As a pediatrician, I never imagined having lawmakers decide which children\u2019s suffering deserves treatment.<\/p>\n
I have watched with alarm as policies restricting gender-affirming care have spread rapidly across the country. Since 2021, 27 states<\/a> have enacted bans on gender-affirming hormones, surgery, or both for minors, despite decades of evidence demonstrating this care\u2019s safety and efficacy. In January, the Trump administration escalated the attack by issuing an executive order<\/a> threatening to cut federal funding to institutions providing gender-affirming care. What began as a patchwork of state restrictions became a federal campaign dismantling a vital part of adolescent health care.<\/p>\n Then, last week, the Supreme Court made the crisis even more dire. In a 6-3 decision in U.S. v. Skrmetti, the court upheld Tennessee\u2019s ban<\/a> on gender-affirming care for minors, ruling that it does not constitute sex-based discrimination. The court\u2019s decision gives federal cover to what was once a patchwork of harmful state laws and sets a devastating precedent for the future.<\/p>\n \t\t\t \t\t\t\t Although several federal judges issued preliminary injunctions<\/a> blocking enforcement of the executive order, the damage has been profound. Multiple children\u2019s hospitals<\/a> initially halted gender-affirming care for trans adolescents following the order, and others<\/a> have closed their gender programs entirely under increasing pressure from the administration. Families have been devastated<\/a>, forced to interrupt vital medical treatment while litigation proceeds. The present and future of gender-affirming care for youth remains deeply uncertain.\u00a0<\/a><\/p>\n Fewer than 1 in 1,000<\/a> adolescents receive gender-affirming care. So why has the health care of some of our most vulnerable youth become the target of a relentless national crusade?<\/p>\n The irony is stark: What the executive order deems \u201cjunk science\u201d and \u201cexperimental\u201d medicine is, in fact, long-standing, evidence-based practice. We routinely prescribe hormones to adolescents for a variety of medical reasons. As an adolescent medicine doctor, I\u2019ve prescribed hormonal medication to suppress menstruation in teens with developmental delays to improve their quality of life, and to girls whose periods are so painful they can\u2019t attend school. I\u2019ve followed patients who were on puberty blockers as children because of precocious puberty. I\u2019ve referred 15- and 16-year-olds to breast surgeons for breast reductions because of extreme physical discomfort. I\u2019ve provided hormone therapy to young women whose ovaries fail to produce estrogen \u2014 without hesitation, and without controversy.<\/p>\n But the moment I provide the same evidence-based treatments to transgender youth, the executive order labels it as \u201cchemical mutilation.\u201d<\/p>\n No politician threatens to defund hospitals that provide care for teens with developmental delays or children who are starting puberty too early. The medical evaluation is just as rigorous. The medications are identical. The benefits and risks are carefully weighed in every case. Yet only the patient\u2019s identity determines whether I am practicing medicine or committing a crime.<\/p>\n In the majority opinion in Skrmetti, Chief Justice John Roberts wrote that the Tennessee ban does not discriminate on the basis of gender because it simply \u201cremoves one set of diagnoses \u2014 gender dysphoria, gender identity disorder, and gender incongruence \u2014 from the range of treatable conditions.\u201d He went on to say that the law separates minors into two groups: those seeking treatment for these diagnoses, and those seeking treatment for other conditions. It\u2019s a neat trick to side-step the discrimination claim, but it doesn\u2019t make sense.<\/p>\n What does it mean to strip an entire set of medical conditions of legitimacy, denying it the same treatment we offer other conditions? That a young person can get hormone therapy or a breast reduction to improve quality of life, but deny the same treatment the second the diagnosis of gender identity disorder is established even if it would also improve quality of life?<\/p>\n This legal decision does not create neutrality but instead enforces a chilling double standard \u2014 stripping the decision to pursue treatment away from the youth, their families, and their health care providers.<\/p>\n To declare that a person\u2019s right to care can be revoked because of political opinion is to disregard the lived experiences of young people in pain, their families\u2019 rights to make this decision, and the expert consensus<\/a> of multiple medical societies that are on the frontlines of this care. The American Academy of Pediatrics<\/a>, the Pediatric Endocrine Society<\/a>, and the Society of Adolescent Health and Medicine<\/a> have all provided evidence-based recommendations supporting this care. The conclusion of the very professional societies we trust to guide care for asthma, diabetes, and is unambiguous: Gender-affirming care is effective, safe, and medically necessary.\u00a0<\/p>\n \t\t\t \t\t\t\t\t\tQ&A: How institutions have responded to the gender-affirming care executive order, one week later<\/a><\/p>\n The stakes are life and death. According to a 2024 report from the Trevor Project, nearly half of transgender and nonbinary youth have\u00a0seriously considered suicide<\/a>\u00a0in the past year \u2014 more than\u00a0twice the rate<\/a>\u00a0a 2023 CDC study found among their peers. And research is clear: Gender-affirming care saves lives. Extensive studies have shown youth who received gender-affirming care had improved psychological functioning<\/a> and long-term higher rates of life satisfaction<\/a>. Gender-affirming medical care was associated with 60% lower odds of moderate or severe depression<\/a> and 73% lower odds of suicidality. And timing matters: Accessing care during adolescence is especially critical, lowering suicide risk<\/a> compared with starting treatment in adulthood.<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/06\/GettyImages-2188212973-768x432.jpg\")
\t\t<\/p>\n![\"\"\/](\"https:\/\/www.statnews.com\/wp-content\/themes\/stat\/images\/home\/statplus.svg\")
\n\t\t\t\tSupreme Court ruling on gender-affirming care delivers major setback for transgender rights<\/a><\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/06\/AP23104839926309-768x432.jpg\")
\t\t<\/p>\n