But other trans health specialists are concerned about the surge in adolescents being referred to gender clinics, and worry that the desire for hormones and surgery is driven in part by peer influence on social media platforms such as TikTok and YouTube.
“The kids presenting today are very different from what I used to see,” said Dr. Edwards-Leeper, who helped set up one of the United States’ first youth gender clinics in 2007, in Boston.
dr. Edwards-Leeper said she was now more likely to see adolescents who had recently begun to question their gender, while her patients a decade ago were more likely to have long-term body issues.
These seemingly abrupt changes — as well as other mental health issues or a history of trauma — should be flags for providers to slow down, she said. Instead, some gender clinics with long waiting lists blindly affirm adolescent patients, she said, by offering them hormones without taking these potential problems seriously.
And while it’s unclear how often it happens, some people who transitioned as teenagers have later reported transitioning. While some people who go through the transition continue to live with a more fluid gender identity, others are upset about living with the irreversible changes caused by hormones or surgery.
“These problems of inadequate assessment and what I sometimes termed hasty or careless care have resulted in potential harm,” he said. Erica Anderson, a clinical psychologist who works with transgender adolescents in Berkeley, California.
dr. Anderson, 70, said she understood the trauma of refusing care. She first realized she was transgender in her thirties, but it wasn’t until she was 45 that she approached an endocrinologist about hormone treatments. “The doctor replied, ‘I can’t help you,'” she said. Desperate, she waited several more years before going through another medical transition.