copenlu/druid huggingface dataset:
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2024-07-03): The Biden administration on Tuesday afternoon provided more details about its opposition to gender-affirming surgery for transgender minors, a position at odds with its previously broad support for gender-affirming care — and one taken by a presidential administration that has closely aligned itself with LGBTQ+ advocates. "These are deeply personal decisions and we believe these surgeries should be limited to adults," a White House spokesperson said over email. "We continue 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." [...] Most transgender youth receiving gender-affirming care will not undergo surgery as a minor. Trans youth who, along with their parents, elect to begin gender-affirming medical care as they enter adolescence due to persistent gender dysphoria will typically receive puberty blockers. This treatment intervenes before puberty causes bodily changes that may require surgery in the future. Puberty blockers are typically used until patients get to an age where they can consider taking hormone replacement therapy.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-02-01): Gender-affirming surgery for transgender Adolescents: Ethical and legal considerations [...] In this paper, we consider the ethico-legal issues surrounding gender-affirming surgeries in minors, with a specific focus on English law. First, we outline and discuss the current clinical guidelines on genital surgery for minors with gender incongruence/dysphoria. Second, we consider the recent legal developments following R (on the application of) Quincy Bell and A v Tavistock and Portman NHS Trust and others, and we discuss how these might impact the ability of doctors to agree to surgical procedures when their patients are still minors. Finally, we explain why the removal of the adulthood threshold is justified. However, we argue that surgical interventions should remain differentiated from fully reversible interventions, and that clear guidance on eligibility criteria for genital surgery is needed from clinical guidelines, which, in consideration of the legal, professional and regulatory framework in which clinicians work, can provide needed reassurance regarding when it is in the best interests of competent young people to be considered suitable candidates for genital surgery.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2021-12-21): First, know what it is—and isn’t "Gender-affirmative care," also called gender-affirming care, "is a model of care and an approach to the patients and families that we work with," said Jason Rafferty, MD, MPH, a child psychiatrist and pediatrician at Hasbro Children’s Hospital, in Providence, Rhode Island. "It’s not necessarily a protocol. It's not guided steps." [...] Access to gender-affirming care is endangered by legislative efforts to interfere with the delivery of that care, Dr. Janssen said, adding that "almost half the states in this country are in the process of enacting legislation that will bar care for transgender youth." The AMA recently urged governors to oppose state legislation that would prohibit medically necessary gender transition-related care for minor patients.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-12-28): It is hard for minors to get gender-affirming surgical care in Sweden. But much of that stems from a 1970s law that is unrelated to DeSantis’ point. [...] Speaking about gender-affirming surgical care for minors, DeSantis said Sweden "shut it down." [...] Sources - Email interview with Jêran Rostam, expert on transgender issues at the The Swedish Federation for Lesbian, Gay, Bisexual, Transgender, Queer and Intersex Rights or RFSL, Aug. 31, 2023 - Email interview with Deekshitha Ganesan, Policy Officer at TGEU (Transgender Europe), Aug. 31, 2023 - Interview with Marci Bowers, Gynecological surgeon and President of the World Professional Association for Transgender Health, Oct. 12, 2023 - PolitiFact, "Gender-affirming surgery is not banned for minors in Europe, but is mostly inaccessible," Sept. 6, 2023 - PolitiFact, "Is all gender-affirming care for children ‘experimental’? Experts say no," Jan. 17, 2023 - PolitiFact, "Transition-related surgery limited to teens, not 'young kids.'
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-08-23): Finland and the United Kingdom’s health policies limit gender-affirming surgeries to people older than 18. Sweden and the Netherlands allow chest surgery at age 16 and genital surgeries at 18. Norway generally does not offer surgical care to minors, but has not banned it. [...] "Norway, Finland, Sweden, Holland, and the U.K. have now banned gender transition surgery for minors," read the Aug. 23 post. [...] Gender-affirming surgical care in these countries is mostly regulated through guidelines and recommendations, not laws banning care. None of these countries have banned gender-affirming care for minors outright in the way that some U.S. states have.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-12-31): It is hard for transgender minors to get gender-affirming surgical care in Sweden. But much of that stems from a 1970s law that is unrelated to DeSantis’ point. [...] The gender-affirming surgery DeSantis cited is rarely performed on minors, said Marci Bowers, a gynecological surgeon and president of the World Professional Association for Transgender Health. Surgeries on minors happen "only under the most severe conditions of gender dysphoria," she said. Gender dysphoria is the experience of distress that results when people’s sex assigned at birth does not match their gender identity. [...] Speaking about gender-affirming surgical care for minors, DeSantis said Sweden "shut it down."
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-12-26): The claim: Florida Gov. Ron DeSantis said parents who seek gender-affirming care for their children subject those children to abuse — so much so that other nations have sought to ban it. During the fourth Republican presidential primary debate Dec. 6 in Tuscaloosa, Alabama, DeSantis cited Sweden as an example. "As a parent, you do not have the right to abuse your kids," DeSantis said. "This is cutting off their genitals, this is mutilating these minors, these are irreversible procedures. And this is something that other countries in Europe like Sweden, once they started doing it, they saw it did incalculable damage. They’ve shut it down."
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-06-06): Increasingly, European nations are adopting a more cautious approach to gender-affirming care among minors. In March, for example, the Norwegian Healthcare Investigation Board announced it would revise its current clinical recommendations with respect to "gender-affirming care" for minors. The updated guidelines would restrict the use of puberty blockers, cross-sex hormones and transition-related surgery to clinical research settings. Norway joins other European nations, such as Finland, Sweden and the U.K., in introducing limits on the provision of gender-affirming care to minors. [...] A common claim by Americans who oppose state restrictions on gender-affirming care for minors is that Sweden, Finland, the Netherlands and the U.K. have not done away with hormonal interventions, and therefore lawmakers who seek limits are presumably going against what European health authorities recommend. Additionally, voices in America’s "affirmative-medicine" movement point to Europe not having bans on gender-affirming care for minors. It’s true that Europeans aren’t banning such care, and so legislators in the U.S. who pursue bans are at odds with European recommendations. But this only tells part of an evolving and layered story.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-06-21): Federal judge blocks the country's first ban on gender-affirming care for minors A federal judge has permanently struck down the country's first law banning gender-affirming care for minors, signaling a victory for LGBTQ advocates. [...] KELLY: Hi. So this case goes back to 2021. That is when lawmakers in Arkansas passed the nation's first-ever ban on gender-affirming health care for minors. Just walk me briefly through how it's ended up in federal court.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-12-06): Why Ron DeSantis’ claim that Sweden ‘shut down’ gender-affirming surgical care is Half True [...] The gender-affirming surgery DeSantis cited is rarely performed on minors, said Dr. Marci Bowers, a gynecological surgeon and president of the World Professional Association for Transgender Health. Surgeries on minors happen "only under the most severe conditions of gender dysphoria," she said. Gender dysphoria is the experience of distress that results when people’s sex assigned at birth does not match their gender identity. [...] Speaking about gender-affirming surgical care for minors, DeSantis said Sweden "shut it down."
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2024-09-24): WHO clarifies that "gender-affirmative care" is not supported by evidence in children and adolescents, but signals that it will recommend expanded hormone availability and legal recognition of self-determined gender for all others.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-02-16): Sweden, a pioneer in LGBTQ rights, is now restricting gender-affirming treatments for minors, citing concerns about their long-term side effects. [...] Sweden, known as a pioneer in LGBTQ rights, started restricting gender-affirming hormone therapy for minors - allowing it only in very rare cases - a year ago. [...] She believes the current debate shows the issue of gender-affirming care for trans teens is "more complex than the healthcare system and society had hoped".
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2021-05-05): The Karolinska Hospital’s new policies echo a growing international concern over the proliferation of medical interventions that have a low certainty of benefits, while carrying a significant potential for medical harm. The latest policy issued by the Karolinska cites the UK NICE evidence review, which found the risk / benefit ratio of hormonal interventions for minors highly uncertain; the 2020 UK judicial review, which highlighted the overarching ethical problems with the practice of medical "affirmation" of minors; as well as Sweden's own Health and Technology Assessment (SBU) evidence review conducted in 2019, which found a lack of evidence for medical treatments, and a lack of explanation for the sharp increase in the numbers of adolescents presenting with gender dysphoria in recent years. [...] In North America, the debate about treatments for gender-dysphoric minors has become highly politicized. A number of US states have recently introduced laws banning the use of hormonal interventions in gender-dysphoric minors. In contrast, other states have introduced laws mandating public and private insurance coverage for a wide range of gender-"affirming" medical and surgical interventions for "gender incongruence," regardless of a patient's age or mental health status. In Canada, Bill C-6 goes even further, seeking to criminalize psychological treatment modalities, which represent the primary non-invasive alternative to medical and surgical "affirmation."
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-06-21): This memo addresses the frequently made claim that "gender affirming" hormonal and surgical interventions for minors are appropriate because most major medical organizations in the U.S. support them. While it is understandable that doctors and their patients should want to follow guidelines issued by professional medical groups, it is important to recognize that these groups don’t always get the science right. [...] The three main American medical organizations to have recommended "gender affirming care" for minors are the American Academy of Pediatrics (AAP), the Endocrine Society, and the World Professional Association for Transgender Health (WPATH). Other organizations, including the American Medical Association, have issued public statements in support of the use of hormones to address gender dysphoria, but without discussing the research. [...] Because the Dutch study, published in 2011 and 2014, is widely regarded as the gold standard of research in support of "gender affirming" hormonal and surgical interventions for minors, its five main problems[9] should be well understood:
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2024-09-24): The practice of medically transitioning minors, currently referred to as "gender-affirmative care," began to gain momentum following a single-site study in the Netherlands. Previously, gender transition was available only to mature adults, with the average age of transition frequently in the 30's. However, it was noted that the results of adult transitions were frequently disappointing, which was believed to be explained by unsatisfactory cosmetic outcomes, particularly for males, who had a "never disappearing masculine appearance." in the 1990's, the Dutch clinicians began to experiment with transitioning minors using endocrine interventions with the hope that a better cosmetic outcome would also lead to better mental health ones. The results of the innovative Dutch experiment, which has become known as "the Dutch Protocol," were documented in two publications: the 2011 study, which reported on cases who underwent puberty blockade, and the 2014 study, which reported on a subset of the cases who completed surgeries, including the removal of ovaries and testes upon reaching the age of 18.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-08-17): However, following systematic reviews of evidence conducted in Europe and the subsequent reversal of the "gender-affirmation" paradigm in favor of a cautious, developmentally-informed approach that prioritizes psychosocial support and noninvasive resolution of gender distress in Sweden and Finland, Denmark appears to have made a quiet but resolute shift to treat most youth presenting with gender dysphoria with supportive counseling rather than puberty blockers, hormones, or surgery. In 2022, only 6% of those referred to Denmark’s centralized gender clinic were prescribed endocrine interventions (puberty blockers and/or cross-sex hormones).* [...] - Surgical interventions in minors, already rare, will likely be removed as an option. The current treatment guidelines do not allow genital surgeries for those under 18, but it appears that mastectomies for some older teens are still an option (although perhaps an option on paper only). Recent comments by the Danish Minister of Health suggest that mastectomies may be officially disallowed in the updated guidelines. "I can also inform you that the National Board of Health ["Sundhedsstyrelsen"] issued a new guideline for gender reassignment surgery on March 28 this year at the latest, which is now in consultation. In the new referral guidelines, it is no longer possible to offer surgical treatment to children under the age of 18... An option that, by the way, has never been used in Denmark." **
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-04-28): "In the Netherlands there are more and more people saying that gender diversity is woke and it’s nonsense and it’s bullshit," Visser, the consultant for parents of trans teens, told me. Sam van den Berg, a spokesperson for an Utrecht-based trans-rights organization called Transvisie, argued that this debate does not need to happen. The quality of care for children with gender dysphoria is better in the Netherlands than almost anywhere else, she said. "We don’t feel it’s necessary to change anything." Indeed, doctors in the Netherlands are still free to provide gender-affirming care as they see fit. The same is true of their colleagues in Finland, Sweden, France, Norway, and the U.K., where new official guidelines and recommendations are not binding. No legal prohibitions have been put in place in Europe, as they have been in more than a dozen U.S. states, where physicians risk losing their medical license or facing criminal sanctions for prescribing certain forms of gender-affirming care.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-10-06): Last July, the country’s National Health Service said it would shutter the public Gender Identity Development Service at the Tavistock clinic in London, the only provider of gender-affirming care for minors in England and Wales. The NHS cited an internal review that raised concerns that children were being referred too quickly, causing an unsustainable surge in patients. [...] While Sweden was the first country in the world to allow people to legally change their gender in 1972, it has recently tightened its eligibility criteria for gender-affirming care for minors. But it hasn’t banned it. [...] A year and a half after the Karolinska decision, the National Board of Health and Welfare, a Swedish government agency, updated its guidelines on gender-affirming care for minors. It stated that puberty blockers, hormones, and mastectomies should only be used in "exceptional cases," as the risks are likely to outweigh the benefits. In addition, the board said, mental health care should be offered to patients when doctors are assessing them.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-03-08): Ban on gender-affirming care for transgender minors heads to Reynolds’ desk [...] Republicans sent a ban on gender-affirming care for minors to Gov. Kim Reynolds’ desk Wednesday, less than two weeks after the measure was first brought up as a possibility. [...] Republicans cited studies from Sweden, which restricted hormone treatment therapy for minors in 2022 as doctors call for more research into the long-term effects of beginning gender-related care at an early age. These studies show substantially higher rates of suicidal thoughts and attempts as well as psychiatric hospitalization among transgender people after undergoing gender-affirming surgery than a healthy control population.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-02-08): Sweden puts brakes on treatments for trans minors Stockholm (AFP) – Sweden, the first country to introduce legal gender reassignment, has begun restricting gender reassignment hormone treatments for minors, as it, like many Western countries, grapples with the highly-sensitive issue. [...] Sweden decided in February 2022 to halt hormone therapy for minors except in very rare cases, and in December, the National Board of Health and Welfare said mastectomies for teenage girls wanting to transition should be limited to a research setting.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-07-27): This so-called ``gender-affirming care'' is anything but affirming and caring, and the language matters. This is adults deciding to permanently alter the bodies of children who do not have the capacity to make life-altering decisions on their own. [...] She is right. Banning access to gender-affirming care would violate parents' due process rights, and the Federal Courts agree. They agree that banning gender-affirming care for minors violates Constitutionally protected parental rights, and that politicians should stay out of those decisions. [...] We have also heard conservative lawmakers and activists argue that bans on gender-affirming care are necessary to protect minors with many labeling gender-affirming treatments experimental. As we have seen here today repeatedly deliberately confusing gender-affirming care with gender transition surgery. Can you speak to that issue?
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2023-12-02): In the U.S., a politically partisan divide is shaping up between states that allow for and guarantee access to youth gender-affirming care and states that ban such treatment altogether. Twenty-two states have passed bans on the use of cross-sex hormones, puberty blockers and surgery in minors. [...] Finland was among the first countries to adopt the so-called Dutch Protocol for pediatric gender medicine. In the 1990s, Dutch gender specialists began laying the foundation for a comprehensive manual, if you will, for providing gender-affirming healthcare for minors. As it was envisioned, the Dutch Protocol laid out a set of criteria for treatment eligibility. There needs to be a documented early childhood onset of gender dysphoria, increase of gender incongruence after pubertal changes, absence of significant psychiatric comorbidity and demonstrated knowledge and understanding of the consequences of medical transition. Treatment with puberty blockers can only be initiated starting at the age of 12. Interventions with clearly irreversible effects, which include cross-sex hormones and surgery, are not available until ages 16 and 18, respectively. Should patients go through with the transitioning process, all youth are provided with psychotherapy throughout.
Claim: Discussing gender-affirming surgical care for minors, said that Sweden “shut it down.” (Ron DeSantis, 2023-12-06)
Evidence (2024-06-18): But according to Haim, the hospital did not stop gender-affirming care for minors. [...] In a City Journal story published in January, Haim revealed his identity and detailed the gender-affirming care he had seen firsthand, including a surgeon who had implanted a hormone device for gender dysphoria in an 11-year-old girl. Haim said the frequency of procedures like that one had increased, and that "potentially hundreds more children" had received hormone interventions for gender dysphoria. [...] Given the concerns increasingly expressed by medical professionals, it's stunning that discussions about life-altering care of transgender children are still so politically volatile. My home state of Texas isn't alone in restricting such care; 24 other states have banned medical gender-affirming treatment of minors.