Missouri joins other Republican led state governments that have been restricting gender-affirming care for minors. Bypassing the State Legislature, Missouri’s Attorney General said he will limit access to gender-affirming care for minors and like Texas, label such as ‘child absue.’
Gender-affirming care for children and adults encompasses a range of social, psychological, behavioral, and medical interventions “designed to support and affirm an individual’s gender identity.” The interventions help transgender people align various aspects of their lives — emotional, interpersonal, and biological — with their gender identity.
The interventions fall along a continuum from only counseling to changes in social expression and to medications (such as hormone therapy). For minors in particular, the timing of the interventions is based on several factors, including cognitive and physical development as well as parental consent.
Surgery, including to reduce a person’s Adam’s Apple, or to align their chest or genitalia with their gender identity, is rarely provided to people under 18.
“The goal is not treatment, but to listen to the child and build understanding — to create an environment of safety in which emotions, questions, and concerns can be explored,” says Rafferty, lead author of a policy statement from the American Academy of Pediatrics (AAP) on gender-affirming care.
15 states have restricted access to gender-affirming care or are currently considering laws that would do so. The bills carry severe penalties for health care providers, and sometimes families, who provide or seek out gender-affirming care for minors.
There are over 150,000 minors in the U.S. currently accessing gender-affirming care. The new laws, if passed would block any care for a full third of those, harming them possibly irreparably, as they struggle with questions of gender and sexuality.
Gender-affirming care, including the use of hormones to delay puberty and to promote the development of secondary sex characteristics that are consistent with a child’s gender identity, is recommended for transgender youth by the American Academy of Pediatricians and the Endocrine Society and is viewed by the American Academy of Child and Adolescent Psychiatry (AACAP) and the American Psychiatric Association (APA) as evidence-based patient care. Moreover, the American Medical Association supports insurance coverage for gender-affirming care for transgender people.
Just to note, Missouri also recently passed laws that allow children to carry guns in public, and bars female legislators from wearing clothing that exposes their bare arms.
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