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The goal of health care is to prevent or reduce suffering and risk of death. But a huge debate revolves around gender-affirming care. Gender-affirming care supports and validates the gender with which patients identify.

It can be confusing for people whose gender identity correlates with what they were assigned at birth, called “cis-gendered,” when someone else does not identify their gender based on what they were born with or when the gender changes from time to time. “Gender identity” refers to what gender a person knows or feels they are most similar to, regardless of what genitals they were born with.

It is a common misconception that gender is defined purely by biology. It is also based on the influence of hormones on the developing brain and social influences. Many had not known that there were people who questioned their gender identity. Individuals who identify as a gender different from what they were assigned at birth may identify as “transgender.” Some people do not identify as male or female, and others identify differently at different times. Some may use the terms “genderless,” “agender,” “gender non-binary” or “gender non-conforming.”

With the increase in individuals identifying as non-cisgender, some cisgender individuals attribute that increase to confusion and indoctrination. This is not the case. These different states of being have always existed.

As part of normal development, young people experiment and try different things to figure out who they are. There is no credible evidence that exposure to information about non-cisgender people converts cisgendered people — credible is the key word. Not all studies are done rigorously with adequate controls, and sometimes, people draw erroneous conclusions.

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Years of data and studies conducted and endorsed by the National Institutes of Health, the American Pediatric Association, the American Psychological Association, the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry and most other health organizations around the world support that gender-affirming care significantly reduces the severity and rates of depression, anxiety, self-harming behaviors and suicidal behavior. Gender-affirming care includes using the pronouns and name that the person identifies with, emotional support, allowing the person to wear the clothing that matches their identity, and sometimes hormone blockers, which delay the development of the physical changes in the body during puberty.

As far as scientists know, the hormone blocker exposure has minimal long-term risks and effects compared to denying gender-affirming care. Surgeries in minors rarely, if ever, are performed for gender reassignment.

When children or teenagers know or know of others their age who engage in self-harm or suicidal behaviors, they, themselves, are at increased risk for those same problems, regardless of gender identity. Gender-affirming care can be life-saving for everyone.

For questions or to get assistance, contact the Brattleboro Retreat at 1-800-Retreat or

Lance Thigpen is a child and adolescent psychiatrist in the Brattleboro Retreat partial hospitalization and intensive outpatient programs.


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