Gender-affirming hormones
very little long-term effects on youth who use them,” Vaughn said.
Hormones like testosterone or estrogen are used to help a patient’s body align more with their identity. If their sex assigned at birth was female, but their gender identity is male, testosterone may be prescribed to promote growth of facial hair, increase muscle mass, and stop periods.
Republican lawmakers opposed to gender-affirming care cite concerns with the potential health consequences of such treatments, such as fertility when it comes to hormone treatments.
Hormones are not prescribed haphazardly, children’s health systems say. Some of the effects of hormones are reversible, some are not. Risks are discussed with families, along with options on preserving fertility.
To start gender-affirming hormones through health centers like Cincinnati Children’s Transgender Health Center, a young person needs to have either gone through puberty or have been on puberty blockers for several years.
The patient also will need a letter from their therapist and baseline blood work. The patient’s care team will help determine the appropriate type and timing of treatment based in part on physical examination and blood work.
Patients, their families, and the treatment team all need to agree that this is the appropriate next step if the patient is under 18 years old, Cincinnati Children’s says.
Other children’s hospitals in the state, like Akron Children’s Hospital, outline the path a patient’s health journey may take when seeking out gender-affirming care. Multidisciplinary teams can include doctors, therapists, endocrinologists and social workers.
Satisfaction rates after care
Health experts say this process is meant to avoid someone making a decision they later regret.
Morgan Keller testified before the Ohio Senate on behalf of H.B. 68. She said she was dealing with trauma and other mental health issues and “put on life-altering crosssex hormones with minimal questioning or treatment of my underlying issues.”
She started taking testosterone at 21, and at 22 received surgery with a letter of recommendation from a therapist, she said. The treatment did more harm than good, she testified.
“I needed the practitioners that I trusted to help me make peace with my body, not affirm my delusion that hormones and a cosmetic mastectomy might make me feel better. I needed them to just say no,” she told lawmakers.
“I couldn’t give informed consent at 21, so why are we pretending that children can do that?”
Keller has not said where she received care. She did not respond to interview requests from the Journal-News.
The U.S. Transgender Survey, the largest survey of transgender people in the U.S., found this outcome is more the exception than the norm.
While 2% of respondents said they were “a lot less satisfied” with life since transitioning, 79% reported that they were “a lot more satisfied.”
Parent: Removing access is ‘cruel’
More minors are seeking out gender care, but experts say this is likely due to minors having the language to describe their feelings and the resources to educate themselves.
“There’s not only an education awareness, but also a cultural awareness,” said Richelle Frabotta, LGBTQ+ health initiatives project manager at Public Health - Dayton and Montgomery County.
Transgender adults and parents of gender-diverse adult children interviewed by the Journal-News said they did not have the language to describe the gender dysphoria they felt as minors, leading them to transition in their adulthood.
“I don’t think there’s any more transgender identified youth than there ever have been. I think the phenomenon that people might be referring to is the fact that we now have an awareness,” Frabotta said.
Many of the transgender adults interviewed by this newspaper have experienced suicidal ideation, they said. If they’d thought about suicide, they were still in a desperate position when they sought gender-affirming care.
Many parents of transgender and/or nonbinary children — whether their children are still minors or are now young adults — told the Journal-News their children experienced suicidal ideation and struggled with their mental health.
“These laws are going to end up being something that is going to cause a rise in transgender youth suicide,” said Sarah Nolan, a Kentucky resident who had been traveling to Ohio to get access to gender-affirming care for her son.
Now, their family will have to travel further for care as the “grandfather” or legacy clause of H.B. 68 doesn’t provide exceptions for out-ofstate patients who received gender-affirming care in Ohio.
“I’ve seen the gender dysphoria and how it hurts him,” Nolan said about her son. “Taking away access to things that are going to help transgender children is cruel, and it should be illegal to do that. This is their right to health care and the government is just saying no, it’s not. And the government needs a stop overstepping.”