Less than 1 in 1,000 insured US adolescents get gender-affirming meds

A vial of testosterone is prepared for injection at a Florida home. Laura Bargfeld/ap 2023

As lawmakers across the country debate issues around health care for transgender youth, it’s been difficult to determine the number of young people receiving gender- affirming medications, leaving room for exaggerated and false claims.

Now, a medical journal has published the most reliable estimate yet and the numbers are low, reflecting more clearly on medical practices now being weighed by the U.S. Supreme Court.

Fewer than 1 in 1,000 U.S. adolescents with commercial insurance received gender-affirming medications — puberty blockers or hormones — during a recent five-year period, according to the recently released study.

At least 26 states have adopted laws restricting or banning gender-affirming medical care for transgender minors, and most of those states face lawsuits. A decision by the Supreme Court in a Tennessee case is expected later this year. President-elect Donald Trump has promised to roll back protections for transgender people.

“We are not seeing inappropriate use of this sort of care,” said lead author Landon Hughes, a Harvard University public health researcher. “And it’s certainly not happening at the rate at which people often think it is.”

The researchers analyzed a large insurance claims database covering more than 5 million patients ages 8 to 17.

Only 926 adolescents with a gender-related diagnosis received puberty blockers from 2018 through 2022. During that time, 1,927 received hormones. The findings, published in JAMA Pediatrics, suggest that fewer than 0.1% of all youth in the database received these medications.

The researchers found that no patients under age 12 were prescribed hormones, an indication that doctors are appropriately cautious about when to start such treatments, Hughes said.

“I hope that our paper cools heads on this issue and ensures that the public is getting a true sense of the number of people who are accessing this care,” he said.

The study did not look at surgeries among transgender adolescents. Other researchers have found those procedures are extremely rare among young people.