Confusing White House Statement on Trans Youth Care Leads to Backlash

The White House has released a statement reiterating its support for gender-affirming care for transgender youth after an official was met with backlash last week for suggesting that the Biden administration supported some restrictions on such care.

A Biden spokesperson, in email communications with The 19th, said last week that the administration supports gender-affirming care for trans youth in almost all regards, except when it comes to surgery.

“These are deeply personal decisions and we believe these surgeries should be limited to adults,” the spokesperson told the publication last week. “We continue to support gender-affirming care for minors, which represents a continuum of care, and respect the role of parents, families, and doctors in these decisions.”

Notably, surgical treatment is not the most common form of gender-affirming care, which often consists of therapy and sometimes medical treatment in the form of puberty blockers or hormones. However, when doctors determine that surgery is needed in conjunction with patients and their family members, such treatment can be highly beneficial to those who receive it.

Opponents of such treatment, and the rights of transgender youth in general, have crafted many lines of attack against gender-affirming care on the basis that these surgeries happen frequently and result in detrimental, life-altering outcomes.

In fact, the opposite is true: surveys of transgender youth who receive the most common form of surgery as part of their treatment — male chest reconstruction, commonly called “top surgery” — consistently show that it has had a positive outcome in their lives, with little to no regret recorded years afterward.

Anti-trans activists have also peddled false claims that youth are undergoing genital surgery on a widespread scale. However, such surgeries are extremely rare, and are only performed on older trans teens in dire situations in which such treatment is considered lifesaving.

Many medical groups have stated unequivocally that barring surgery for transgender youth, or enforcing overly strict age limits for such treatments, unnecessarily prevents doctors, their patients and their families from seeking care options that could be beneficial. The World Professional Association for Transgender Health (WPATH), for example, has refused to promote minimum ages for these treatments, “to reflect that one-size-fits-all health care models, especially transgender care, are not accurate or appropriate for every individual person.”

“The listing of ages would lead to further limitations to care by creating or reinforcing arbitrary boundaries to care and/or by ignoring possible contributing health factors including mental health, family support, or other individual health needs,” the organization also said.

In response to the Biden administration’s statement last week, several advocates for transgender youth spoke out, demanding clarification from the White House on the administration’s commitment to protecting trans health care.

“It’s angering and disheartening that the Biden Administration would choose to disregard the needs of transgender young people and decades of clinical research at a time when transgender health and rights are under attack across the country,” said Louie Ortiz-Fonseca, Director of LGBTQ Health & Rights at Advocates for Youth.

Added Ortiz-Fonseca:

Transgender young people must be able to be themselves and make the best decisions for their bodies and their futures — and to know that adults in power have their back. We urge the Biden Administration to join us in working with, not against transgender youth and their families to ensure every young person has the lifesaving gender-affirming care they need.

In a letter coordinated by the Human Rights Campaign (HRC) and a number of other LGBTQ advocacy groups, organizations similarly condemned the statement from the administration last week.

“No parent should ever be put in the position where they and their doctor agree on one course of action for their children, supported by the overwhelming majority of medical experts, but the government forbids it,” that letter said.

In response to the backlash, another administration official sought to clear up the statement from last week, emphasizing on Monday that the Biden White House would continue defending access to all types of gender-affirming care for trans youth.

“We continue to fight state and national bans on gender-affirming care, which represents a continuum of care, and respect the role of parents, families, and doctors — not politicians — in these decisions,” read a statement from Neera Tanden, director of the White House Domestic Policy Council.

“Gender-affirming surgeries are typically reserved for adults, and we believe they should be,” Tanden went on.

Although the statement continued to press the idea that gender-affirming surgeries should generally be reserved for adults, it clarified that the administration wouldn’t seek to restrict youth surgeries when needed.

HRC President Kelly Robinson responded to the new statement positively.
“We appreciate that the administration has clarified that its position on healthcare for the transgender community has not changed — that it opposes any and all bans on access to care and will continue to fight these bans both in the courts and at the legislative level,” Robinson said.