Debates Surrounding Youth Gender Medicine are Escalating

This week I challenged myself to delve into the complex and detailed debate over youth gender medicine and sex-altering procedures. During my daily 45 minutes on the Stairmaster, I spent my time listening and reading about the history and cultural context of adolescent transgender individuals and their journeys. In order to learn more about the processes that follow youth gender dysphoria and their place in the medical field, I listened to a six-part series conducted by the New York Times called The Protocol. 

Hosted and researched by Azeen Ghorayashi, the podcast series takes listeners through six episodes that explore landmark cases and studies that have propelled gender-changing protocols. Each episode works somewhat chronologically through the history of the first gender medicine to bans on procedures being challenged in court today. They are complete with insightful and nuanced interviews from the first minor to be administered hormones, clinical psychologists, scientists, and pediatricians who share their experience and opinions on the subject. 

One of the most important landmarks in youth gender medicine history is the Dutch protocol. When it emerged in the late 20th century, the protocol served as a basis of diagnosis and processing time by temporarily suppressing sex-related growth through puberty blockers. 

Over time, however, the protocol slowly lowered its age requirement down to 12 years old from its initial prerequisite of 16 years old. Yet, as more and more adolescents—primarily female-born individuals—have shown interest in being administered puberty suppressants, and eventually hormones, the Netherlands has taken a cautious step toward increased regulation. 

Additionally, an insufficient number of studies displaying proper evidence about the medical implications of youth gender medicine has escalated the debate, and even caused doubt surrounding the 2018 Dutch protocol currently in place. 

The 2018 protocol was not based on sufficient evidence, and instead relaxed much of the standards that allow adolescents with gender dysphoria to begin puberty blockers. According to the Society of Evidence Based Gender Medicine, “the majority of youth transitioned under the 2018 Dutch Protocol today likely have post-pubertal emergence of gender dysphoria, and would not have qualified for gender transition based on the original criteria.”
As of now, debates have continued and over half of states in the United States have banned surgical care and medical practice for transgender youth.