What Is Gender-Affirming Care?

Key Takeaways

Gender-affirming care has been the subject of much debate in legislatures around the country in recent months, leading to countless misconceptions and myths about what it actually entails and who it’s for.

According toa reportfrom The Williams Institute, 30 states had introduced or were considering laws to restrict access to gender-affirming care as of March 2023. The result is 146,300 transgender youth who have lost or are at risk of losing access to gender-affirming care. Several bans proposed in 2023 would also limit access to care for those up to age 26.

“Gender-affirming care is considered life-saving,” saidRebecca Minor, MSW, LICSW,a gender specialist and therapist who provides gender-affirming care. “It plays a crucial role in improving the mental health, well-being, and overall quality of life for transgender, non-binary, and gender diverse individuals.”

What Does Gender-Affirming Care Involve?

Gender-affirming care refers to medical, psychological, and social support provided to individuals who are transgender, non-binary, or gender expansive, Minor explained. The goal of gender-affirming care is to assist individuals in aligning their sense of self with their outward appearance and to improve their overall well-being.

“Gender-affirming care means different things for different people,”Uri Belkind, MD, a pediatric medicine specialist who works in adolescent medicine at the New York-based LGBTQ+ health center Callen-Lorde, told Verywell. “It is not a specific process, but rather a collection of tools from which we can select to better fit the individual’s goals and needs.”

One aspect of gender-affirming care requires no medical intervention but instead involvestransitioning socially. This may include changing one’s name and pronouns, and dressing or presenting in a way that affirms their gender identity, according toSean Arayasirikul, PhD, an associate professor in residence of health, society, and behavior at the University of California, Irvine.

Beyond socially transitioning, there are three general medical options available when it comes to gender-affirming care, Belkind said, adding that some people may want or need all of them, while some may find happiness and well-being with only some. These include puberty blockers, gender-affirming hormone therapy, and gender-affirming procedures.

Puberty blockersare for younger patients who are entering puberty and are finding the changes their bodies are going through to be distressing. To access this kind of care, these patients must have shown insistent, persistent, and consistent identification with a gender that is different than their sex assigned at birth.

“This allows us to temporarily ‘pause’ these changes while the young person, with support from their family, further explores their needs and gains a better understanding of what is possible, medically speaking, and what it entails,” Belkind said.

Gender-affirming hormone therapy, on the other hand, refers to the process of using either estrogen or testosterone to promote certain physical changes and to inhibit others, Belkind said.

Gender-affirming procedures, both surgical and non-surgical, change certain physical characteristics that may not otherwise be modified with the use of hormone therapy. Belkind said these may include chest masculinization, facial feminization, permanent hair removal or hair grafting, and genital surgeries such as vaginoplasty or phalloplasty.

“One common misconception is that gender-affirming procedures are regulated only for trans and gender expansive people and that these procedures are experimental, lacking solid medical evidence,” Arayasirikul said.

In reality, cisgender people—or people who are not trans—also choose to undergo gender-affirming procedures to affirm their identity, Arayasirikul explained. This may include a breast augmentation, a mastectomy for gynecomastia, a hair transplant, a rhinoplasty, liposuction, facial fillers, or hormone therapy.

“These procedures and so many more are part of the health care of cisgender people,” Arayasirikul said. “Yet this same care is actively being criminalized for trans and gender-expansive people solely because they are different.”

Can People of All Ages Receive Gender-Affirming Care?

In states where gender-affirming care is not criminalized, trans youth can access puberty blockers to delay the onset of puberty and cross-sex hormones to develop their bodies in ways that align with their gender identity.

And yet, much of the uproar surrounding gender-affirming care in the U.S. has been surrounding the subject of children undergoing surgery.

According to Belkind, some patients choose to start puberty blockers once puberty begins, while other patients may only begin to seek medical advice after puberty or much later into adulthood.

“It is important to note that, for children who strongly identify with a gender identity that is different from their sex assigned at birth, there are no medical interventions needed before puberty begins and only then do we consider the use of puberty blockers, if needed,” Belkind said.

Medical interventions always happen after a thorough evaluation of the patient’s needs, Belkind added.

Why Gender-Affirming Care Is Necessary

Gender-affirming care helps to reduce gender dysphoria, which is the distress an individual may experience when their gender identity does not align with their assigned sex at birth, Minor said.

Another study found that gender-affirming surgeries were associated with a 42% reduction in psychological distress and a 44% reduction in suicidal ideation when compared with transgender and gender-diverse people who had not had gender-affirming surgery but wanted it.

“Gender-affirming care allows individuals to express their gender identity authentically, promoting self-acceptance and improved self-esteem,” Minor said. “By aligning their physical appearance, social interactions, and personal identity, individuals can develop a stronger sense of identity and self-worth, leading to improved mental health outcomes.”

Additionally, gender-affirming care often includes support groups, peer networks, and counseling services that provide a safe and inclusive environment for individuals to connect, share experiences, and receive emotional support, Minor said. These social support systems, she said, are critical in combating feelings of isolation and promoting healthy relationships.

This kind of care can help combat the societal discrimination, stigma, and marginalization transgender and gender-diverse individuals often face. Minor said gender-affirming care can empower individuals to assert their rights, advocate for themselves, and challenge discriminatory practices.

“By affirming their gender identity, individuals can experience improved resilience, reduced psychological distress, and increased social acceptance,” she said.

What This Means For YouDespite the overwhelming amount of misinformation circulating about gender-affirming care, it’s important to be aware that the medical evidence shows it is safe, effective, and necessary for trans and gender-diverse individuals who want it. There is no one-size-fits-all approach—rather, it’s about what makes sense for one specific individual’s needs and well-being.

What This Means For You

Despite the overwhelming amount of misinformation circulating about gender-affirming care, it’s important to be aware that the medical evidence shows it is safe, effective, and necessary for trans and gender-diverse individuals who want it. There is no one-size-fits-all approach—rather, it’s about what makes sense for one specific individual’s needs and well-being.

3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Valentine SE, Shipherd JC.A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States.Clin Psychol Rev. 2018;66:24-38. doi:10.1016/j.cpr.2018.03.003Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K.Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care.JAMA Netw Open. 2022;5(2):e220978. doi:10.1001/jamanetworkopen.2022.0978Almazan AN, Keuroghlian AS.Association between gender-affirming surgeries and mental health outcomes.JAMA Surg. 2021;156(7):611-618. doi:10.1001/jamasurg.2021.0952

3 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Valentine SE, Shipherd JC.A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States.Clin Psychol Rev. 2018;66:24-38. doi:10.1016/j.cpr.2018.03.003Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K.Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care.JAMA Netw Open. 2022;5(2):e220978. doi:10.1001/jamanetworkopen.2022.0978Almazan AN, Keuroghlian AS.Association between gender-affirming surgeries and mental health outcomes.JAMA Surg. 2021;156(7):611-618. doi:10.1001/jamasurg.2021.0952

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Valentine SE, Shipherd JC.A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States.Clin Psychol Rev. 2018;66:24-38. doi:10.1016/j.cpr.2018.03.003Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K.Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care.JAMA Netw Open. 2022;5(2):e220978. doi:10.1001/jamanetworkopen.2022.0978Almazan AN, Keuroghlian AS.Association between gender-affirming surgeries and mental health outcomes.JAMA Surg. 2021;156(7):611-618. doi:10.1001/jamasurg.2021.0952

Valentine SE, Shipherd JC.A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States.Clin Psychol Rev. 2018;66:24-38. doi:10.1016/j.cpr.2018.03.003

Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K.Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care.JAMA Netw Open. 2022;5(2):e220978. doi:10.1001/jamanetworkopen.2022.0978

Almazan AN, Keuroghlian AS.Association between gender-affirming surgeries and mental health outcomes.JAMA Surg. 2021;156(7):611-618. doi:10.1001/jamasurg.2021.0952

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