The GOP’s attack on trans kids’ health care, explained

“Nowadays, doctors recommend taking a humane and affirming approach when a child expresses that their gender may not match their assigned sex at birth. This affirmation includes allowing trans kids to socially transition (i.e., use whichever name, pronouns, and clothing make them comfortable). Medical interventions — like puberty suppression or gender-affirming hormones like estrogen or testosterone — are only recommended for adolescents who have been insistent, persistent, and consistent in their gender identity over long periods.

The affirming model has been recommended by nearly every major American medical association, including the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, the Endocrine Society, the World Professional Association for Transgender Health, the American College of Obstetricians and Gynecologists, and many others.

While the affirming model is often willfully misconstrued as instructing parents to accept a child’s gender identity and rush them off into medical interventions, it’s really more about creating a space for trans kids to explore their own gender expression and more thoroughly understand their dysphoria before deciding on whether to transition or not. Allowing a trans adolescent to go on puberty blockers is a decision most parents don’t take lightly. Transitioning is a slow, deliberative process for minors.

Puberty blockers merely act as a pause on an adolescent’s natal puberty, so that adolescents ages 9 to 14 can be more mentally mature before deciding on the course of their permanent treatment when the time comes”

“puberty… brings along its own permanent changes, which could only partially be reversed through painful and expensive medical treatments in adulthood. Trans women forced through male puberty would then have to undergo painful and expensive electrolysis to remove facial hair and may be left with a body frame (shoulder and hip width) that would be unchangeable by any surgeries. Trans men would have to have surgery to remove their breasts and, like their trans female counterparts, be forced to live in an unwanted body frame for their entire lives.”

The massive Republican push to ban trans athletes, explained

“It’s perhaps the harshest in a wave of state-level anti-trans legislation aimed at barring trans girls and women from playing girls’ and women’s scholastic sports. About 30 states have introduced anti-trans athlete bills this year, and two of those became law this month: Mississippi and Arkansas. Tennessee’s ban, meanwhile, is awaiting the governor’s signature. Idaho passed a similar law last year, which was later enjoined by a federal court.”

“science has found that trans girls who hormonally transition at younger ages do not necessarily have a “biological advantage” athletically. And none of it justifies banning middle school trans girls from the local girls’ soccer team.”

“An Associated Press investigation into these athletic bans found that most lawmakers supporting such bills cannot name a single trans athlete competing in their state. A New York Times report indicated that out of about 200,000 women taking part in NCAA women’s sports at a given time, about 50 are transgender.”

“Advocates say that laws that exclude and punish trans kids — and messaging that classifies young trans girls as “biological boys” — is scare-mongering and unfair, and only seeks to reinforce ugly stereotypes about trans girls and women to an uninformed public. It’s another attack on trans kids that potentially threatens not just their school life but also their relationship with their parents — which, advocates say, is ultimately the goal for anti-trans conservatives: forcing trans kids back into the closet.”

“Children frequently play coed sports until puberty begins, and only then does there begin to be a separation in athletic performance between boys and girls. The existence of girls like Walker, however, further complicates matters. She largely avoided male puberty to begin with, thanks to her middle school puberty blockers and hormonal transition. Taking a look at her slight physique would render absurd the idea that she’s some genetically giant super-athlete compared to her cis peers.”

“Even for trans women athletes, many experts agree that trans women at least lose some performance ability when they hormonally transition, even if it’s after puberty has been completed, rendering it unlikely that they would be able to keep up — or stay safe — competing against their cis male counterparts.
Estrogen is much less efficient at building and maintaining muscle than testosterone, and early research indicates that trans women lose significant strength through their transition-related hormone replacement therapy regimen. So for trans women athletes, that means they need to take longer to recover between workouts than they did before transition, causing muscle loss.

While some studies have suggested that trans women do retain at least some of their previous pure strength advantage even after a year on estrogen, with further drops past the one-year mark, how this exactly translates to more complicated athletic movements beyond pure strength and endurance tests remains to be proven.”

“Part of the problem on the anti-trans side is that they’re starting from the base assumption that trans women are men, and substitute cis male physical traits when discussing whether trans women may have competitive advantages. They’ll argue that men have bigger hearts and more lung capacity, or produce more red blood cells on average than cis women, and then assume trans women’s bodies would be the same.

But initial scientific findings don’t necessarily support that, according to Loughborough University PhD student Joanna Harper, who has spent the past decade researching trans athletes. Harper noted that a trans athlete she previously studied at Arizona State University saw the ejection fraction rate of her heart drop significantly after HRT, meaning less blood was pumped with each beat. “The heart itself might be the same, but the muscles may not work as well,” she told Vox. “And if the ejection fraction goes down, who cares about the size of the heart? It’s how much blood you can pump that matters.””

“Trans women were allowed to begin competing as women in the Olympics if they’d had bottom surgery beginning in 2004. The surgery requirement was lifted in 2016 and replaced by guidelines stating that trans women must lower their testosterone levels for an entire year before eligibility. Despite the more open stance, no openly trans woman has ever qualified to compete as a woman in the Olympics.”

“Sports — and, ultimately, being part of a team — are a normal part of kids’ socialization. Studies have shown that athletic participation provides all sorts of positive effects on children, from reduced rates of depression to positive physical health outcomes. But more importantly, high school and college sports are a common space for community-building. Small towns often gather at the local high school’s athletic events and socialize and build a common identity. By excluding trans girls from these spaces, it sends a clear message to all trans kids that they don’t belong.”

Why Republicans are suddenly in a rush to regulate every trans kid’s puberty

“Compiled by the Trevor Project in a research brief, study after study has shown that affirming trans and gender-diverse kids in their self-exploration improves mental health and lowers suicide risk. The affirming model, which allows children to explore their gender identities at their own pace and can include puberty blockers, has been recommended by nearly every major American medical association, including the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, the Endocrine Society, the World Professional Association for Transgender Health, and the American College of Obstetricians and Gynecologists.”

“The state now threatens to insert itself into the most basic decisions of body and identity, all to drive a handful of votes from the conservative base to win in an election year. Lost in the conservative rush to tamp down the trans rights movement are the very real lives of trans kids who simply want to transition and move on to adulthood.”