Despite intense political debates and a seemingly endless stream of social media commentary, a new study published in the prestigious journal JAMA Pediatrics has shown that puberty blockers and gender-affirming hormones are extremely rare among U.S. transgender and gender-diverse (TGD) adolescents. Researchers from Harvard T.H. Chan School of Public Health, Harvard Pilgrim Health Care Institute, and FOLX Health found that fewer than 0.1% of privately insured youth aged 8 to 17 received this kind of care over a recent five-year period. That’s less than 1 in 1,000 kids in the data set—an astonishingly small number when compared to the political rhetoric blasting throughout news cycles and legislative chambers alike.
Yet, if you listened to certain lawmakers and media outlets, you might think these medications were being prescribed to nearly every kid who questions their gender. After all, the debate around trans youth in the United States and the United Kingdom has reached a fever pitch—angry slogans, heated public hearings, and a swirl of misinformation that’s left many families confused, frightened, and sometimes downright angry. This new peer-reviewed research puts reality back on the table: children receiving puberty blockers or gender-affirming hormones are an exceedingly small group, contrary to the sweeping claims made by those who would prefer to politicize trans issues.
The Numbers Speak Volumes
The study, released in JAMA Pediatrics on January 6, 2025, analyzed private insurance data from 2018 to 2022, examining more than 5.1 million patients between the ages of 8 and 17. Out of all those youngsters, fewer than 18,000 had any form of gender-related diagnosis. Even more striking, of that subset:
- Only 926 received puberty blockers
- Just 1,927 received hormone therapy
That’s out of more than five million adolescents—a rate of under 0.1%. In other words, the alarming narrative that “millions of children” are on a fast track to being handed hormones simply doesn’t hold up. If these treatments are as widespread as some politicians claim, the data sure isn’t showing it.
Lead author Landon Hughes, a Yerby Fellow in Harvard Chan School’s Department of Epidemiology, highlighted the gulf between public perception and reality: “The politicization of gender-affirming care for transgender youth has been driven by a narrative that millions of children are using hormones and that this type of care is too freely given. Our findings reveal that is not the case.”
Meanwhile, co-author Jae Corman, head of analytics and research at FOLX Health, was equally emphatic: “Our study found that, overall, very few TGD youth access gender-affirming care. Among those that do, the timing of care aligns with the standards outlined by the World Professional Association for Transgender Health, the Endocrine Society, and the American Academy of Pediatrics.”
The study also noted zero TGD patients under 12 received hormones, once again debunking the increasingly popular myth that elementary-aged children are being ushered into clinics for “irreversible” medical interventions. The data just doesn’t bear that out.
“One is Too Many”: A Rallying Cry for the Fiercest Critics
You’d think this study might put to rest at least some of the panic swirling around gender-affirming care. But the sad reality is, many of the fiercest anti-transgender groups are already scoffing at these numbers. Their message? Even one minor receiving puberty blockers or hormones is “too many.” It’s a neatly packaged soundbite that’s easy to remember and even easier to splash across headlines, but it ignores a few key facts—namely, that gender-affirming care for trans youth has been tied to improved psychological functioning, better mental health outcomes, and, in some cases, a life-saving reduction in suicidal ideation. That’s hardly the storyline you hear in the political scuffle.
Opponents of trans healthcare seem prepared to keep forging ahead with laws that ban minors from accessing not just medications but also social support in the form of name changes or pronoun usage at school. Some states have already adopted or proposed bans that punish healthcare providers simply for following standard medical guidelines. For parents of transgender children, the conversation has jumped from “Should we talk to our doctor?” to “Do we have to move to a different state?”
Researchers like Hughes hope the data will at least remind the public that we’re not talking about millions of kids. In the broader context of American healthcare, the actual number of adolescents receiving puberty blockers or hormones is minimal. “We are not seeing inappropriate use of this sort of care,” Hughes told the Associated Press. “And it’s certainly not happening at the rate at which people often think it is.”
Putting the Research in Context
There’s another critical piece of this story: the study used private insurance data. Private coverage is typically more comprehensive than Medicaid or uninsured care, implying that if there were going to be higher prescription rates of gender-affirming medications, this data set would be the most likely place to find them. That’s because individuals with robust private insurance often face fewer financial and bureaucratic barriers when it comes to accessing specialized healthcare.
And yet, even in this presumably more accessible environment, well under 0.1% of adolescents were prescribed puberty blockers or hormones. That underscores just how misleading—and damaging—the moral panic around trans youth healthcare can be. If fewer than 1 in 1,000 privately insured minors receives gender-affirming medicine, one can only imagine the smaller numbers among families with patchy or no insurance coverage.
Furthermore, this study follows a 2024 investigation by the same team that documented the rarity of gender-affirming surgeries in minors. “Little is known about hormone use among transgender and gender-diverse adolescents,” the authors wrote, “so we set out to fill that void.” They filled it with meticulously gathered, peer-reviewed data that leaves little room for argument—though that’s not to say certain politicians won’t keep trying.
Changing the Subject: How the Debate Steers Away From Facts
If this all feels reminiscent of a worn-out pop culture trope—where a rumor starts on social media and snowballs into a nationwide controversy—it’s because that’s exactly how misinformation tends to take off. Politicians, advocacy groups, and media personalities latch onto a sensational storyline: “Think of the children!” They warn about wild over-prescription of hormones, conjure up images of kids trooping into clinics and walking out changed forever the same day.
When new data arrives to contradict that storyline, it’s often ignored, downplayed, or swiftly replaced with an emotional appeal that stokes even more fear. “Sure,” the thinking goes, “it might be only 1 in 1,000. But one is too many!” For those opposed to transgender equality, that rhetorical pivot allows them to keep the moral outrage burning, no matter how small the actual numbers might be.
What’s missing from that conversation? The perspective of actual transgender adolescents—real young people who, along with their parents and doctors, make these decisions. Many TGD teenagers decide against medications or wait longer to confirm their feelings. Others might adopt new clothes, names, or pronouns well before exploring any medical interventions. But those human stories rarely trend on social media like fear-based narratives do.
Legislative and Legal Battles Heat Up
The study’s release comes at a time when the U.S. Supreme Court is expected to rule on a major case involving the constitutionality of bans on gender-affirming care for minors in Tennessee. Already, at least 26 states have passed or proposed restrictions—ranging from partial to complete bans—on puberty blockers, hormone therapy, and, in some cases, mental health counseling for transgender youth. The sheer volume of these laws would make your head spin.
According to the Associated Press, the Supreme Court’s decision could set a precedent that either upholds these restrictive laws or strikes them down. And while the data from this Harvard-FOLX Health study provides a fresh perspective, it’s unclear whether reasoned analysis will outweigh heated political theatrics and fear-mongering. President-elect Donald Trump, for one, has promised to roll back protections for transgender people, demonstrating just how quickly the national climate can shift on these issues.
Transgender individuals, their families, and allies continue to watch these developments with a mixture of apprehension, frustration, and often heartbreak. In many cases, laws that restrict care force families to travel out of state or hide crucial aspects of a child’s identity from their local community. The emotional toll on these young people can be staggering, leaving them feeling demonized, isolated, and misunderstood.
A Call for Clarity and Compassion
So, what’s next? One might hope that a study published in a respected medical journal would put an end to misinformation. Unfortunately, previous experience suggests otherwise. Anti-trans groups might shift their messaging, double down on fear-based tactics, or question the credibility of the researchers. They’ll say the study is “skewed,” or that it doesn’t matter if it’s only 1 in 1,000 because one is too many. The conversation could quickly spiral, overshadowing the data with sensational headlines.
For transgender youth and their families, it’s a tired dance. Navigating the complexities of identity is challenging enough without the added weight of nationwide policy debates, lawsuits, and media sensationalism. Beyond all the noise, the fact remains that these gender-affirming medical interventions—when deemed appropriate by licensed medical professionals—are relatively rare, carefully regulated, and, for those who need them, deeply life-affirming.
Those of us who value evidence-based medicine, empathy, and personal freedoms would do well to keep sharing the facts:
- Transgender and gender-diverse teens exist.
- They’re not taking over every pediatric clinic in the country.
- Many benefit profoundly from the option of gender-affirming care.
When the conversation drifts into hyperbole, refer back to the data. If a well-funded media campaign claims tens of thousands of kids are on hormones without proper oversight, bring up the cold, hard statistics: fewer than 1 in 1,000 minors in this extensive study received these treatments. Think of it as a real-world fact-check against the fear-based rhetoric.
The Road Ahead
As we move into a new legislative season and brace for more court battles, it’s critical to remember that these issues don’t vanish when the cameras turn off. Transgender kids still have to go to school, deal with social pressures, and figure out who they are. They don’t disappear because a politician announces a new ban or a cable-news host runs a segment stoking fears of a “woke agenda.” This is their real life, and the medical community continues to underscore that when provided ethically, gender-affirming care can be a lifeline.
If there’s any lesson to glean from the swirl of controversy and the clarity of research, it’s that facts should guide policy—not fear. This JAMA Pediatrics study stands as a reality check, providing data that’s both straightforward and surprising (at least to some) in its conclusion: puberty blockers and hormones are rarely prescribed to TGD youth. That doesn’t mean the conversation about trans healthcare should end, but it does mean it’s time to retire the myth that “millions of children” are rushing into irreversible treatments.
And perhaps, amid all the shouting and posturing, we can do something truly radical: listen to trans youth and their families. Let’s have the difficult conversations but ground them in evidence, empathy, and respect. Let’s stop treating transgender issues as a hot-button political talking point, and start focusing on the actual well-being of real people who, in many cases, are simply trying to live their lives.
Because if the data is this clear, and the benefits are so widely acknowledged by major medical organizations, maybe the only real crisis is the refusal to hear the truth. And that, in the words of so many exasperated families, is the biggest tragedy of all.
