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Red states are blocking trans medical care. Families are fleeing.

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Florida state Rep. Joe Harding, a Republican who sponsored the “Don’t Say Gay” bill, maintained the policy was based on science. “There are two genders, man and woman,” Harding said in a telephone interview. “It’s hardly debatable.”

He claimed that “life-altering surgeries and extreme changes” related to gender-affirming care could result in long-term harm to minors. And the father of four insists that the state has an obligation to step in to protect them, even if parents disagree.

Even though the New York Times reported that some research suggests the treatment could seriously weaken bone health in youths, multiple mainstream medical organizations — the American Medical Association, the American Academy of Pediatrics and the American College of Physicians, among many others — have taken the position that gender-affirming care is a medical necessity.

Left untreated, studies have shown, individuals with gender dysphoria face a higher risk of self-harm and suicidal thoughts. For adults, studies have found medical interventions to treat gender dysphoria — including hormone replacement therapies and surgeries — substantially reduce the likelihood of those negative mental health outcomes.

These treatments may be more effective earlier on in life, before puberty locks somebody into having physical features that don’t align with their gender identity. In January, a Stanford University study based on the largest-ever survey of U.S. transgender adults found that those who received hormonal treatment in childhood are less likely to experience major health disorders or have problems with substance abuse.

Such studies are why those who treat trans people say the care they provide has nothing to do with politics.

“It’s just health care,” said Joshua Safer, a doctor and executive director of the Mount Sinai Center for Transgender Medicine and Surgery.

Safer helped write science-based guidelines for treating transgender adults and children for the Endocrine Society, an international medical organization, and contributed to a recent updating of the World Professional Association for Transgender Health’s Standards of Care for Transgender and Gender Diverse People.

There is no evidence that doctors are overtreating transgender youth, Safer said. If anything, “there’s undertreatment” and “a gap.”