Access: Solutions We Love

This Is Gender-Affirming Care

May 23, 2024

Transgender and nonbinary people have long faced barriers to health care, but today’s efforts to eliminate access to this medically necessary care are unprecedented. Skeptics claim gender-affirming care for trans people is experimental and dangerous—but that is false. Gender-affirming care for trans people is based on 40 years of clinical research, with best practices regulated by the World Professional Association for Transgender Health (WPATH). WPATH requires “extensive exploration of psychological, family, and social issues” before considering physical interventions for young people, which means that no reputable provider is performing surgeries on or providing “experimental” medication to minors. 

Transphobia by the NumbersThe number of anti-trans bills has broken records for four years running, sending a chilling message to trans people that their health care—and their existence—is at risk

500-plus+: Bills considered in 2024 blocking trans people’s access to health care, education, and public accommodation (SOURCE: Trans Legislation Tracker)

24: States limiting access to gender-affirming care38: Percentage of U.S. trans youths (ages 13-17) living in states that restrict access to gender-affirming care 

22: States currently penalizing providers who provide minors gender-affirming health care (SOURCE:

1: State that can revoke custody from parents who pursue gender-affirming care for their child (Florida) (SOURCE:

1.3 million: U.S. adults who identify as transgender, 2022 (SOURCE: Williams Institute)

300,000: U.S. youths ages 13-17 who identify as transgender, 2022 (SOURCE: Williams Institute)

333.3 million: U.S. population, 2022 (SOURCE: U.S. Census Bureau)
All People Access Gender-Affirming Care.

Gender-affirming care has existed since the first midwives supported people giving birth with health care that other gender(s) didn’t require, and today includes medication, surgery, and other clinical treatment.

Popping Pills.
Many people access gender-affirming care through medication prescribed and managed by their doctor. 
3,613,744: Sildenafil (used to treat erectile dysfunction) prescriptions written in 2021 (SOURCE:
11,382,723: Estradiol (hormonal treatment for postmenopause and post-hysterectomy) prescriptions written in 2021 (SOURCE:
37,557,117: Prescriptions for combined hormonal oral contraceptives written in 2021 (SOURCE:
Under the Knife.
Many surgical techniques now offered to trans people originated as plastic surgery procedures to treat (presumably cisgender) men maimed in war. And plastic surgery’s popularity changes over time.

Patients seeking breast augmentation from 2005 to 2017: 79% are cisgender women; 21% are transfeminine people.
SOURCE: National Institutes of Health

Men seeking “minimally invasive” plastic surgery: 1.4 million in 2022; 396,601 in 2019. 
SOURCE: American Society of Plastic Surgeons, 2023 

Cisgender women seeking labiaplasty: 12,903 in 2019; 10,774 in 2016.
SOURCE: Aesthetic Plastic Surgery Database, 2016 and 2019

People pursuing Brazilian butt lift: 19,019 in 2016; 34,086 in 2019.
SOURCE: Aesthetic Plastic Surgery Database, 2016 and 2019
Who’s Using Hormones?

Hormone replacement therapy (HRT) is one clinical treatment prescribed for gender dysphoria. It’s also prescribed to postmenopausal cisgender women, cancer survivors, and others. 

78% are U.S. trans adults wanting HRT (SOURCE: 2015 U.S. Transgender Survey) 

49% are U.S. trans adults taking HRT (SOURCE: 2015 U.S. Transgender Survey)

44% are U.S. postmenopausal women have used HRT (SOURCE: CDC National Health and Nutrition Examination Survey, 1988-1994) 

For context, in 2022, there were 1.6 million  trans people in the U.S. over age 13 (SOURCE: Williams Institute,138.97 million women in the U.S. age 15+ (SOURCE: Statista), 134.96 million men in the U.S. age 15+  (SOURCE: Statista)

Puberty Blockers Aren’t Just for Trans Kids.

Medication to delay the onset of puberty is often prescribed to trans youth, but the most common medication—gonadotropin-releasing hormone (GnRH) analogues—is also prescribed to cisgender youth to prevent precocious puberty, and to adults to treat prostate cancer, endometriosis, and other conditions. 


From 2017 to 2021, 121,882: U.S. children ages 6-17 were diagnosed with gender dysphoria (SOURCE: Reuters) and 17,683: U.S. kids ages 6-17 started puberty blockers (SOURCE: Reuters)
Regret Is Rare.

Trans people who pursue medical transition have a markedly lower regret rate for those procedures than any other surgical patients. 

The regret rate for trans people’s gender-affirming surgery is 1% (SOURCE: Plastic Reconstructive Surgery Open, 2021). The regret rate for all surgeries is 14.4% (SOURCE: World Journal of Surgeries, 2017).

Jacob Anderson-Minshall is a transgender journalist, editor, and co-author of the memoir Queerly Beloved: A Love Story Across Genders
Sunnivie Brydum is the managing editor at YES! An award-winning investigative journalist with a background covering LGBTQ equality, Sunnivie previously led digital coverage at The Advocate, Free Speech TV, and Out Front Colorado. Their writing has appeared in Vox, Religion Dispatches, them., and elsewhere. She has a degree in magazine journalism from the S.I. Newhouse School of Public Communications at Syracuse University, and is a co-founder of Historias No Contadas, an annual symposium in Medellín, Colombia, that amplifies the stories of LGBTQ people in Latin America. They are based in Seattle, speak English and Spanish, and are a member of NLGJA, SPJ, and ONA.