Transgender health care misinformation

Misinformation and disinformation about transgender health care are false and misleading claims about gender diversity, gender dysphoria, and gender-affirming healthcare that have been used in proposed attempts to ban such healthcare. These include claims that most pre-pubertal transgender children "desist" and cease desiring transition after puberty, that most people who transition regret it, that gender dysphoria can be socially contagious (an unevidenced theory labelled rapid onset gender dysphoria), and that gender dysphoria is caused by mental illness, among others.

Proponents of this misinformation have included organizations such as the Society for Evidence-Based Gender Medicine, Genspect, the Alliance Defending Freedom, and the American College of Pediatricians.

Origins

Transgender healthcare misinformation primarily relies on manufactured uncertainty from a network of conservative legal and advocacy organizations. These organizations have relied on similar techniques to climate change denialism, generating exaggerated uncertainty around reproductive health care, conversion therapy, and gender-affirming care.

The Southern Poverty Law Center stated the hub of the pseudoscience movement was the Society for Evidence-Based Gender Medicine, which was closely related to Genspect and Therapy First. A Yale School of Medicine report described them as spreading "biased and unscientific content" and "without apparent ties to mainstream scientific or professional organizations".

Other notable producers of anti-LGBTQ misinformation and disinformation include the evangelical organizations the Alliance Defending Freedom, American College of Pediatricians, and Family Research Council. These efforts have been aided by scientists who were once dominant in transgender care but are now fringe such as Kenneth Zucker, Stephen B. Levine, and Ray Blanchard. Misinformation and disinformation about transgender health care sometimes relies on biased journalism in popular media.

Common misinformation

Desistance myth

Some have argued that the majority of pre-pubertal youth diagnosed with gender dysphoria will "desist" and stop desiring to transition by adulthood without intervention.

These claims stem from a commentary by James Cantor in 2020 who argued based on outdated studies that most children diagnosed with gender dysphoria will grow up to be gay and lesbian adults if denied gender-affirming care. The studies had serious methodological flaws such as low sample sizes, outdated diagnostic frameworks that conflated gender non-conformity with transgender identity, usage of conversion therapy on the sample population, and poor definitions of desistance. Most youth sampled in them never identified as transgender or desired to transition, but were counted as desisting.

Recent work has found the vast majority of pre-pubertal children who express transgender identities and socially transition with parental support continue to do so in adolescence.

Detransition and regret

Some have claimed that the majority of transgender people regret or reverse their transition by relying on anecdotes and misinterpreted studies.

Transgender identity as a mental health condition

Some argue that gender dysphoria is caused by underlying mental illness, trauma, or neurodivergence such as autism, and ADHD. Though transgender people have higher rates of mental illness, there is no evidence these cause gender dysphoria and evidence suggests this is due to minority stress and discrimination experienced by transgender people.

The American Psychological Association stated "legislative efforts to restrict access to care have involved the dissemination of misleading and unfounded narratives (e.g., mischaracterizing gender dysphoria as a manifestation of traumatic stress or neurodivergence, and equating affirming care for transgender, gender-diverse, and nonbinary youth with child abuse), creating a distorted perception of the psychological and medical support necessary for these youth and creating a hostile environment that adversely affects their mental health and wellbeing" and such misinformation is "widely disseminated through formal and informal networks".

Others have argued that transgender youth are incapable of providing informed consent. However, transgender children require their parents to consent to their medical treatment and scientific literature demonstrates that transgender youth with mental health conditions can competently participate in decision-making.

Transgender children require psychotherapy

Some have argued that youth with gender dysphoria should receive psychotherapy, including the form of conversion therapy gender exploratory therapy (GET), instead of medical treatment. Practitioners of GET often view medical transition as a last resort and propose their patient's dysphoria is caused by factors such as homophobia, social contagion, sexual trauma, and autism. Some practitioners of GET avoid using their patients' chosen names and pronouns while questioning their identification States that have banned gender-affirming care for minors in the United States have called expert witnesses to argue that exploratory therapy should be the alternative treatment.

There are no known empirical studies examining psychosocial or medical outcomes following GET. Concerns have been raised that by not providing an estimated length of time for the therapy, the delays in medical interventions may compound mental suffering in trans youth, while gender-affirming model of care already promotes individualized care and gender identity exploration without favoring any particular identity. Commenting on gender exploratory therapy in 2022, bioethicist Florence Ashley argued that its framing as an undirected exploration of underlying psychological issues bore similarities to gay conversion practices such as "reparative" therapy.

Multiple groups exist worldwide to promote GET and have been successful in influencing legal discussions and clinical guidance in some regions. Therapy First, previously named the Gender Exploratory Therapy Association, asserts that "psychological approaches should be the first-line treatment for all cases of gender dysphoria", that medical interventions for transgender youth are "experimental and should be avoided if possible", and that social transition is "risky". All of GETA's leaders are members of Genspect, a "gender-critical" group that promotes GET and argues that gender-affirming care should not be available to those under 25. GETA also shares a large overlap with the Society for Evidence-Based Gender Medicine (SEGM), which promotes the same position.

Social contagion and rapid onset gender dysphoria

Main article: Rapid-onset gender dysphoria controversy

Some have claimed that modern youth are experiencing a new type of gender dysphoria, "rapid onset gender dysphoria" (ROGD), which is spread through social contagion and peer groups. The concept stems from a heavily corrected study by Lisa Littman in 2018, which relied on anonymous parental reports on transgender children collected from websites known for anti-trans misinformation and gender-critical politics who were informed of the study's hypothesis.

While there is no empirical evidence to support the hypothesis, it has been heavily referenced in discourse about transgender youth. In 2021, a coalition of psychological professional bodies issued a position statement on ROGD that "supports eliminating the use of Rapid-Onset Gender Dysphoria (ROGD) and similar concepts for clinical and diagnostic application given the lack of rigorous empirical support for its existence." It stated that "there is no evidence that ROGD aligns with the lived experiences of transgender children and adolescents" and "The proliferation of misinformation regarding ROGD is also infiltrating policy decisions. Currently, there are over 100 bills under consideration in legislative bodies across the country that seek to limit the rights of transgender adolescents, many of which are predicated on the unsupported claims advanced by ROGD".

Medical organizations are untrustworthy

Though every major medical organization endorses gender-affirming care, proponents of gender-affirming care bans argue the mainstream medical community is untrustworthy, ignores the evidence, and that doctors are pushing transgender youth into transition due to political ideology and disregard for their well being. This extends to claims that standards of care and guidelines from reputable medical organizations do not reflect clinical consensus.

Schools are medically transitioning children

In 2024, Donald Trump attended a Moms for Liberty Rally and stated children were being given gender-affirming surgery at school, and continued to repeat the claim. There is no evidence any school has ever provided a student gender-affirming surgery.

Impact

Misinformation and disinformation has led to proposed legislative restrictions on gender-affirming care across the United States and in the United Kingdom through claims in the Cass Review. It has also led to bomb threats against Boston Children's Hospital.

Responses from medical organizations

In June 2023 the Endocrine Society stated:

Due to widespread misinformation about medical care for transgender and gender-diverse teens, 18 states have passed laws or instituted policies banning gender-affirming care. More than 30 percent of the nation’s transgender and gender-diverse youth now live in states with gender-affirming care bans, according to the Human Rights Campaign. Some policies are even restricting transgender and gender-diverse adults’ access to care.

These policies do not reflect the research landscape. 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.

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. Major medical organizations also agree on waiting until an individual has turned 18 or reached the age of majority in their country to undergo gender-affirming genital surgery.

The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Urological Association, the American Society for Reproductive Medicine, the American College of Physicians, the American Association of Clinical Endocrinology, GLMA: Health Professionals Advancing LGBTQ+ Equality, the American Medical Association (AMA), AMA’s Medical Student Section cosponsored an Endocrine Society resolution "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."

In February 2024 the American Psychological Association released a policy statement addressing "the spread of misleading and unfounded narratives that mischaracterize gender dysphoria and affirming care, likely resulting in further stigmatization, marginalization, and lack of access to psychological and medical supports for transgender, gender diverse, and nonbinary individuals" stating "such misinformation is widely disseminated through formal and informal networks, yet credible scientific evidence has not been widely disseminated and is not readily accessible to the public". It stated: "legislative efforts to restrict access to care have involved the dissemination of misleading and unfounded narratives (e.g., mischaracterizing gender dysphoria as a manifestation of traumatic stress or neurodivergence, and equating affirming care for transgender, gender-diverse, and nonbinary youth with child abuse), creating a distorted perception of the psychological and medical support necessary for these youth and creating a hostile environment", and resolved that "the APA opposes state bans on gender-affirming care, which are contrary to the principles of evidence-based healthcare, human rights, and social justice, and which should be reconsidered in favor of policies that prioritize the well-being and autonomy of transgender, gender-diverse, and nonbinary individuals;"

See also

• 21st-century anti-trans movement in the United Kingdom
• 2020s anti-LGBTQ movement in the United States
• Evaluation of Transsexual Surgery
• Transphobia
• Transmedicalism