-affirming care is not the real goal, Riffel said. Instead, “We just don’t want to see trans people in public.”