Gender-Affirming Care Explained: Separating Myth From Reality

Written by: Cath Brew

Understandably, myths form, untruths become fact and genderdiverse people suffer. This article aims to explain what gender-affirming care is, clarify common myths, and describe the reality of how it is approached for young people.

WHAT IS GENDER-AFFIRMING CARE?

Gender-affirming care pertains to a range of medical, psychological, and social supports that help people to live in a way that aligns with their gender identity.

Gender identity is an individual’s personal and deeply held sense of being male, female, both, neither, or somewhere along a spectrum (transgender, non-binary etc). If you’ve never questioned your gender, it can hard to imagine how it might feel. However, many people feel this way. It’s not wrong, just a different way of being human.

It is important to understand that genderaffirming care is not a single treatment, but
rather an umbrella term that can include:

• Social support (e.g. selecting a chosen name, different pronouns or a new haircut)
• Mental health care (counselling or therapy)
• Medical care (which may include hormones or, for adults, surgery

Not all people who seek gender-affirming care need every type of care under that umbrella. Many may only access social or psychological support. It depends hugely on
the person’s relationship to themselves. At its core, gender-affirming care is completely
individualised, evidence-based healthcare focused on a person’s overall well-being.

TRUTHS ABOUT GENDER-AFFIRMING CARE

It is About Health and Well-Being

Gender-affirming care is recognised as healthcare intended to reduce distress (known as gender dysphoria) and to improve quality of life. Research consistently shows that appropriate support improves mental health, including reduced anxiety, depression, and risk of self-harm.

A 2022 study by the Seattle Children’s Gender Clinic showed that access to hormones and puberty blockers (13 – 20 years) reduced the likelihood of depression by 60%, and self-harm or suicidal thoughts by 70% over one year. Similarly, a 2021 study of over 9000 trans and non-binary youth (13 – 24 years) published in the Journal of Adolescent Health, found that those who had received hormone therapy were 40% less likely to report depression and a past suicide attempt, than those who sought hormone therapy and not received it.

It is Careful and Deliberate

Contrary to popular belief, genderaffirming care, especially for young people, is not rushed. For medical and mental health support, it typically involves thorough assessments, ongoing conversations, and the involvement of qualified specialist healthcare professionals.

In the UK, a young person can consent to their own medical care at 16 years (generally this relates to hormones). Under 16 years, it’s up to the medical professional to decide if a young person has the competence to make a decision about their care. Either way, they also commonly still seek parental permission. Social changes, which are reversible, tend to happen more quickly. They are particularly effective in bringing some immediate relief from distress.

It Looks Different for Different People

There is no single route along the path of gender-affirming care. Just like all medical
and health issues, every person is different, and how they are treated medically varies
depending on their specific circumstances.

Some people transition socially, some medically, some not at all. Genderaffirming care is also not about pushing people toward any specific outcome, but about supporting them where they are and where they want to end up.

For a lot of young people, gender affirming care may simply be a different haircut or a new wardrobe that feels more aligned to who they are. Some individuals ask to be known by a different name (chosen name). In the UK, schools are required to ask parental permission if a child wants to change their name at school.

However, it can be complex to manage in the best interests of the child, as seeking
permission may also put the child at risk at home.

Access to Care Varies Enormously

Access to gender-affirming care varies enormously around the globe. It is largely
dependent on the country, its jurisdictions, waiting lists and costs. For example, it’s
banned in Russia (2023), Egypt (2003), Jordan (2018), Chad and more.

Conversely, in some countries it’s legal but with age restrictions for minors (Finland, Hungary, Italy, Serbia, Macedonia, Japan and others). Whilst it’s legal in Germany (1945), Norway, Switzerland, France (1975), India (2019), Pakistan (2018), Mongolia (1994), Bangladesh (2024), Nepal and many more countries. Even when it is legal, gender
affirming care can be expensive (in private health care) and waiting lists for national health services are long; years in many cases.

GENDER-AFFIRMING CARE FOR CHILDREN AND TEENAGERS

This is often the most sensitive and misunderstood part of the discussion.

For Children (Pre-Puberty)

For young children, gender-affirming care focuses on:

• Emotional support
• Family counselling
• Allowing exploration of identity in safe, reversible ways (such as clothing or hairstyles)

There are no medical interventions at this stage.

For Adolescents (During Puberty)

Care may include:

• Continued mental health support
• Careful monitoring of well-being
• In some cases, puberty blockers may be used. These have been used to treat children for decades for conditions like precocious puberty and are used with adults in the treatment of prostate cancer and peri-menopause.

Puberty blockers are considered fully reversible in the sense that discontinuing
them allows typical puberty to resume. They are prescribed only after careful
evaluation and are not given to all transgender or gender-questioning teens.

Parental and Professional Involvement

Gender-affirming care for minors typically involves:

• Parents or guardians
• Mental health professionals
• Medical specialists

It is a collaborative process, not a unilateral decision made by a child or a single doctor.

The Reality of the Debate

Much of the public conversation about gender-affirming care is shaped by fear, misinformation, and politicisation rather than medical evidence. While most people
can disagree on policy and ethics, it is important to ground discussions in facts rather than myths.

For young people in particular, the reality is that gender-affirming care prioritises safety, caution, and mental health. It is not about fast-tracking irreversible decisions,
but about supporting vulnerable individuals during critical developmental years.

COMMON MYTHS AND THE REALITY

MYTH: “Gender-diverse people are mentally ill”
REALITY: Gender diversity is a normal part of the human experience and is not a mental disorder. Mental health support is most sought to cope with how society treats trans and non-binary people. It helps individuals navigate the emotional impact of the stigma, discrimination, and social rejection of being themselves.

MYTH: “Gender-affirming care means surgery.”
REALITY: Surgery is only one possible form of gender-affirming care, and it is generally reserved for adults. Most transgender people, especially children and teens, never undergo surgery.

MYTH: “Children are being given irreversible medical treatments.”
REALITY: For pre-pubescent children, gender-affirming care is almost entirely non-medical and reversible. It may involve social support and counselling. Medical interventions are not used before puberty.

MYTH: “Doctors are encouraging kids to be transgender.”
REALITY: Healthcare providers do not ‘make’ someone transgender. Gender identity is not created by medical professionals. Their role is to listen, assess, and support a young person’s mental and physical health.

MYTH: “Lots of people regret transitioning.”
REALITY: Of all people who transition, only 1-2% of people detransition. This means that 98-99% are still happy within 5 years. For any other procedure, this would be considered a medical miracle. The number of ciswomen who regret cosmetic surgery is 65% yet it is only trans people who are subjected to all kinds of inspection. Of the people who detransition, a common reason is that hiding who you are is easier than
living in a society that doesn’t accept gender diverse people.

CONCLUSION

Gender-affirming care is centred on compassion, evidence, and individual needs. For children and teenagers, it is especially careful and conservative, focused first on understanding, mental health, and family support.

Understanding the truths behind genderaffirming care allows for more thoughtful
conversations, ones that recognize the humanity of transgender and gender diverse people while engaging honestly with the complexities involved.