United States

Explained: Gender-affirming care in the United States

In a nation divided over gender-affirming care, the 2024 election looms large as progressive states defend transgender healthcare access for minors while conservative-leaning counterparts enact restrictions, sparking a legal battleground

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Gender-affirming care is a medically essential and evidence-based approach that employs a multidisciplinary strategy to assist people in their journey to transition from their assigned gender at birth to their affirmed gender, the one with which they identify. Medical care for transgender minors remains a focal point of political debate, particularly in conservative-leaning states in the US. It has become an important issue in the lead-up to the 2024 election. In response, progressive states have taken measures to safeguard access to healthcare services for transgender individuals.

Gender-affirming support for children and adolescents may include the following:

1. Using the pronouns of choice.

2. Addressing patients by their preferred name.

3. Prescribing medications such as hormone blockers.

4. Providing therapy and counseling services.

5. In certain cases, it may include surgical interventions.


Gender-affirming opposition

Opponents of gender-affirming healthcare, a group that includes certain U.S. legislators, express concerns regarding potential regrets among young people who undergo permanent alterations to their bodies.

They contend that these choices pose significant risks.

As a response, several U.S. states have either enacted or initiated the process of enacting legislation aimed at limiting or prohibiting gender-affirming medical care for minors.

The AMA, which stands as the largest professional medical association with a membership exceeding 270,000 physicians, stands against imposing limitations on transgender medical care. They assert that medical and surgical interventions for gender dysphoria are medically essential. While surgical procedures may be pursued by transgender adults, it is important to note that such interventions are not commonly performed on minors, and many healthcare providers do not offer them to individuals under the age of majority.

In various jurisdictions throughout the United States, there have been contrasting rulings regarding the fate of state regulations limiting access to gender-affirming medical treatment for transgender youth. These legal disputes are also intensifying amidst the recent surge of bans implemented this year.

Alabama recently received approval to enforce its prohibition on delivering medical care to young individuals, while just a day earlier, a partial injunction was granted against Georgia's similar ban.

At least 22 states have implemented legislation prohibiting or regulating gender-affirming healthcare for individuals under the age of 18. Many of these bans are currently undergoing legal challenges.