White House draws criticism from LGBTQ groups over position on gender-affirming care for youth

The Biden administration is facing blowback from LGBTQ groups after a White House statement expressed opposition to gender-affirming surgery for youth.

The White House’s position came to light in response to reporting about the administration by the New York Times and The 19th, a non-profit publication.

A New York Times story detailed court documents outlining efforts by the Biden administration’s assistant secretary of the Department of Health and Human Services, Dr. Rachel Levine, to remove age limits for treatments and surgeries associated with gender-affirming care out of apparent fear of political backlash. Initial draft guidelines from 2021 sought to reduce age minimums for hormonal treatments to 14 and set the age limit for mastectomies or facial surgeries at 15, according to the Times, while genital surgeries or hysterectomies would have been set at 17. The proposed age limits were eliminated in the final guidelines outlining standards of care, according to the New York Times.

Subsequent reporting by The 19th, a non-profit publication, shed further light on the issue as the Biden administration sought to clarify its position. While the Biden administration maintained the position that gender-affirming “surgeries should be limited to adults,” a White House spokesperson told The 19th that the Biden administration continues “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.”

A Biden administration spokesperson did not respond to Gay City News’ request for comment about the statement. 

Human Rights Campaign president Kelley Robinson, who recently delivered remarks on the same stage as the president at the opening of the new Stonewall National Monument Visitor Center, described the administration’s statement as a harmful one, saying it was an example of government overreach.

“The Biden administration is flat wrong on this,” Robinson said. “It’s wrong on the science and wrong on the substance. It’s also inconsistent with other steps the administration has taken to support transgender youth. The Biden administration, and every elected official, need to leave these decisions to families, doctors and patients — where they belong. Although transgender young people make up an extremely small percentage of youth in this country, the care they receive is based on decades of clinical research and is backed by every major medical association in the U.S. representing over 1.3 million doctors. The administration has committed to fight any ban on healthcare for transgender youth and must continue this without hesitation — the entire community is watching. No parent should ever be put in the position where they and their doctor agree on one course of action, supported by the overwhelming majority of medical experts, but the government forbids it.”

The issue comes as the Supreme Court recently announced that it would take up a case — led in large part by the Biden administration — challenging a Tennessee law targeting gender-affirming care for youth at a time when dozens of states have targeted access to gender-affirming care. 

According to the New York Times, a two-page document administered by the Department of Health and Human Services’ Office of Population Affairs notes that gender-affirming surgeries have primarily been limited to adults, but can also be utilized among adolescents on a limited, case-by-case basis. 

Like Robinson, many of those who are criticizing the administration’s position are emphasizing that the government should not be interfering in medical decisions surrounding gender-affirming care.

“Living authentically and free from boxes requires courage,” the Transgender Law Center said in a written statement. “What it calls for from us as allies is engaging in every possible action to ensure that the bodily autonomy of trans youth, and by extension all of ours, is respected. This terrible mistake by the Biden administration could have been avoided by listening to trans youth themselves.

PFLAG National’s CEO, Brian K. Bond, also spoke out, according to the Advocate. 

“Transgender youth and their parents deserve to get the medically necessary healthcare they need when they need it, just like everyone else,” Bond said. “Yet, because the Biden administration bowed to a transparently politicized campaign to harm transgender people and families and weaken our health system, now the government stands between patients, parents, and doctors. The White House’s wholesale opposition to physician-approved, medically necessary rare surgical interventions for transgender youth is misguided, harmful, and unnecessary.”

Advocates for Youth, a non-profit working to fight for sexual health, rights, and justice for younger people, said the Biden administration’s statement was a confusing departure from their public stance in support of expanding access to health for trans youth. 

“It’s angering and disheartening that the Biden administration would choose to disregard the needs of transgender young people and decades of clinical research at a time when transgender health and rights are under attack across the country,” Louie Ortiz-Fonseca, Advocates for Youth’s director of LGBTQ Health & Rights.

In an interview with Gay City News earlier this year, Levine underscored the need for policies geared towards bolstering gender-affirming care for youth, but she said those efforts have been hindered by the amount of disinformation about trans medicine and anti-trans laws that have passed in many states.

“It is literally suicide prevention care and it has been shown to improve the quality of life and save lives,” Levine said, referring to gender-affirming care. “Trans medicine for youth has evolved over the last 10 to 20 years and it is not different from any other medical care. You have evidence-based guidelines that have been vilified.”

Advocates for Trans Equality — a new organization that formed when The National Center for Transgender Equality and Transgender Legal Defense and Education Fund merged — also condemned the administration.

“No parent should ever be put in the position where they, their child, and their doctor agree on a course of action, supported by the overwhelming majority of medical experts, but the government forbids it,” Rodrigo Heng-Lehtinen, Advocates for Trans Equality’s executive director, said in a written statement. “Sadly, the Biden Administration has chosen to put politics over science, and that mistake backs up the bullies, reinforces misinformation from extremists, and puts lives in jeopardy. “The Biden Administration is sending mixed messages that are misguided and dangerous for trans youth. We need the President to keep the promise he made to have the backs of trans youth and clarify his opposition to the dangerously sweeping bans that target trans youth and their families.”