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• Professional medical organizations recommend against puberty blockers for children who have not reached puberty, which typically begins between ages 10 and 12.
• Hormone treatment for feminization or masculinization of the body is typically not considered until patients are at least 16 years old.
• Gender reassignment surgery is typically only available to those 18 and older in the United States.
Misinformation about medical treatments for transgender patients has proliferated in recent weeks, as a spate of events brought transgender rights into the spotlight.
The social media backlash was swift following executive actions from President Joe Biden to expand transgender rights, his nomination of a transgender woman for assistant health secretary and the U.S. House of Representatives’ passing of the Equality Act to prohibit discrimation based on sexual orientation and gender identity.
One Facebook post features an image of a father and son from the comic strip "The Family Circus," with text that reads, "Can I have a cigarette? No, you’re 5. Can I have a beer? No, you’re 5. Can I drive the car? No, you’re 5. Can I take hormones and change my sex? Sure! You know best."
The onset of puberty is the baseline for medical intervention. Puberty typically occurs between ages 10 and 14 for girls and 12 and 16 for boys.
Guidelines for the medical care of transgender patients, developed by organizations such as the Endocrine Society and the World Professional Association for Transgender Health, begin with counseling and psychological evaluation by a team of medical professionals before any physical interventions are considered.
If patients have begun to go through puberty, and they have "demonstrated a long-lasting and intense pattern of gender nonconformity or gender dysphoria," then treatments such as puberty blockers can be considered, according to the standards of care for transgender people by the World Professional Association for Transgender Health. Gender dysphoria refers to distress people may experience as a result of the discrepancy between their gender identity and the sex assigned to them at birth.
Puberty blockers, which suppress the release of testosterone and estrogen during puberty, allow adolescents "more time to explore their gender nonconformity and other developmental issues," and can be used for a few years, the standards of care say. One guideline for giving the medication says parents or guardians must consent to the treatment and also provide support to the youth during the process.
If a patient decides to continue transitioning, hormone therapy for feminization or masculinization of the body can follow the use of puberty blockers. But, again, the Endocrine Society’s guidelines say patients should be at least 16 years old to receive hormone treatment, which is partly irreversible. Many hospitals, such as the Duke Health Center for Gender Care for Children and Adolescents, will only offer hormone replacement therapies for adolescents 16 or older.
The World Professional Association for Transgender Health reports that gender dysphoria in childhood "does not inevitably continue into adulthood." One study showed that children who had not yet reached puberty who were referred to clinics for assessment of gender dysphoria had a 12% to 27% persistence rate of gender dysphoria into adulthood.
By comparison, adolescents with gender dysphoria are much more likely to have it persist into adulthood, the association reports, though no formal studies have been conducted for adolescents.
A cartoon on Facebook implies that a child who is 5 can "take hormones and change my sex."
The information is unsubstantiated. The guidelines for the medical care of transgender patients, developed by organizations such as the Endocrine Society and the World Professional Association for Transgender Health, do not recommend puberty blockers for children who have not reached puberty; do not recommend hormone treatment for those under 16 years old; and typically restrict genital reassignment surgery to those 18 and older, who also meet other criteria.
We rate this claim False.
Comics Kingdom, "The Family Circus," accessed March 3, 2021
Endocrine Society, "Gender Dysphoria/Gender Incongruence Guideline Resources," Sept. 1, 2017
PolitiFact, "Rachel Levine does not support gender confirmation surgery for all children," March 2, 2021
U.S. National Library of Medicine, Medline Plus, "Puberty," accessed March 3, 2021
World Professional Association for Transgender Health, "Standards of Care," 2012
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