The Gender-Affirming Care Double Standard
Ian Kingsbury, Jay P. Greene
January 15, 2025
City Journal / Archive
In medical terms, is one in 1,000 a rare event? The answer, it turns out, is political.
When it comes to Type-2 diabetes, the health-care establishment appears to agree that the prevalence of 1.04 cases per 1,000 among 15- to 19-year-olds is cause for alarm. Diabetes Care, the flagship journal of the American Diabetes Association, noted in 2009 an “increasing and alarming incidence of type 2 diabetes in adolescent populations.” By 2023 that journal referred to it as “an awakening epidemic.” That same year, another journal echoed the sentiment, calling pediatric Type-2 diabetes an “urgent challenge.”
While a one-in-1,000 event is an “epidemic” and “urgent challenge” when it comes to Type-2 diabetes, however, it’s apparently nothing of the kind when it comes to so-called gender-affirming care for minors. A newly published study in the Journal of the American Medical Association Pediatrics estimates that 1.40 of every 1,000 adolescents born female have received a prescription for cross-sex hormones by the time they turn 18. The study therefore concludes that, from 2018 through 2022, “receipt of puberty blockers and hormones was rare.”
And it’s not just health “experts” who apply a double standard in how they characterize a one-in-1,000 medical event. Sympathetic members of legacy media faithfully parrot the same message.
A 2012 NPR segment noted that fears about a Type-2 diabetes epidemic among kids were coming true: “Researchers are especially concerned about the high rate of diabetes among teenage girls,” the report noted. “If their weight is not healthy,” a physiologist told NPR, “we’re going to have another generation of these children with metabolic problems that lead to diabetes and prediabetes.”
More than a dozen years later, characterizing the new study on pediatric gender medicine, NPR ran a story under the headline, “‘A very, very small number’ of teens receive gender-affirming care, study finds.” And while metabolic concerns and gender disparities are a concern for NPR when it comes to Type-2 diabetes, the same doesn’t hold true for gender medicine. No mention is made of how girls are more than twice as likely to receive a hormone prescription as boys, or of the metabolic effects of hormone treatment.
USA Today has run a number of articles elevating concerns about Type-2 diabetes in children, including a 2022 piece that calls the phenomenon “concerning” and “unsettling.” And yet, the same paper opines, “Despite public uproar over teenagers and children changing their genders, transgender teenagers and children rarely get prescribed gender-affirming medications.” It goes on to make the false claim that “Just .1% of children ages 8 to 17 who identify as transgender or gender-diverse [emphasis ours] were prescribed gender-affirming hormones or puberty blockers.” In reality, 0.1 percent of all children are prescribed hormones by 18. The figure would be far higher if analysis were limited to those who identify as transgender.
Transgender advocates are on their heels. Almost half of all states have adopted laws prohibiting the use of puberty blockers, hormones, and surgeries for minors. Once the Supreme Court affirms the constitutionality of these bans, which appears likely, these laws will spread to more states. Assertions by transgender advocates that these medical interventions were necessary to save lives have not persuaded most Americans. As that line of defense has crumbled, advocates are scrambling to offer the new defense: that these interventions are so rare that they don’t warrant legislative attention.
But like the claim that puberty blockers, hormones, and surgeries save lives, the claim that these procedures are not common is based on falsehoods and distortions. And just as the legacy media’s promotion of the life-saving narrative failed, the new effort to frame these interventions as rare events will also fall short. (And besides, critics of gender-affirming care object to it because it’s harmful, regardless of how common it is.)
People increasingly know of friends and family caught up in transgender trend and can see the disastrous consequences with their own eyes. If we believe the estimates of JAMA Pediatrics for cross-sex hormone use, more than 7,800 teenagers are taking these drugs. And given that the transgender social contagion is concentrated in upper-income communities on the coasts, many politically influential people personally know of cases of children on cross-sex hormones.
The media and advocacy groups can keep telling us that the sky is green, but we can see that it’s blue. No amount of misleading narratives will reverse the spread of state bans on transgender drugs and procedures for children.
Ian Kingsbury is the director of research for Do No Harm, where Jay P. Greene is a senior fellow.
by the sociologist Tay Meadow:
