Understanding the reports on health care for trans youth
Learn more about reports on trans health care, catch up on the U.S. v. Skrmetti arguments, and read a message from the TJA's interim executive director about our work in 2025.
Table of contents
- The work to come
- Style guide updates
- How you can help
- Understanding the reports on health care for trans youth
- Resources to catch up on U.S. v. Skrmetti
- How police and media deadname trans people
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The work to come
In the aftermath of the U.S. presidential election last month, Trans Journalists Association volunteers started writing a piece offering fresh advice for covering our community.
We envisioned it as evergreen guidance. It would — we hoped — help journalists think critically about their coverage of ongoing political attacks on trans communities, in the context of President-elect Donald Trump’s promised escalation of these policies under a GOP-controlled House, Senate, and executive branch.
The same day the piece was published, a brewing controversy in D.C. escalated: A Republican representative filed a national bathroom bill. It came barely a week after legacy media organizations published thinkpiece after thinkpiece that not only presented pseudoscience as fact and misinterpreted polling data, but also positioned trans people — and our existence — as a discardable electorate issue.
It became clear that "evergreen advice" was part of, but not all, the industry needed.
We moved quickly, updated our style guide, connected with newsroom leaders, and started to plan what comes next.
That week showed us just a small glimpse of the work to come. Between recent news in sports, evolving postmortem election analyses, and the ongoing litigation of health care bans and other civil and human rights restrictions, trans communities haven’t left the headlines since.
Even though our industry has adopted the most basic recommendations, like using correct names and pronouns, news publications have still struggled with the bigger picture. Some coverage echoes anti-trans political language and framing uncritically, fails to check the facts, and ignores widely accepted precedent to avoid deferring to partisan phrasing on other topics. Glaringly, many fail to identify the discriminatory and national implications of recent conflicts. Even fewer situate this ongoing public conversation in the context of the increasingly frequent and successful removals of trans Americans’ rights through legislation and policy.
These journalistic failures aren’t new. The TJA launched in 2020 in part because trans journalists saw the same factual errors and ethical oversights in coverage of our communities, again and again. Trans people aren’t the only “issues” plagued by failures to check facts and hold officials accountable: U.S. news outlets have run retracted statements about the Israel-Palestine conflict amid Israel’s killing of journalists and amplified baseless claims about migrants when the incoming president has pledged to enact mass deportations.
There is opportunity, right now, for our industry to do critical, necessary work in the face of increasing disinformation, meddling publishers, dwindling resources, and threats from the highest reaches of the U.S. government.
Some have already covered the political attacks on trans people with forethought and context, a sense of compassion and history and scale; followed the money and connected the dots and documented the role misinformation has played in making public policy; and remembered trans voices — especially the young people who’ve often borne the brunt of these political attacks.
Thank you, as always, for your work. At the Trans Journalists Association, we’re dedicated to supporting it however we can.
As the old journalists’ adage goes: If one person says it is raining, and the other says it is not, it is our job to look outside and report back.
Look outside, colleagues.
Kae Petrin
Interim executive director
P.S. Here's that coverage guidance:
Kae Petrin
And we have more resources further down in this newsletter:
- Style guide updates
- Understanding the reports on health care for trans youth
- Resources to catch up on U.S. v. Skrmetti
- How police and media deadname trans people
Style guide updates
In response to recent breaking news and questions we have received, we have added new guidance on several topics.
- New coverage guidance on bathroom restrictions
- New best practices entry around slurs and inflammatory language
- New language entry around accurate terminology for gender-neutral bathrooms
- Consolidated policy-related guidance under a new subsection for anti-trans law and policy coverage
- Several new definitional entries in our glossary
How you can help
Have these resources helped you? Our work is increasingly urgent. We’re newly incorporated as a 501c3 nonprofit, and your tax-deductible donation goes directly to paying trans professionals and services that support gender-expansive journalists.
Does your newsroom want to learn more about fair, accurate, and timely coverage of trans communities? We’re working directly with newsrooms and journalists to connect them with resources, trainings, and more. Reach out to us at contact@transjournalists.org.
Are you a trans, nonbinary, or gender-nonconforming journalist? We have resources. You can join us on our members site.
Understanding recent trans health care reviews
If you've been paying attention to news about trans health care restrictions, you've likely heard of the Cass Review, as well as changing European standards of care for transgender youth. Justices referenced both in the oral arguments in the case U.S. v. Skrmetti at the Supreme Court this week.
Here are some resources to learn more about the recent reviews on this subject.
Despite common claims that the Cass Review debunks the efficacy of trans health care, the report's conclusions are more complex than that. The review does recommend that some common treatments, like hormone therapy, should be provided to minors only with "extreme caution."
But it also calls for investing in trans health care by "expanding capacity at all levels of the system" to enable decreased wait times and "more timely care," "an individualised, personal approach," and the collection of additional data on longer-term outcomes.
For further context on the review, read the Yale-led, evidence-based critique of its conclusions. It's also worth diving into the Cass Review's underlying data. According to the Yale critique, the review "misinterprets and misrepresents its own data."
The report has not been uncontroversial in Britain, either. The British Medical Association called for a pause on the review's implementation and voted to independently evaluate its findings. After some of its members criticized the decision, the association's leadership reaffirmed its intent to evaluate the review and pledged to do so "from a position of neutrality." Its leaders also noted concerns that England's National Health Service chose to implement the review's recommendations inconsistently.
These episodes underscore the TJA's perennial coverage guidance for considering research: As with datasets, you should treat studies, reviews, and research like any other source. Evaluate their expertise, their authority, and their point of view. It's important to know how to understand and contextualize research — and potential bias — for your audience.
It’s also important to distinguish between peer-reviewed studies, scientific literature reviews, and the findings of health authorities. The U.S. Food and Drug Administration, the U.K. National Health Service, and the Florida Department of Health, for example, are all government bodies. Like for any document you obtain from a government agency, ask questions and apply scrutiny; it may not have gone through the same evaluation process as something published in a journal. Research itself has a number of possible methodological biases, which the Association for Health Care Journalists offers helpful resources for understanding. Academic journals' internal safeguards and conflict of interest policies also vary widely.
Claims that the U.S. has less-regulated gender health care, or that Europe is uniformly urging increased caution in providing gender-related health care to trans youth, also oversimplify the landscape. Some countries, such as the U.K. and Sweden, have restricted eligibility for care; there are also wide variations in access to care. However, as of early 2024, no European country except Russia had outright banned care. Two dozen U.S. states now have laws or policies that ban this care, mostly for youth but increasingly also for adults.
Meanwhile, the French Society of Pediatric Endocrinology and Diabetology this week released "expert consensus" that comes to different conclusions than the Cass Review, writing that "a wait-and-see attitude" does not "reduce psychological distress" and "increases the risk of committing suicide." This review argues against the use of "strict age criteria" and instead advises that physicians consider individual medical history, psychological state, and maturity.
So, what exactly is the health care at the center of all this debate?
Generally, it might involve mental health evaluation, then puberty-delaying medication or hormone therapy. These medications are commonly prescribed to cisgender youth for managing conditions such as early puberty, hypogonadism, or severe acne. Despite claims that gender-affirming surgery is widespread in the U.S., it is in fact incredibly rare: Harvard researchers found "little to no utilization" of surgery for trans minors. (Instead, they found that 97% of breast-reduction surgeries among minors are performed on cisgender teenage boys with gynecomastia, for example.)
In fact, surgery is rare even for trans adults. Only about 1 in 6 trans Americans of any age have received gender-related surgery, according to data from KFF/The Washington Post Trans Survey.
For additional style and coverage guidance, see our style guide's health care subsection.
Journalism on U.S. v. Skrmetti
This week the Supreme Court heard arguments on Tennessee's restriction on trans health care for youth. Trying to keep up or catch up? You can listen to the arguments or read the transcripts.
We've also compiled some helpful coverage and resources.
Post-hearing coverage
L.W., a trans teen from Tennessee, has her day in the Supreme Court from the Washington Post
Assigned
Lil Kalish
Orion Rummler, Shefali Luthra
Interviews
Previews
Lil Kalish
Chris Geidner
Orion Rummler
Jo Yurcaba
Lex McMenamin
Jules Gill-Peterson
How police and media deadname trans people
Learn more about how to fact-check names and genders in police reports — and why it's important — from The Marshall Project.
The Marshall Project covers the U.S. criminal justice system, including the experiences of trans people in prisons.
Interested in this topic? This video references our guide on how to fact-check names and genders on a deadline. We also offer style guide resources on what to do if you can't determine someone's pronouns.
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