These providers do not always realize they’ve confessed to ignoring the standards of care. “Gender-affirming medicine,” Eckert holds, means that “you are best equipped to make decisions about your own body,” full stop. Eckert is wary of psychologists who follow the guidelines by completing a comprehensive assessment before recommending medical intervention for youths. Eckert, the medical director of Anchor Health Initiative in Connecticut. “If you are trans, I believe you,” says A.J. Many openly discuss how they use the adult informed-consent model of care with their teen patients, which almost always means no mental health involvement and sometimes no parent input, either. In professional circles, we hear from pediatric endocrinologists and others who prescribe hormones for trans youth. As a result, we may be harming some of the young people we strive to support - people who may not be prepared for the gender transitions they are being rushed into. Providers and their behavior haven’t been closely studied, but we find evidence every single day, from our peers across the country and concerned parents who reach out, that the field has moved from a more nuanced, individualized and developmentally appropriate assessment process to one where every problem looks like a medical one that can be solved quickly with medication or, ultimately, surgery. But few are trained to do it properly, and some clinicians don’t even believe in it, contending without evidence that treating dysphoria medically will resolve other mental health issues. The process, done conscientiously, can take a few months (when a young person’s gender has been persistent and there are no simultaneous mental health issues) or up to several years in complicated cases. The standards of care recommend mental health support and comprehensive assessment for all dysphoric youth before starting medical interventions.
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