White House Reverses Stance on Gender-Affirming Care for Youth

Last week, the Biden administration reversed its stance on gender-affirming care for youth, confirming its position that surgeries should be limited to adults.

In a brief statement delivered to the New York Times, the White House responded to an article reported by the staff of Adm. Rachel Levine, assistant secretary at the Department of Health and Human Services. Levine’s staff allegedly urged an influential international transgender health organization to remove age barriers for gender-affirming surgery from its treatment guidelines regarding minors. The draft guidelines would have lowered the ages for different models of care, while the final draft in 2022 eliminated age-based recommendations.

In a statement from a HHS spokesperson, “Adm. Levine shared her view … that publishing the proposed lowered ages for gender transition was not supported by science or research and could lead to an onslaught of attacks on the transgender community.”

The Biden administration has since put out its own statement to The 19th, asserting that it does not support gender-affirming surgery for minors. “These are deeply personal decisions, and we believe these surgeries should be limited to adults,” according to a White House spokesperson via email. The administration, however, has stressed that it still supports gender-affirming care for minors, just not in terms of surgical intervention: “We continue to support gender-affirming care for minors, which represents a continuum of care and respect the role of parents, families, and doctors in these decisions.”

Meanwhile, studies continue to show that the vast majority of gender-affirming surgeries for youth are being performed on cisgender children. Not trans kids. This is congruent with research that shows that transgender minors are unlikely to detransition.

The issue stands as a reversal for the White House due to the moral panic created by conservatives concerning gender-affirming care for minors, leaving Democrats and the President unwilling to legitimately fight against the debate though previous rhetoric from the White House has stated that transgender minors have a right to gender-affirming care.

That right should include surgeries. Both the Human Rights Campaign and the Campaign for Southern Equality have condemned this recent statement from the Biden administration as “cowardly.”

“Let’s be very, very clear: Government has no business inserting itself into private medical decisions that should be exclusively between patients, their providers, and the patients’ parent or guardian,” says Allison Scott, director of Impact and Innovation at CSE.

HRC president Kelly Robinson wrote in an emailed statement to the press, “The Biden administration is flat wrong on this.” She then reinforced the idea that these conversations are to be had between “a patient, their family, and their healthcare provider,” not the government. She had previously lauded the President for maintaining “the most pro-equality Administration in history.”

Recently, the Supreme Court has opted to take on a case to make the final decision about gender-affirming care bans for minors in response to a recently approved Tennessee ban that would penalize adults for assisting minors in getting an abortion or gender-affirming care.

Harmful rhetoric around gender-affirming care for youth has taken charge in the conversations surrounding the transgender community, leading to nationwide proposed legislation restricting access to care. According to the Trans Legislation Tracker, 620 anti-trans bills across 43 states have been introduced in 2024. This compares to 611 across 49 states in 2023 and 174 across 33 states in 2022.

With LGBTQ+ youth and adults being affected by this legislature who are looking towards the 2024 Presidential election with opposing, harsher restrictions being proposed in the right-wing plan to takeover the federal government that is Project 2025, it is disappointing to see the current administration give in to a narrative that would negatively impact the lives of transgender youth.

Featured Photo via Sarah Silbiger/The New York Times/Redux