Arkansas lawmakers voted this week to stop doctors from providing gender transition-related care to minors, a measure which – if signed into law by the Republican governor – would make it the first US state to ban such treatment for transgender youth.
Healthcare professionals who provide puberty blockers, cross-sex hormones, or gender-affirming surgery to minors, could face losing their licences, as well as lawsuits from patients who later regret the treatment.
The law’s passage comes as 16 other US states consider similar bills, amid a global debate about the age at which someone can transition gender, and the use of puberty-delaying medication in gender identity care.
So, what do puberty blockers do and why are they so controversial?
Puberty blockers are used to delay the onset of puberty or stop a child’s body maturing to become sexually reproductive, according to US academic medical centre, Mayo Clinic.
They act as hormone-obstructing agents, administered by injection or implants, that hinder the signs of puberty, such as the growth of facial hair and testes, or breast tissue growth and the onset of menstruation.
Puberty blockers have been used for decades to treat precocious puberty, a rare condition in which a child’s body matures early, usually before they turn eight.
More recently, doctors have prescribed puberty blockers for children who are experiencing gender dysphoria, a discomfort that their gender identity does not match their body, to delay physical changes.
“It’s to stop the clock,” Joshua Safer, executive director of the Mount Sinai Center for Transgender Medicine and Surgery, told the Thomson Reuters Foundation.
“The entire point is to allow the child and the parents and the medical providers time to think about what is most logical for that individual.”
Puberty blockers help offset the stress of gender dysphoria, according to the World Professional Association for Transgender Health, a global body of doctors specialised in treating trans people.
A study by Boston Children’s Gender Multispecialty Service found those who take them are less likely to have a history of suicidal thoughts, or suicide attempts by their mid-30s.
The same study found nine in 10 trans adults, who were denied access to the medication, experienced suicidal thoughts.
[Critics] say the medication could lead to lower bone density, and might hamper bone growth.
Research from the Journal of Endocrine Society, which looked at several dozen children taking puberty blockers for less than two months, concluded that “later pubertal onset” as a result of puberty blockers “leads to lower adult bone mineral content.”
The Provincial Health Services Authority, the publicly funded health service provider in the Canadian province of British Columbia, also found that the medication will temporarily delay growth in height and fertility.
-Matthew Lavietes and Rachel Savage @rachelmsavage – Thomson Reuters Foundation