Gender Affirming Care (GAC)

Myth: “Gender-affirming care means surgery for kids.”

• Counterpoint: For adolescents, gender-affirming care is usually social support and mental health care, sometimes puberty blockers (for those who’ve started puberty) and/or hormones for some older teens; surgery for minors is uncommon, and many clinical frameworks tie most surgeries to adulthood/age of majority (18+).

Myth: “Clinicians give hormones to prepubertal children.”

• Counterpoint: Major endocrine guidance (Endocrine Society) does not recommend hormones for prepubertal children; puberty-related interventions are considered after puberty begins, and only in carefully evaluated cases.

Myth: “Puberty blockers are new, untested drugs.”

• Counterpoint: GnRH analogues (aka pubertal suppression/”blockers”) have a long history of use in pediatric care (e.g., for Central Precocious Puberty). In gender-related care, their use is described as puberty suppression after puberty has started (Tanner Stage 2-5), with ongoing monitoring and counseling about knowns/unknowns (including fertility implications).

Myth: “Gender-affirming care is ‘one protocol’ that everyone gets.”

• Counterpoint: The standards of care that clinical frameworks follow emphasize individualized assessment, typically involving a multidisciplinary team, and tailoring options to the patient’s developmental and health status needs.

Myth: “Most trans teens are rushed into irreversible treatment.”

• Counterpoint: Clinical guidance describes multi-step care (often starting with psychosocial support, with medical steps considered later), and highlights informed consent/assent, mental health evaluation/support, and follow-up monitoring—especially for partially reversible or irreversible interventions.

Myth: “Doctors ignore mental health—affirmation means ‘no questions asked.’”

• Counterpoint: Standards of care and best-practice guidance explicitly call for evaluating and addressing mental health and psychosocial factors, and for ensuring that the patient can meaningfully participate in informed consent for partially irreversible steps.

Myth: “Fertility is never discussed.”

• Counterpoint: Endocrine clinical guidance explicitly recommends counseling adolescents and adults about fertility effects and preservation options before puberty suppression and before gender-affirming hormones.

Myth: “Major medical groups say this care is never medically necessary.”

• Counterpoint: The American Medical Association has publicly opposed blanket bans and described such care as medically necessary treatment for some patients, emphasizing physician–patient decision-making. The “major medical groups” opponents refer to are fringe, ideology-driven (as opposed to evidence-based) groups such as the American College of Pediatricians (ACP), Society for Evidence-based Gender Medicine (SEGM), and others.

Myth: “There’s no professional guidance—clinicians are improvising.”

• Counterpoint: The Endocrine Society clinical practice guideline (2017, with ongoing updates/hosting) and the World Professional Association for Transgender Health Standards of Care (SOC-8) provide structured recommendations on assessment, monitoring, and criteria for interventions.

Myth: “All experts agree the evidence is settled in one direction.”

• Counterpoint: The current landscape includes some degree of disagreement about the certainty of evidence and thresholds for irreversible interventions in youth. For example, the American Society of Plastic Surgeons (ASPS) has recently argued for delaying gender-related surgeries until at least 19, citing evidence uncertainty, while other organizations continue to support individualized care within clinical criteria.
• It is important to note that the ASPS position statement cites both the heavily criticized (for bias) U.S. Department of Health and Human Services’ “Treatment for Pediatric Gender Dysphoria Review of Evidence and Best Practices” (2025), and the thoroughly debunked UK-based “Cass Review”, a Yale Law School critique of which can be found here.