In the last year, a series of almost 500 anti-LGBTQ+ bills were introduced in state legislatures. The effect of these laws on the everyday lives of transgender people in the United States is far from negligible. More than 60 percent of transgender adults in the United States say they have heard anti-transgender remarks from someone in their family or community, and almost 25 percent say that their access to gender-affirming care has been disrupted in some way.

Due to the social effects of our legislature, the news cycle and even misinformation within our communities, myths about gender-affirming care are pervasive. In this Drug Issue article, we will identify, break down and confront six myths that surround gender-affirming care.

Myth: All gender-affirming care is medical

There are multiple forms of medical intervention that can be considered gender-affirming care. Hormone replacement therapy (HRT) is usually taken by transgender or nonbinary people to produce physical changes associated with puberty, also called secondary sex characteristics. This form of care usually involves taking prescribed synthetic estrogen or testosterone, either orally, topically or via injection.

However, medical intervention is not the only form of gender-affirming care. Nick Martin, the associate director of the Q Center at Binghamton University, wrote in an email that many misconceptions about gender-affirming care stem from this myth.

“In my work over the past few years with the Q Center, I’ve found that the myths and misconceptions arise when students, faculty, staff and local health care providers stop viewing gender-affirming care as an umbrella term that can represent a variety of important medications, procedures and treatments,” Martin wrote. “Instead [they] view it as coded language in place of terms like trans health care or gender-affirmation surgery.”

Along with medical intervention, much of gender-affirming care is social. Using the correct pronouns and names for transgender individuals, changing one’s wardrobe or any other change that alleviates gender dysphoria — the stress that results from one’s assigned sex at birth not aligning with one’s gender identity — are also gender-affirming care. These changes are called “social transitioning,” and can also be classified as a form of gender-affirming care.

Myth: HRT poses a significant risk to an individual’s overall health

Some of the biggest myths perpetuated are the potential harms that HRT and puberty blockers pose to the overall health of an individual undergoing treatment. A study published in the Journal of Clinical & Translational Endocrinology concluded that current data supports the safety of HRT with physician supervision. Risks of side effects such as blood clots, stroke or diabetes are minimal, but could be elevated. Typically, though, the small increase in risk is offset by improvements in quality of life — the risks are no greater than those posed by any other form of medication, and patients are given the opportunity to make informed decisions about their health care plans before beginning HRT.

Myth: HRT is irreversible, and there is a high regret rate for the treatment 

Depending on how long an individual has been receiving HRT, the results could be partially or completely reversible. Importantly, though, the regret rate for gender-affirming care and medical transition is incredibly low. A review of 27 studies found that the transition regret rate was 1 percent, and transgender youth who meet the criteria for a diagnosis of gender dysphoria are the least likely of anyone to de-transition, with over 90 percent remaining consistent in their identity according to one study in pediatrics.

Myth: Children are being given hormone replacement therapy and gender-affirmation surgeries

Importantly, HRT is almost always taken by adult transgender individuals. For children who have not reached puberty, no medical intervention is available. For those who have, the typical treatment is puberty blockers. These medications are gonadotropin-releasing hormone (GnRH) analogues — that’s a long term that describes a medication that temporarily stops the body from producing sex hormones. These medications are not only given to transgender children — Cisgender children who experience puberty too early are often prescribed them, too, and the medications are considered a safe form of intervention that has been used by endocrinologists for nearly 40 years.

Myth: Gender-affirming care is only for transgender people 

Mansha Rahman, a student manager at the Q Center and a sophomore double-majoring in graphic design and Spanish, wrote in an email that gender-affirming care is not trans-specific.

“Things like breast transplants, hair transplants [and] even hormone therapy are utilized by cisgender individuals for acne and hormonal imbalance,” Rahman wrote.

Indeed, puberty blockers, haircuts and affirming wardrobes — many forms of gender-affirming care — are not specific to transgender individuals.

Myth: Gender-affirming care isn’t generally accessible

If you or someone you know is looking for more information on or support with gender-affirming care, Martin has several recommendations for students on BU’s campus.

“For current students going into health care looking for additional resources, I highly recommend the World Professional Association for Transgender Health (WPATH),” Martin wrote. “Multiple providers at the Decker Student Health Services Center and UHS are WPATH certified and the Q Center can help you get connected to them as needed. We encourage all students to visit the Q Center on the ground floor of [Glenn G.] Bartle Library or email us at lgbtq@binghamton.edu if they don’t know where to start and need help.”

Editor’s Note (4/15/24): This article has been updated with Mansha Rahman’s correct majors. Pipe Dream regrets the error.