Rachel Levine does not guidance gender affirmation surgery for all young children

Considering that currently being nominated for the publish of assistant health secretary, Dr. Rachel Levine has confronted recurring assaults focusing on her identification as a transgender lady. 

One particular of these assaults circulated on social media platforms in the sort of a viral picture, which capabilities a picture of Levine photoshopped up coming to a team of prepubescent youngsters. 

“Dr. Rachel Levine, US Assistant Secretary for Health, thinks that all youngsters really should be authorized to choose their gender and have access to govt-funded sexual intercourse reassignment surgery with out parental notification or authorization,” reads the text beside the impression.

The post was flagged as section of Facebook’s endeavours to fight untrue news and misinformation on its Information Feed. (Go through far more about our partnership with Facebook.) 

In aid of their claims, Levine’s critics have surfaced a 2017 lecture she gave at Franklin & Marshall Faculty, in which she described expert standards of treatment for transgender youth. They have also referenced a tweet in which Levine cited a study that found that entry to puberty blockers decreases the chance of suicide and mental health complications for adolecents with gender dysphoria.

Having said that, we could not locate any occasion where by Levine advocated for small children to obtain govt-funded gender confirmation surgery devoid of parental consent. Doing genital surgery on prepubescent minors violates professional standards of transgender medicine. 

Levine lays out qualified requirements of care

For the duration of her lecture at Franklin & Marshall, Levine explained the standards of treatment for transgender patients laid out by specialist companies these types of as the Planet Experienced Affiliation for Transgender Health. Present U.S. health suggestions do not endorse surgical treatment for minors. 

At a single level of the lecture, Levine explicitly notes that the recommendations do not advise any sort of medical treatment for children prior to puberty. “For prepubertal little ones (with gender dysphoria) there is no medical treatment,” she states. “The concept would be to see a counselor or therapist who is supportive and has understanding about these concerns, to perform with the dad and mom.” 

At yet another position of the lecture, Levine discusses standards of treatment for transgender youth, laying out a three-tiered protocol drawn up by professionals in transgender medicine. 

Prior to doctors prescribe any bodily interventions, the suggestions require clients to endure counseling and psychological evaluation by a staff of health experts, such as psychologists, pediatricians and endocrinologists. This course of action also enables kids to start off the process of socially transitioning to a further gender by making use of distinct names and wearing unique clothes. 

If a individual has begun to go by way of puberty and is decided to have professional “persistent, properly-documented gender dysphoria” for a long period of time of time, the youth results in being suitable to get puberty blockers. These prescription drugs suppress the launch of testosterone and estrogen during puberty. The target of this phase of treatment is to let transgender youth more time to mirror on their determination. Various youth expertise the onset of puberty at various ages, so the tips don’t supply a demanding age threshold at which individuals come to be qualified for the 1st phase of treatment. On the other hand, most scientific tests of transgender youth have featured topics at the very least 12 a long time outdated. 

If the youth completes this stage of treatment, medical doctors can bit by bit get started off with interventions these types of as hormone treatment to masculinize or feminize the system. Some of these changes (this kind of as the deepening of the voice caused by testosterone) are irreversible. Some others may well involve reconstructive surgery to be reversed. Many hospitals, this kind of as the Duke Health Center for Gender Treatment for Young children and Adolescents, will only offer you hormone alternative therapies for adolescents 16 or more mature. 

Genital surgery, the previous period of the process, is frequently limited to grown ups. The Planet Professional Association for Transgender Health rules point out that genital surgery shouldn’t be carried out till the individual reaches the age of greater part, which is at least 18 across the U.S. — and there are lots of other aspects apart from age that must also be deemed.

“Genital surgery must not be carried out right up until (i) sufferers reach the legal age of the vast majority to give consent for medical strategies in a offered place, and (ii) individuals have lived repeatedly for at least 12 months in the gender job that is congruent with their gender identity. The age threshold need to be found as a minimum criterion and not an indication in and of itself for energetic intervention,” the tips read through. 

All through her lecture, Levine noted that homeless youth could be eligible for an accelerated transition method. Considering that these youth lack parental help and are far more very likely to acquire hazardous black marketplace hormones, she proposed that it might be essential to skip the puberty-blocker period of treatment and go straight to hormone therapy. Even so, at no issue in the lecture did Levine condition that homeless youth could be eligible for genital surgery ahead of achieving the age of greater part. 

Our ruling

Facebook posts reported that Rachel Levine supports “govt-funded sexual intercourse reassignment surgery without parental notification or authorization” for all young children.

There is no record of Levine supporting genital surgery for young little ones. In a lecture, Levine stated that “there is no medical treatment” for prepubescent children with gender dysphoria. 

Accomplishing genital surgery on prepubescent small children violates the specifications of treatment laid out by specialists in transgender medicine. 

This declare is False.