Citing “changing federal expectations,” the gender clinic at MultiCare’s Mary Bridge Children’s Hospital & Health Network in Tacoma has cut its waitlist for trans youth, according to an email the Health Network’s Chief Medical Officer Dr. Barbara Thompson sent to staff this morning. It won’t start new medical care for trans youth after September 12, but will continue providing hormones and puberty blockers to patients already receiving them.
According to the email obtained by The Stranger, Mary Bridge has provided children with puberty blockers and hormones for “many years,” but started a waitlist when “staffing challenges” prevented it from taking new patients. The hospital does not perform gender-affirming surgery, but the clinic’s website still says its multidisciplinary team includes “endocrinology experts.”
“This month, we began notifying families that we will no longer maintain a wait list as we assess the changing federal expectations around our provision of medical interventions to minors as a treatment for gender dysphoria,” Thompson’s email read. “While the waitlist for medical interventions is no longer available, we will continue to provide patients with behavioral health support.”
“After Sept. 12, we will not start new patients on medical treatment. This applies to both existing patients not currently on medications and patients who are new to the clinic.”
According to a 2023 post announcing Thompson’s promotion to CMO of Mary Bridge’s health network, she’s a pediatric endocrinologist and her responsibilities included “pediatric outpatient services, specialty and subspecialty clinics, as well as Mary Bridge Children’s urgent care, primary care and affiliate clinics.”
When asked about the changes to their care, a spokesperson for the hospital confirmed the change in policy. They also confirmed that it was due to concerns over the loss of federal funding. “We continue to assess the changing federal expectations around our provision of medical interventions to minors as a treatment for gender dysphoria,” the spokesperson wrote in an email. “At the risk of losing federal funding (more than 60% of Mary Bridge Children’s patients rely on Medicaid), we needed to make adjustments to the services provided at the gender clinic.”
Soon after taking office, President Donald Trump issued an executive order banning federal support for trans care for people under 19. The attorneys general of Washington, Oregon and Minnesota sued, and it was blocked by a federal judge in Seattle. The preliminary injunction is still in effect, according to Attorney General Nick Brown’s office. The office says it was not aware of Thompson’s letter and had no additional comments at this time.
Earlier this year, Seattle Children’s halted gender-affirming surgeries for youth, restarted gender-affirming surgeries, and then stopped providing them again. In that time, the National Institutes of Health cancelled one of its grants funding research on gender affirming care. Brown’s office argued in court the cancellation was retaliatory, but the judge didn’t see the connection as other grants were left untouched. After Children’s stopped performing surgeries the second time, advocates including the ACLU of Washington’s health policy director signed a letter alleging the hospital was violating state anti-discrimination law.
According to an NBC News analysis, at least 21 hospitals and health systems in the US have ended or restricted trans care since January. Another five have taken down webpages dedicated to trans care for minors. Federal attempts to disrupt trans care or defund hospitals often conflict with state laws against discrimination in medical care.
This is a developing story. It has been updated to include comment from Mary Bridge Hospital.
Self ID with informed consent and affirmative care is fine for over 18 year olds. But because over half of children who experience gender dysphoria have it desist post puberty without medical intervention and there is no way to tell who will and who won’t desist, medicalization should wait until 18.
Raw dogging a strawprog. Can you quote a progressive in some position of authority denying minors getting gender affirming surgery and not some 14 year old on reddit?
@7, The numbers are vanishingly small but not zero — .002% of youth with a confirmed diagnosis of gender dysphoria get surgery, almost exclusively top surgeries in trans boys a year or 2 shy of 18. Bottom surgeries are rare even for adults and they require fully mature tissue so they are not indicated for anyone who hasn’t reached sexual maturity.
https://hsph.harvard.edu/news/gender-affirming-surgeries-rarely-performed-on-transgender-youth/
@8 actually misstated the population. 97% of gender-affirming top surgeries are in cisgender boys, not trans boys.
Always check with Grok on statistics claimed by 8:
To evaluate the accuracy of the article from the Harvard T.H. Chan School of Public Health titled “Gender-affirming surgeries rarely performed on transgender youth,” published on July 8, 2024, I’ll assess its claims, methodology, data sources, and potential biases based on the provided content and general principles of evaluating scientific claims. The article reports findings from a study published in JAMA Network Open on June 27, 2024, which examines the prevalence of gender-affirming surgeries among transgender and gender-diverse (TGD) minors in the U.S. Below is a detailed evaluation.
Summary of the Article
The article states that gender-affirming surgeries are rarely performed on TGD minors in the U.S., with no surgeries recorded for TGD youth aged 12 and younger in 2019, and those performed on older minors (13–17) being almost exclusively chest-related procedures (e.g., breast reductions). It also claims that cisgender minors and adults have higher utilization of analogous surgeries compared to TGD individuals. The study used 2019 medical insurance claims data from a nationally representative pool to analyze surgical procedures, excluding cases with non-gender-affirming indications (e.g., breast cancer). The authors argue that these findings counter narratives suggesting high rates of gender-affirming surgeries among TGD youth and imply that legislative bans may be driven by bias rather than evidence of widespread procedures.
Evaluation of Accuracy
Strengths:
The study uses a large, nationally representative dataset of medical insurance claims from 2019, covering 47,437,919 adults and 22,827,194 children and adolescents aged 17 or younger. This large sample size enhances the reliability of prevalence estimates.
The researchers excluded procedures with clinical justifications unrelated to gender affirmation (e.g., surgeries for cancer or injury), which helps isolate gender-affirming surgeries specifically. This is critical for accuracy in distinguishing procedures performed for gender affirmation from those for other medical reasons.
The study’s focus on breast reduction surgeries as a comparator between TGD and cisgender populations is novel and relevant, as it’s one of the few gender-affirming proceduresinfectious diseases, such as HIV/AIDS, which require lifelong management and medication, are not considered gender-affirming by this study’s definition.
The finding of no gender-affirming surgeries for TGD youth aged 12 and younger aligns with international guidelines (e.g., World Professional Association for Transgender Health), which do not recommend surgical interventions for prepubertal TGD individuals. This enhances the plausibility of the claim.
Limitations:
The study relies on diagnostic and procedure codes in insurance claims data to identify TGD-related diagnoses and surgeries. This method risks misclassification, as coding errors or incomplete documentation could affect accuracy.
The data only includes insurance-covered procedures, excluding self-paid surgeries, which could underreport the total number of gender-affirming surgeries. However, this is likely a minor issue for minors, as such procedures typically require insurance due to cost.
The study is limited to 2019 data, which may not reflect trends in subsequent years, especially given the increasing visibility of transgender issues. More recent data could show different patterns, though the article’s claim of rarity is specific to 2019.
Assessment: The methodology appears robust for a cross-sectional study, with a large dataset and clear exclusion criteria. However, the reliance on claims data introduces potential errors, and the single-year focus limits its scope. The article accurately reflects the study’s findings but should acknowledge these limitations more explicitly.
Claim: Gender-affirming surgeries are rarely performed on TGD minors:
The study found approximately 150 gender-affirming surgeries among TGD minors in 2019, a small fraction of the 22.8 million insured youth population (less than 0.001%). This supports the claim of rarity.
The specific finding that no surgeries occurred for TGD youth aged 12 and younger is consistent with clinical standards, as surgeries are not recommended before puberty.
The claim is further supported by the fact that most procedures for TGD minors were chest-related (e.g., mastectomies or breast reductions), which aligns with the World Professional Association for Transgender Health (WPATH) standards allowing such surgeries on a case-by-case basis for minors.
Claim: Cisgender individuals have higher utilization of analogous surgeries:
The study compares breast reduction surgeries between cisgender males and TGD individuals, finding that cisgender males underwent more of these procedures. This is plausible, as breast reductions for cisgender males (e.g., for gynecomastia) are common and often covered by insurance, whereas TGD-specific surgeries face stricter criteria.
However, the term “analogous” could be misleading, as the clinical and psychological contexts of breast reductions for cisgender males (e.g., for medical conditions like gynecomastia) differ from those for TGD individuals (gender affirmation). The article does not fully clarify this distinction, which could lead to misinterpretation.
Claim: Legislation blocking gender-affirming care is rooted in bias and addresses a non-existent problem:
The study’s data supports the argument that gender-affirming surgeries are rare, challenging narratives of widespread procedures. Lead author Dannie Dai’s statement that such legislation addresses a “perceived problem that does not actually exist” is consistent with the low prevalence found (e.g., 150 cases in a population of over 22 million).
However, the claim of “bias and stigma” is an interpretation, not a direct finding of the data. While the low prevalence undermines arguments for blanket bans, the article does not provide evidence directly proving bias as the sole motivation for legislation. Other factors, such as differing medical opinions or parental concerns, could also play a role, though these are not addressed.
Assessment: The claims about the rarity of surgeries and higher cisgender utilization are well-supported by the data. The assertion about legislative bias is a reasonable interpretation but not empirically proven by the study, introducing a potential editorial slant.
Supporting Evidence from Other Sources:
A 2025 study in JAMA Pediatrics found that less than 0.1% of U.S. adolescents received puberty blockers or hormones, reinforcing the rarity of gender-affirming care (including surgeries) among TGD youth.
Previous research, such as the 2015 U.S. Transgender Survey, indicates that only 12.8% of transgender individuals had undergone gender-affirming surgery, with most desiring but not accessing it, further supporting the low prevalence.
The mental health benefits of gender-affirming care, including reduced psychological distress and suicidality, are well-documented, providing context for why such care is sought despite its rarity.
Potential Bias:
The article’s language, particularly the statement about legislation being “rooted in bias and stigma,” suggests an advocacy perspective. While the data supports the rarity of surgeries, the framing of legislative motives may reflect the authors’ or institution’s views rather than objective evidence. This could alienate readers who see legitimate concerns in the debate (e.g., long-term outcomes or parental rights).
The study’s affiliation with Harvard T.H. Chan School of Public Health and the LGBTQ Health Center of Excellence may raise questions about ideological leanings, as these institutions are known for progressive stances on social issues. However, the peer-reviewed nature of the JAMA Network Open publication and the transparent methodology mitigate concerns about significant bias.
The article does not discuss opposing views, such as concerns about the long-term effects of surgeries or the ethical considerations of performing them on minors, which are part of the broader debate. This omission could make the article appear one-sided.
Assessment: The article’s data-driven claims are accurate within the study’s scope, supported by robust evidence and consistent with other research. However, its interpretive statements about legislative motives introduce a subjective element that may not be fully substantiated, potentially reflecting an advocacy bias.
Data Limitations: The article acknowledges reliance on claims data and the exclusion of self-paid surgeries but does not emphasize the potential for underreporting or coding errors, which could affect precision.
Scope Limitation: The focus on 2019 data means the findings may not reflect current trends, especially given the evolving political and medical landscape. The article could clarify that more recent data might show different rates.
Lack of Counterarguments: The article does not engage with concerns raised by critics of gender-affirming care, such as the irreversibility of some surgeries, potential regret (though studies show low regret rates, e.g., <1% for adults), or the developmental capacity of minors to make such decisions.
Political Context: The article’s claim about bias-driven legislation could be strengthened by acknowledging the complexity of the debate, including medical, ethical, and parental perspectives, to present a more balanced view.
The rarity of gender-affirming surgeries aligns with other studies, such as a 2025 analysis showing less than 0.1% of adolescents accessed gender-affirming medications.
The mental health benefits of gender-affirming care, including surgery, are supported by multiple studies, such as the 2015 U.S. Transgender Survey and a 2021 JAMA Surgery study, which found a 42% reduction in psychological distress and a 44% reduction in suicidal ideation among those who underwent surgery.
The claim that cisgender individuals receive more analogous surgeries is consistent with medical practices, as procedures like gynecomastia surgery are more common and less restricted by insurance policies.
The article challenges the narrative that gender-affirming surgeries are common among TGD youth, which is often used to justify legislative bans. The data strongly supports this challenge, showing a prevalence of less than 0.001% in 2019.
However, the article’s dismissal of legislative concerns as bias-driven oversimplifies the issue. Critics of gender-affirming care for minors often cite the lack of long-term outcome data, the potential for regret, and the ethical implications of irreversible decisions in adolescence. While regret rates are low in adults, less is known about minors due to their rarity, which the article does not address.
The article’s focus on international guidelines (e.g., WPATH) is accurate, as these standards restrict surgeries to post-pubertal minors on a case-by-case basis, but it does not discuss variations in guideline interpretation or debates over their appropriateness for minors.
Conclusion
The article is highly accurate in its primary claims about the rarity of gender-affirming surgeries among TGD minors and the higher utilization of analogous surgeries among cisgender individuals, supported by a robust 2019 insurance claims dataset and consistent with other studies. The methodology is sound, though limited by potential coding errors and the single-year focus. The claim that legislation is driven by bias is a plausible interpretation but lacks direct evidence and may reflect an advocacy perspective, as it does not engage with counterarguments or the complexity of the debate. To improve accuracy, the article could acknowledge these limitations and the broader ethical considerations. Overall, it provides a reliable, data-driven perspective but could benefit from a more balanced discussion of the contentious issues surrounding gender-affirming care for minors.
Final Rating: 8.5/10
– Strengths: Strong data, clear methodology, alignment with broader research.
– Weaknesses: Subjective framing of legislative motives, limited engagement with counterarguments, and lack of emphasis on data limitations.
@10 why are you asking a chat bot when the stats are taken directly from a scientific paper that you can read for yourself in the link
Since we’re checking stats I’m curious where @5 is getting >50% detransition rates because there isn’t a lot of research into this and the only population based study I could find reported a 2.5% detransition rate after 5 years of follow up
https://publications.aap.org/pediatrics/article/150/2/e2021056082/186992/Gender-Identity-5-Years-After-Social-Transition?autologincheck=redirected
@11: To provide context for a complete discussion.
Lets ask Grok to evaluate the accuracy of the link in @12:
To evaluate the accuracy of the article “Gender Identity 5 Years After Social Transition” published in Pediatrics (2022), I’ll assess its methodology, findings, and alignment with broader research, while critically examining potential limitations and biases. The article, authored by Kristina R. Olson and colleagues, is a longitudinal study from the Trans Youth Project that tracks the gender identities of 317 transgender youth (208 transgender girls, 109 transgender boys; mean age 8.1 years at study start) an average of 5 years after their initial social transition.
Summary of the Article
Objective: To estimate the rate of retransition (changing gender identification after an initial social transition) and report current gender identities of transgender youth.
Methods: The study involved 317 youth who socially transitioned (e.g., changed pronouns, names, or presentation). Data were collected from youth and parents via in-person or online visits, email, or phone correspondence over approximately 5 years.
Key Finding: 7.3% of youth retransitioned at least once, meaning the vast majority (92.7%) maintained their transgender identity 5 years after social transition.
Evaluation of Accuracy
To assess accuracy, I’ll consider the study’s methodology, data interpretation, alignment with other research, and potential limitations.
Longitudinal Design: The study’s longitudinal approach, tracking participants over 5 years, provides valuable data on gender identity persistence, which is rare in pediatric transgender research. This design strengthens the reliability of observing changes over time compared to cross-sectional studies.
Sample Size: With 317 participants, the study has a relatively large sample for a specialized population, enhancing statistical power compared to smaller studies (e.g., earlier studies with 20–50 participants).
Data Collection: Combining parent and youth reports through multiple methods (in-person, online, email, phone) reduces reliance on a single perspective, potentially improving data robustness.
Retransition Rate: The 7.3% retransition rate is a significant finding, as it provides the first quantitative estimate of retransition among socially transitioned transgender youth. The study notes that retransitions are “infrequent,” and most youth continue identifying as transgender. This aligns with the authors’ conclusion that early social transitions do not commonly lead to retransition, addressing concerns about distress from potential identity shifts.
Contextual Clarity: The article clearly defines social transition (e.g., changes in pronouns, names, or presentation) and retransition (changing gender identification after initial transition). This clarity aids in interpreting the findings accurately.
Comparison to Other Studies: The study’s finding that 92.7% of youth maintained their transgender identity contrasts with earlier research suggesting higher rates of desistance (reverting to cisgender identity). For example, studies cited in the article (e.g., Drummond et al., 2008; Singh et al., 2021) report that only 20% of youth with gender-nonconforming behavior before puberty identify as transgender in adulthood. The authors argue that their cohort, which fully socially transitioned, differs from earlier studies that included youth with less intense gender dysphoria or no social transition. This distinction is plausible but requires further scrutiny (see Limitations).
Persistence and Social Transition: The article’s finding of high persistence (92.7%) aligns with research indicating that social transition intensity correlates with sustained transgender identity. For instance, a cited study notes 100% persistence among prepubertal youth with complete social transitions, compared to 60.1% with partial transitions and 25.6% with no transition. This supports the article’s claim that early, complete social transitions may reflect stronger, more stable gender identities.
Gender-Affirming Care: The article’s companion piece and related literature emphasize that gender-affirming interventions (e.g., social transition, puberty suppression) are associated with improved mental health outcomes, such as reduced depression and suicidality. The low retransition rate in this study indirectly supports the argument that early social transitions can be beneficial and stable for many youth.
Contrasting Evidence: However, some studies, such as those following the “Dutch approach” or qualitative follow-ups, report higher desistance rates (up to 80% in prepubertal youth not socially transitioned). The article acknowledges these but argues its cohort is unique due to full social transitions, which may select for youth with more persistent gender dysphoria. This interpretation is reasonable but not definitive without direct comparison.
Sample Bias: The study’s cohort may not be representative of all transgender youth. Participants were part of the Trans Youth Project, likely involving supportive families and access to affirming care, which may skew persistence rates. Youth in less supportive environments or without access to care might show different outcomes. The article does not fully address how selection bias (e.g., families opting into a longitudinal study) might affect results.
Lack of Control Group: The study lacks a control group of transgender youth who did not socially transition, limiting the ability to isolate the effect of social transition on persistence. This weakens causal claims about social transition’s role in identity stability.
Retransition Definition: The study defines retransition as any change in gender identification, but it doesn’t provide detailed breakdowns (e.g., how many reverted to cisgender vs. adopted nonbinary identities). This lack of granularity limits understanding of retransition’s nature and implications. A related study by Durwood et al. (2022) explores retransition experiences qualitatively, suggesting complexity, but this is not integrated into the quantitative findings.
Self-Report Reliance: Data rely on parent and youth reports, which may be subject to social desirability bias (e.g., reluctance to report retransition due to perceived stigma). Objective measures or third-party verification could strengthen accuracy.
Short Follow-Up Period: Five years is significant but may not capture later retransitions, especially as youth enter adolescence or adulthood, where identity exploration may increase. The article acknowledges this but doesn’t speculate on long-term trends.
Potential Narrative Bias: The authors frame social transitions as largely stable and beneficial, aligning with gender-affirming care advocacy. While supported by their data, this framing may downplay uncertainties or alternative perspectives (e.g., “watchful waiting” approaches favored in some European guidelines). Critical commentary, such as Temple Newhook et al. (2018), questions desistance theories but also calls for nuanced exploration of gender fluidity, which this study only briefly addresses.
The article aligns with the American Academy of Pediatrics’ (AAP) gender-affirming care framework, which emphasizes supporting transgender youth through social and medical interventions. However, this narrative faces challenges:
– Contrasting Guidelines: Some European countries (e.g., Sweden, Finland) have shifted toward more cautious approaches, prioritizing psychological support over early medical interventions due to concerns about evidence strength and long-term outcomes. The article doesn’t engage with these perspectives, potentially reflecting a U.S.-centric bias.
– Disinformation Concerns: Related AAP publications highlight disinformation campaigns against gender-affirming care, suggesting resistance to studies like this may be politically motivated. However, legitimate scientific debate exists (e.g., about irreversible effects of hormone therapy), and dismissing all critique as disinformation risks oversimplification.
– Ethical Considerations: The study doesn’t deeply explore the ethical implications of early social transitions, such as potential social pressures or the impact of retransition distress, which are raised in companion papers. This limits its ability to address broader societal concerns.
The article’s core finding—that 7.3% of socially transitioned transgender youth retransition after 5 years—is likely accurate within the study’s scope, given its robust sample size, longitudinal design, and clear methodology. It provides a valuable first estimate of retransition rates, supported by consistent data collection. However, its generalizability is limited by potential sample bias, lack of a control group, and a relatively short follow-up period. The interpretation aligns with gender-affirming care research but may underplay alternative perspectives (e.g., higher desistance rates in less transitioned cohorts or cautious approaches in other regions).
Recommendations for Interpretation
Strengths: The study offers a reliable estimate of retransition rates for a specific cohort, contributing to evidence that early social transitions are often stable and beneficial for transgender youth.
Cautions: Readers should note the study’s focus on a supportive, socially transitioned cohort, which may not reflect all transgender youth. The low retransition rate doesn’t negate the need for individualized care or longer-term studies.
Further Research: Longer follow-ups, control groups, and diverse cohorts (e.g., non-supportive environments, nonbinary identities) are needed to confirm findings and address ethical questions about early transitions.
In summary, the article is accurate within its methodological constraints but should be read critically, considering potential biases and the broader, evolving debate on pediatric gender-affirming care.
Start seeing injury lawyers looking for detransitioners to make the adults pay.
The biggest limitation in trans activism stats is a lack of a control group as noted in @14, which are nearly impossible to implement – resulting in unquantifiable data and conjecture. Especially true with the notorious suicide blackmail “stats” used against parents.
Hi barth @12. Where am I getting that from, here you go.
“Asked by Helsingin Sanomat what she thought of gender self-identification for minors—a proposed element of the new Finnish law that did not ultimately pass—Kaltiala emphasized that it is “important to accept [children] as they are,” but this means neither pressuring a child to conform to behaviors traditionally associated with the child’s sex nor “negating the body” by confirming that the child’s gender self-identification is real. “In either case,” said the psychiatrist, “the child gets a message that there is something wrong with him or her.” Evidence from a combined 12 studies to date demonstrates that when children with cross-gender or gender variant behavior are left to develop naturally, the vast majority—“four out of five,” according to Kaltiala—come to terms with their bodies and learn to accept their sex. When they are socially transitioned, virtually none do.”
https://www.tabletmag.com/sections/science/articles/finland-youth-gender-medicine
https://www.transgendertrend.com/wp-content/uploads/2017/10/Steensma-2013_desistance-rates.x72910.pdf
Here in the above study look at table 1 for the desistance rates for no transitioning. That is what Kaltiala is getting at in the article, as an example. So if most gender dysphoria desists but for the affirming care, then that becomes an iatrogenic cause to the dysphoria. If they still feel that way at 18, then let them have at it.
@21
All that does is show that the Biden administration capitulated to political pressure in the face of them having stated surgery should not be preformed on minors. That is not a statement by a progressive saying surgery on minors never happens.
Also, when puberty blocker are given when the child is young and as a result there is not enough penile material to construct a neovagina with, a section of the lower colon is used to make up for the difference.
Hallelujah – this is great news.
I wouldn’t trust Grok (a.k.a. MechaHitler) to tell me what 1+1 equals.
@26: Then run Bart’s links through ChatGBT or a an AI of your choice and report back.
Let’s hear from a child who was groomed into transitioning:
https://youtu.be/AOKOQ5min7E
@17 that study is over a decade old and has not withstood scrutiny (also that is an anti-trans activist website). The authors assumed subjects lost to follow up were detrans when the researchers had simply lost contact. A bunch more of the kids in the study did not meet diagnostic criteria for trans at enrollment; kids were eligible if their parents brought them to the clinic without any further screening for dysphoria. The study’s flaws are detailed here in this article from 2018.
https://www.kqed.org/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth
30: And the links you provided contained old data as well and to pile on you can say the website is anti-trans for which you think everyone will automatically take your word for it. Then you have the gall to post an article from seven years ago by someone with just another theory. Your arrogance is breathtaking.
@30
Loss to follow up is an issue for both sides of the debate. What that loss to follow means is we don’t know, so it is a detriment to both sides and continues to be an issue in more recent studies.
Thanks for your follow up.
Kaiser Permanente Seattle has paused all gender-affirming surgeries for patients under 19 years old, effective August 29, 2025. How come you didn’t mention this equally important information?