Forgotten Victims: The Real Consequences of Hormone Replacement Therapy in Children 

Planned Parenthood is well-known for providing reproductive services and abortions to minors and underprivileged individuals. Recently, the organization has expanded its offerings from free birth control, sexually transmitted infection (STI) testing, and abortion to offering puberty blockers and cross-sex hormones to minors and young adults.

The subject of minors and young adults receiving hormone therapy has been hotly debated for years. However, with Planned Parenthood offering these potentially harmful services to young people, the issue is receiving more attention.

The Rise of Gender-Affirming Care

According to NPR, “more than half of all Planned Parenthood health centers offer gender-affirming care including hormone replacement therapy, mental health services and support with legal processes like name changes.”

In other words, hormone therapy to assist with a sex change is becoming more common, especially in minors. Several states are opening doors for minors to receive puberty blockers and cross-sex hormones as young as 16 years old.

The Age Factor and Parental Consent

Planned Parenthood in Massachusetts, for example, offers hormone therapy to 16 and 17-year-old patients with consent from a parent or guardian. If an individual is under 16, they “can refer you to other Massachusetts providers who can give you hormonal care.”

Similarly, Planned Parenthood divisions in Delaware and New York offer hormone therapy for individuals starting at 17 years old with parental consent. Planned Parenthood in Michigan offers numerous references to outside offices that provide puberty blockers or cross-sex hormones to minors as young as 12.

While it is typical for Planned Parenthood to require parental consent for minors beginning hormone therapy, “depending upon the service provided, PP says it does not always have to notify parents when a minor visits one of its locations.” An FAQ graphic in Planned Parenthood‘s Mar Monte sector website reads, “Our health centers provide confidential services, so your parents do not have to know that you came.”

Other Planned Parenthood divisions, such as Western Pennsylvania and Greater Ohio require patients to be at least 18 years old to receive hormone therapy.

The Risk and Responsibility

Although there are many advocates for allowing minors to receive hormone therapy, it comes with risks as well. In an FAQ from the Pasadena and San Gabriel Valley Planned Parenthood sectors (PPPSGV), they write “for folks taking testosterone, there is a potential risk of infertility.”

Even if an individual does not want children at the time they are beginning hormone therapy, this conviction may change later on. In fact, one’s desire to change their gender may also change with the passing of time. This reality is especially important to consider when focusing on minors — a group of individuals whose prefrontal cortex has not been fully developed.

The Developing Brain and Decision Making

The human brain’s frontal lobe does not develop until one reaches age 25. The frontal lobe, or the prefrontal cortex, is extremely important when it comes to decision making. It “performs reasoning, planning, judgment, and impulse control.” Given that teenagers have yet to fully develop these essential functions for decision making, it is unwise to begin a process as potentially harmful and regrettable as transgender hormone therapy at their age.

Since parental consent is always required for minors to begin hormone therapy, parents and guardians play an essential role in preventing their teenager from making a choice they may later regret or suffer serious consequences from.

Financial Incentives and the Pro-Life Perspective

Aside from physical or psychological consequences, there is also a financial agenda behind Planned Parenthood’s willingness “to offer testosterone or estrogen shots, Joseph Backholm, senior fellow for Biblical Worldview and Strategic Engagement at Family Research Council, told The Washington Stand. “Like birth control, getting someone on hormones creates a monthly revenue stream, since they need the hormones every month for the rest of their lives. So Planned Parenthood has a financial incentive to encourage kids to change their sex, like they have for encouraging kids to have sex.’”

Similar to the pro-life view of abortion, the pro-life perspective of puberty blockers and cross-sex hormones on minors and young adults is unfavorable for reasons mentioned above and according to what the Bible states.

While the Bible does not explicitly say anything against changing one’s sex, there are verses that point to God’s unique design in creating two genders for humanity.

As stated in Genesis 1:27, “ So God created man in his own image, in the image of God He created him; male and female He created them.” (NKJV). As Christians, we believe God had a purpose when he created both the genders and that one’s gender is tied to his or her sex.

Both men and women carry the image of God in a unique way through their differing masculine and feminine qualities, and when a man and woman come together through marriage, they serve as a picture of God by expressing their masculine and feminine qualities together. As Genesis 2:24 states, “Therefore a man shall leave his father and mother and be joined to his wife, and they shall become one flesh” (NKJV).

Overall, the pro-life perspective on gender is based on holy scripture. We believe God designed each person uniquely and intentionally — and this includes their gender.

The Pro-Choice Perspective

The pro-choice view on this issue is one that advocates and encourages Planned Parenthood’s transgender hormone therapy for minors and young adults. Instead of adhering to biblical views of gender, advocates of hormone therapy believe that one’s sex is assigned at birth and gender identity is chosen afterward as one grows and develops.

When it comes to transgender hormone therapy, pro-choicers believe starting hormone therapy younger is more beneficial.

According to Stanford Medicine, “starting gender-affirming hormone treatment in adolescence is linked to better mental health than waiting until adulthood, according to new research led by the Stanford University School of Medicine.” More specifically, the study found that “Transgender people who began hormone treatment as teenagers were less likely to have suicidal thoughts or engage in substance abuse than those who began treatment as adults.”

Thus, advocates of this practice believe that starting younger is favorable to protect mental health. A study by the National Library of Medicine supports these findings, stating that, despite some conflicting data, transgender hormone therapy “reduces symptoms of anxiety and depression, lowers perceived and social distress, and improves quality of life and self-esteem in both male-to-female and female-to-male transgender individuals.”

The Risks of Puberty Blockers

Although some data suggests starting hormone therapy young has benefits for one’s mental health, there are also risks, specifically related to the use of puberty blockers. According to the Mayo Clinic, the medicines most often used for delaying puberty are called gonadotropin-releasing hormone (GnRH) analogues.

Some side effects include swelling at the site of the shot, weight gain, hot flashes, headaches, and mood changes. Potential long-term effects on growth spurts, bone growth, bone density, and fertility are also risk factors for children who take puberty blockers.

Regret and Detransitioning

Given these risks, it’s no surprise that some teenagers have regretted their decision to use puberty blockers. Eighteen-year-old Kayla Lovdahl is one example. According to the New York Post, “At 13, Kayla had her healthy breasts removed in a double mastectomy to masculinize her chest. And, by 17, she’d realized it was all a mistake — and that the professionals around her had failed to protect her.” (Learn more about Lovedahl’s story here.)

Helena Kerschner and Chloe Cole are two other examples of individuals who believed they were transgender as teenagers, claiming that their loneliness and their internet communities had a large influence on their decisions to begin transitioning. After beginning hormone therapy as adolescents, both Kerschner and Cole have detransitioned.

Kerschner claimed being on testosterone severely affected her mental health, causing emotional instability that led to two hospitalizations for self-harm.

On her experiences with transitioning and detransitioning, Cole claims that “she was fast-tracked through her entire transition — from blockers to a mastectomy — in just two years, with parental consent.” Although she has detransitioned, Cole is dealing with permanent changes in her bone structure from testosterone, such as broader shoulders and a sharper jawline. Additionally, “she also struggles with increased body and facial hair [and] has a large scar across her chest from her mastectomy.”

According to the New York Post, Cole’s gravest concern “is her fertility.” Although she’d like to have children one day, Cole doesn’t know whether the viability of her eggs was compromised by years of testosterone injections. She’s working with doctors to find out, and her medical future is uncertain.”

Kerschner and Cole’s experiences point to a larger issue at hand: rushing into the transition process before diving into potential underlying issues. For both Kerschner and Cole, transitioning was given as the solution to underlying issues like loneliness, body dysmorphia, and feelings of insecurity.

According to the New York Times, “Many physicians in the United States and elsewhere are prescribing blockers to patients at the first stage of puberty — as early as age 8 — and allowing them to progress to sex hormones as soon as 12 or 13. Starting treatment at young ages, they believe, helps patients become better aligned physically with their gender identity and helps protect their bones. But that could force life-altering choices, other doctors warn, before patients know who they really are.”

Stories like Lovdahl, Kerschner, and Cole’s reveal that too often adolescents are given puberty blockers as a solution to their psychological struggles. Instead of rushing into potentially life-altering treatments, teenagers must consider the effects puberty blockers may have on their physical appearance, psychological well being, and future fertility.

Parental Rights

Not only are teenagers responsible for understanding the consequences of hormone therapy, their parents and guardians also play a crucial role. As mentioned above, many PP clinics offer hormone therapy to minors. However, minors must always receive the consent of their parents or guardian.

This is a safe and necessary precaution when considering a teenager’s lack of maturity, but some parts of the United States are seeking to lower this barrier.

In September 2022, California legislature passed Senate Bill 107, which allows “courts to take away parents’ rights if their child comes to the state for what is dishonestly called ‘gender-affirming health care.’”

Governor Gavin Newsom signed the bill in hopes of California becoming a place of refuge for minors and their families living in conservative states that have restricted access to transgender hormone therapy for minors. According to NBC, the bill “is intended to protect families and children from prosecution in their home states if they travel to California for gender-affirming care or if they move to California after already receiving transition-related care elsewhere.”

This past March, another bill was proposed in California (AB-1314) that would require school teachers, counselors, and other employees to notify parents that “their child is publicly identifying as transgender within three days from the date they become aware.”

These bills remind us of the importance of a parent’s role. While some believe a parent’s input is unnecessary or even a hindrance — focusing solely on the child or teenager’s feelings — a parent’s opinion matters.

Not only does a parent often know their child well, a parent is more likely to think of potential consequences or regrets their teenager may have later on. As discussed earlier, a teenager’s brain has yet to fully develop, and they may not think through their actions or understand the possible repercussions.

As told in an article from The Atlantic, Mike and Heather (whose names have been changed) are examples of parents who were cautious about letting their teenage daughter (Claire) begin hormone therapy.

They believed her gender dysphoria was a result of struggling with puberty. In the end, they were right. Claire began feeling more at home in her body as time passed, recognizing “that her feeling that she was a boy stemmed from rigid views of gender roles that she had internalized.”

Without the guidance and precaution of her parents, Claire might have taken steps towards transitioning, such as a double mastectomy and testosterone hormone therapy, that she might have regretted in the long run.

Depending on the state a family resides in, parents may have more or less control over their child’s decision to begin hormone therapy. Either way, they have a responsibility and a right to give input on such a serious and life-changing decision.

Hormone Therapy Limitations for Minors

Several states already have policies that limit transgender hormone treatments and surgeries for minors, such as Arkansas, Arizona, and Texas. In 2022, the Arizona Senate “voted to prohibit gender reassignment surgeries for minors.” This past June, Texas Governor Greg Abbott signed “a bill that bars transgender kids from getting puberty blockers and hormone therapies.,” that will take effect on September 1.

These states are only a few examples out of 19 that have restricted what is often referred to as “gender-affirming care” for minors.

According to ABC News, “Critics say gender-affirming care restrictions are an infringement on the rights of families to make their own health decisions. Supporters of the bans argue that transgender people should wait until they are legally adults before making these decisions.”

Illegal Hormone Therapy

As the debate rages on, with different states taking different courses of action, it’s important that pro-life believers know where they stand and why, being ready to defend their position. Mainstream healthcare providers are likely to support transgender hormone therapy for minors, citing that it improves the mental health of the patient the majority of the time.

As the political climate surrounding transgender hormone therapy for minors continues to swell with division, some predict those with limited access will resort to a Do-It-Yourself (DIY) approach. According to NBC, “While not all trans people opt for hormone therapy, a 2020 study published in the Annals of Family Medicine estimated that 9% of those who did had obtained hormones from unlicensed sources, including friends and unregulated online pharmacies.”

With more states considering and placing restrictions on hormone therapy — especially for minors — it’s possible the underground market for hormones and other treatments will grow.

Conclusion

Moving forward, it appears the issue of transgender hormone therapy for minors will play out similarly to other polarizing issues regarding sexuality and healthcare. Much like abortion, many states in the US are taking action against puberty blockers and other hormone therapies for minors. Other states, like California, are taking an opposite approach, encouraging minors who can’t receive hormone therapy in their home state to seek refuge elsewhere.

As this debate continues, we encourage you to stay informed and well-researched. Continue reflecting on scripture and speaking the truth in love and kindness.

Most of all, pro-lifers must be diligent in praying for the nation. There is a persistent spiritual war raging against both our nation and its children, so pray. Pray for unity in the church and in our nation; pray for the truth to be revealed. Pray for God’s purposes and plans to prevail.