Transgender health care misinformation
False and misleading claims about gender diversity, gender dysphoria, and gender-affirming care have been used to justify legislative restrictions on transgender people's right to healthcare. The claims have primarily relied on manufactured uncertainty generated by various conservative religious organizations, pseudoscientific or discredited researchers, anti-trans activists and others.
Common false claims include that most people who transition regret it; that most pre-pubertal transgender children cease desiring transition after puberty; that gender dysphoria is socially contagious, can have a rapid onset, or is caused by mental illness; that medical organizations are pushing youth to transition; and that transgender youth require conversion therapies such as gender exploratory therapy.
Elected officials in Central and South America have called for legislative bans on transgender healthcare based on false claims. Misinformation has been platformed and amplified by mainstream media outlets. Medical organizations such as the Endocrine Society and American Psychological Association, among others, have released statements opposing such bans and the misinformation behind them.
Origins
Transgender healthcare misinformation primarily relies on manufactured uncertainty from a network of conservative legal and advocacy organizations. These organizations have relied on techniques similar to those used in climate change denialism, generating exaggerated uncertainty around reproductive health care, conversion therapy, and gender-affirming care.According to the Southern Poverty Law Center, the hub of the pseudoscience movement is the Society for Evidence-Based Gender Medicine, whose personnel have a large overlap with Genspect and Therapy First. The SPLC has also accused the American College of Pediatricians of sharing misinformation and disinformation about trans healthcare.
A report by researchers at the Yale School of Medicine described SEGM and Genspect as spreading "biased and unscientific content", and SEGM as "without apparent ties to mainstream scientific or professional organizations". It described SEGM's 14 core members as a "small group of repeat players in anti-trans activities", who often write non-peer reviewed letters to the editor of mainstream scientific publications, and who frequently serve on the boards of other organizations which "feature biased and unscientific content".
These efforts have been aided by scientists who were once dominant in transgender care, but are now fringe, such as Ray Blanchard, Stephen B. Levine, and Kenneth Zucker. Misinformation and disinformation about transgender health care sometimes relies on biased journalism in popular media.
Common misinformation
Detransition and transition regret
Detransition is the process of halting or reversing social, medical, or legal aspects of a gender transition, partially or completely. It can be temporary or permanent. Detransition and regret over transition are often erroneously conflated, though there are cases of detransition without regret and regret without detransition. Detransition also does not require a reversal of transgender identity. Prevalence of regret for receiving gender-affirming care is very low. Regarding gender-affirming surgery in particular, a 2024 review stated, "When comparing regret after GAS to regret after other surgeries and major life decisions, the percentage of patients experiencing regret is extremely low." Data suggests that detransition—however defined—is rare, with detransition often caused by factors such as societal or familial pressure, community stigma, or financial difficulties. Studies did not control for such outside influences and found prevalence of discontinuation—before any treatment, while under puberty blockers, and during hormone therapy—to range 0.8–7.4%, 1–7.6%, and 1.6–9.8% respectively.In the United States and the United Kingdom, conservative media outlets and the Alliance Defending Freedom have promoted high-profile detransitioners and advocacy groups who claim that detransition and transition regret are prevalent. The global anti-gender movement has justified anti-trans rhetoric and policies by pointing to detransitioners, arguing they prove transitioning is a hoax or necessitate protecting transgender people from medical transition, distorting the findings that detransition is rare and often caused by social pressure. States in the United States have primarily relied on anecdotes to argue that detransition is cause for bans on gender-affirming care. Detransitioner Chloe Cole has supported several such state bans as a member of the advocacy group Do No Harm. Former detransitioners Ky Schevers and Elisa Rae Shupe have detailed how they were recruited by organizations and activists who used their stories to limit transgender rights before they retransitioned and started working against them.
Most gender-dysphoric children will not remain transgender
It has been claimed that most of children with gender dysphoria or a trans identity will not identify as transgender past adolescence. The claim has been referred to as the "desistance myth". This claim is not supported by the evidence and is based on studies on "desistance" from the 1960s–80s and 2000s.These older studies often did not clearly define desistance, and when they did, their definitions were often inconsistent with each other. Many of the earlier studies treated "gender deviant" behavior as pathological and were explicitly attempting to "cure" it. All the studies, even later studies, often had serious methodological flaws such as low sample sizes and outdated diagnostic frameworks that conflated gender non-conformity with transgender identity. Most youth sampled in these studies never identified as transgender nor desired to transition, but were counted as desisting.
The claim has often been used to support the criminalization of gender-affirming care. The term desistance was first used for trans children by Kenneth Zucker in 2003, who borrowed the term from its usage in oppositional defiance disorder; there, it is regarded as a positive outcome, a history that reflects the pathologization of transgender identities. The claim was primarily popularized in a commentary by James Cantor in 2020, who argued based on the earlier studies that most children diagnosed with gender dysphoria will grow up to be gay and lesbian adults if denied such care. The first seven studies were performed before modern diagnostic criteria and endorsed conversion therapy; the latter four predated the modern diagnostic criteria, and the latest showed that greater cross-gender identification, as opposed to behaviors, predicted ongoing transgender identity.
A 2022 systematic review found that the term was poorly defined and did not allow for dynamic or non-binary gender identities. Quantitative studies on the term were ranked as poor quality as they did not control for outside influences or explicitly define desistance. With varying implicit definitions of the term, the studies reported 83% of their total 251 participants as desisting. The systematic review concluded that desistance' should be removed from clinical and research frameworks, as it does not allow for the varied and complex exploration of gender that is more reflective of reality". Recent work has found that the vast majority of pre-pubertal children who express transgender identities and socially transition with parental support continue to do so in adolescence.
Transgender identity as a mental health condition
Legislative efforts to ban gender-affirming care in the United States have relied on the unfounded narrative that gender dysphoria is caused by underlying mental illness, trauma, or neurodivergence, such as autism and ADHD. Though transgender people have higher rates of mental illness, there is no evidence these cause gender dysphoria and evidence suggests this is due to minority stress and discrimination experienced by transgender people. The American Psychological Association states "misleading and unfounded narratives" such as "mischaracterizing gender dysphoria as a manifestation of traumatic stress or neurodivergence" have created a hostile environment for trans youth and led to misconceptions about the psychological and medical care they require.Social contagion and rapid onset gender dysphoria
In 2018, Lisa Littman authored a study that has since been heavily corrected, arguing modern youth are experiencing rapid onset gender dysphoria, a new type of gender dysphoria spread through social contagion and peer groups. The study relied on anonymous parental reports on transgender children collected from websites known for anti-trans misinformation and gender-critical politics who were informed of the study's hypothesis.The hypothesis has been heavily referenced in discourse about transgender youth despite the absence of empirical evidence to support it. As a result, a coalition of psychological professional bodies issued a position statement calling for eliminating the use of ROGD clinically and diagnostically in 2021. It stated that "there is no evidence that ROGD aligns with the lived experiences of transgender children and adolescents" and that "the proliferation of misinformation regarding ROGD" had led to "over 100 bills under consideration in legislative bodies across the country that seek to limit the rights of transgender adolescents" predicated on ROGD's unsupported claims.
Psychotherapy and conversion therapy
Proponents of bans on gender-affirming care in the United States have argued that youth should receive psychotherapy instead of medical treatments – including gender exploratory therapy, a form of conversion therapy. Practitioners of GET frame medical transition as a last resort and argue that their patient's gender dysphoria may be caused by factors such as homophobia, social contagion, sexual trauma, and autism. Some practitioners avoid using their patients' chosen names and pronouns while questioning their identification.There are no known empirical studies examining psychosocial or medical outcomes following GET. Concerns have been raised that by not providing an estimated length of time for the therapy, the delays in medical interventions may compound mental suffering in trans youth, while the gender-affirming model of care already promotes individualized care and psychotherapeutic gender identity exploration without favoring any particular identity. Bioethicist Florence Ashley has argued that framing gender exploratory therapy as an undirected exploration of underlying psychological issues bears similarities to gay conversion practices such as reparative therapy.
Multiple groups exist worldwide to promote GET and successfully influence legal discussions and clinical guidance in some regions. Therapy First, previously named the Gender Exploratory Therapy Association, asserts that "psychological approaches should be the first-line treatment for all cases of gender dysphoria", that social transition is "risky", and that medical interventions for transgender youth are "experimental and should be avoided if possible". All of TF's leaders are members of Genspect, and many are also members of the Society for Evidence-Based Gender Medicine, both of which promote GET and argue that gender-affirming care should not be available to those under 25.