Thanks to the heightened public awareness of transgenderism, demand for trans-specific medical care like counseling, hormone treatments, and genital surgery has increased significantly. There are 30-plus clinics for transgender youth across the US, but they can barely keep up with the demand.
Chicago’s Lurie Children’s Hospital, for example, opened its trans clinic just four years ago but already has 500 patients – and a four-month waiting list.
One doctor shares what her patients all share: the strong, almost certain, belief that they have been born into the wrong body. Their brains tell them they are one gender, their bodies another. Too often, the doctor said, these kids have no one to help guide them or ease their pain or even offer routine medical care without disparaging them. “It’s not OK to do nothing.” Without support, she said, trans kids are a risk for almost everything: depression, self-harm, substance abuse, homelessness, HIV and suicide.
Not all doctors agree with the approach of this doctor and her colleagues. Some think young patients will grow out of their gender dysphoria, or that children should wait until they are 18 to make critical gender decisions. Many would simply like to see data on whether delaying puberty and allowing children to transition at younger ages is safe and healthy for them in the long run.
In 2015, the first NIH grant was given to study transgender youth. The $5.7 million, five-year study will look at nearly 300 youth, some who received puberty-blocking hormones and others who took masculinizing or feminizing hormones after puberty. Teams at children’s hospitals in L.A., San Francisco, Boston, and Chicago have recruited patients and are now collecting data to evaluate the effect of treatment on mental health and determine how safe the treatments are. The doctors think the study will prove that early treatment and puberty-blocking lead to far better long-term outcomes, making it easier for doctors and parents to accept that approach.