Fact Checker: Endocrine Society responds to misinformation from Republican presidential debate

The statement Florida Gov. Ron DeSantis made during Wednesday’s Republican presidential debate contradicts mainstream medical practice and scientific evidence.

DeSantis’ comments characterizing gender-affirming care for transgender and gender-diverse youth as child abuse and genital mutilation do not reflect the health care landscape.

Contrary to widespread misinformation, gender-affirming genital surgery is rarely offered to anyone under the age of 18.

More than 2,000 scientific studies have examined aspects of gender-affirming care since 1975, including more than 260 studies cited in the Endocrine Society’s Clinical Practice Guideline.

Major medical and scientific organizations including the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics are in alignment with the Endocrine Society on the importance of gender-affirming care.

In June, the American Medical Association (AMA) House of Delegates passed a resolution with overwhelming support to protect access to evidence-based gender-affirming care for transgender and gender-diverse individuals. In the resolution, the AMA committed to opposing any criminal and legal penalties against patients seeking gender-affirming care, family members or guardians who support them in seeking medical care, and health care facilities and clinicians who provide gender-affirming care.

Around 300,000 teenagers ages 13-17 in the United States, or 1.4% of the population, identify as transgender, according to the Williams Institute. An estimated 4,780 adolescents with a diagnosis of gender dysphoria started puberty-delaying medication between 2017 and 2021, according to an analysis performed by Komodo Health Inc for Reuters.

Pediatric gender-affirming care is designed to take a conservative approach. When young children experience feelings that their gender identity does not match the sex recorded at birth, the first course of action is to support the child in exploring their gender identity and to provide mental health support, as needed.

Medical intervention is reserved for older adolescents and adults, with treatment plans tailored to the individual and designed to maximize the time teenagers and their families have to make decisions about their transitions.

Gender-affirming care can be life saving for a population with high suicide rates. For example, a 2020 study analyzed survey data from 89 transgender adults who had access to puberty-delaying medication while adolescents and data from more than 3,400 transgender adults who did not. The study found that those who received puberty-delaying hormone treatment had lower likelihood of lifetime suicidal ideation than those who wanted puberty-delaying treatment but did not receive it, even after adjusting for demographic variables and level of family support. Approximately nine in ten transgender adults who wanted puberty-delaying treatment, but did not receive it, reported lifetime suicidal ideation.

Medical decisions should be made by patients, their relatives and health care providers, not politicians.