Medical Gender Transition for Minors: Equity Push Ignores Evidence

In our drive to eliminate health inequities, my fellow liberal Democrats and I are eager to help children who identify as transgender. This compassionate urge has led our state, Oregon, to fast-track Medicaid coverage of medical transition services for kids, including puberty-blockers, cross-sex hormones, and surgical removal of breasts and genitals. Yet I’m deeply concerned that in the push for equity, Oregon has ignored evidence, to the point of jeopardizing children’s health. I know from experience that my state can do better to ensure that kids get medically necessary care.

Oregon has long been a national and even international model for evidence-based medicine. I personally encountered my state’s strong commitment to medical science after my two young sons were diagnosed with autism in the late 2000s. At the time, few autism treatments were covered by insurance or Medicaid anywhere in America, so I worked with state leaders and a broader coalition to right that wrong. One key hurdle was Oregon’s Health Evidence Review Commission (HERC), which determines what treatments Medicaid covers and strongly influences the coverage of private health-insurance plans.

PT

About the Author

Paul Terdal

Paul Terdal is an advocate for health consumer rights and a visiting fellow at Do No Harm.

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In our drive to eliminate health inequities, my fellow liberal Democrats and I are eager to help children who identify as transgender. This compassionate urge has led our state, Oregon, to fast-track Medicaid coverage of medical transition services for kids, including puberty-blockers, cross-sex hormones, and surgical removal of breasts and genitals. Yet I’m deeply concerned that in the push for equity, Oregon has ignored evidence, to the point of jeopardizing children’s health. I know from experience that my state can do better to ensure that kids get medically necessary care.

Oregon has long been a national and even international model for evidence-based medicine. I personally encountered my state’s strong commitment to medical science after my two young sons were diagnosed with autism in the late 2000s. At the time, few autism treatments were covered by insurance or Medicaid anywhere in America, so I worked with state leaders and a broader coalition to right that wrong. One key hurdle was Oregon’s Health Evidence Review Commission (HERC), which determines what treatments Medicaid covers and strongly influences the coverage of private health-insurance plans.