The Trump administration is pushing therapy for transgender youth. What does that look like?

Since President Donald Trump returned to office in January, federal policy has shifted to promote psychological therapy as the only treatment for transgender youth in distress.
A report issued last month by the Trump administration's Department of Health and Human Services on care for transgender and nonbinary people analyzed 17 studies out of more than 3,400 looking into gender-affirming care - an umbrella term that can include talk therapy, puberty blockers, hormone treatments and surgeries.
They included only analyses of other studies that didn't include any patients older than 26. Those that examined mental health generally found improvements from gender-affirming care, though with low certainty, because they didn't include a large enough group, the effects were small, or other factors.
The report had more sweeping conclusions, however, stating that people under 19 with gender dysphoria should receive only psychological therapy, rather than being able to choose puberty blockers or hormone therapy. Gender dysphoria refers to distress when someone's gender identity and their sex, or the way others see them, don't match.
Major medical groups, such as the American Academy of Pediatrics, have endorsed offering the full range of affirming care to appropriate patients, and experts interviewed by The Denver Post agreed that while some patients only need therapy, others benefit from gender-affirming medical care.
The new report comes as the administration ordered providers to stop offering puberty blockers and hormone therapy to anyone under 19, threatening to take away federal funding from hospitals that didn't comply. A federal judge blocked Trump's executive order while a legal challenge plays out from four states, including Colorado.
The Trump administration also forbade transgender people from serving in the military, threatened federal funding for schools if they promote "gender ideology," removed references to LGBTQ health disparities from health websites, ordered the Justice Department to take action to stop trans girls from playing on sports teams with cisgender girls, forbade the issuing of passports displaying the gender trans people identify with, and moved inmates who are trans women into men's prisons.
Dr. Rae Narr, a nonbinary psychologist in Denver, said the administration's actions targeting transgender people suggest the government is going to push therapy that attempts to change someone's sexual orientation or gender identity. But, done right, therapy can also be affirming, they said.
"On their face, what they are suggesting is therapy and support for these youth," Narr said. "When you really look at what they're suggesting, it's conversion therapy."
Conversion therapy, as typically practiced today, looks for a pathological root for someone's sexual orientation or gender identity, Narr said. For example, the practitioner might argue that another condition, such as autism, caused someone to think that they were transgender, or that they wanted to change their gender because of shame about being gay or a history of sexual trauma, they said.
Mainstream medical groups condemn the practice and Colorado banned conversion therapy for minors, though the law faces a challenge at the Supreme Court.
Affirming therapy, in contrast, starts from the position that no identity is right or wrong, Narr said. The goal isn't to encourage young people to transition, but to help them sort through what would make them comfortable in their bodies and lives, they said.
That can involve talking about how they imagine their adult lives and practical exercises, such as trying on different clothes, Narr said. They also discuss where the young person would feel physically and emotionally safe exploring. For example, someone might go to the next town over to try out going to a store dressed differently, they said.
"I talk to kids a lot about what does it mean to you when you imagine being a boy, or a girl, or something else," they said.
'We listen to them'
In 2024, 46% of transgender or nonbinary young people reported seriously considering suicide, and 14% attempted it, according to the LGBTQ nonprofit The Trevor Project.
Those who reported they'd experienced bullying or physical harm because of their gender identity were more likely to report thoughts of suicide, as were those who said their schools didn't support them.
But the odds of suicide drop when youth report that people in their lives accept them, such as by calling them by their chosen name and pronouns, Narr said.
Dr. Casey Wolf, a child and adolescent psychiatrist at WellPower in Denver, said the field hasn't agreed to a protocol for treating gender dysphoria, but does have evidence-based therapies for the depression, anxiety or trauma that typically push people to seek help.
Sometimes, those symptoms stem from gender dysphoria or from mistreatment based on someone's gender identity, but not always, she said.
"We listen to them. We try to understand what their symptoms are," Wolf said.
While the public is talking about gender identity more than in the past, Wolf said she hasn't seen an increase in young people experiencing gender dysphoria. Despite the perception that being transgender is trendy, people don't take on marginalized identities like they change their hairstyles, she said.
Not all trans people experience gender dysphoria, and not everyone who has gender dysphoria decides to transition, said John Mikovits, an assistant professor of nursing who studies care for LGBTQ people at Moravian University in Pennsylvania. Some people may only need emotional support at some points in their life, but may decide to socially or medically transition later, he said.
What the therapist helps the patient work on may also change, Mikovits said. For example, a person who opts to transition may feel relief from gender dysphoria, but needs to learn skills to cope with increased discrimination, he said.
"The treatment is not about curing someone's transgender or misaligned identity, it's about affirming that identity and improving their quality of life," he said.
'The most basic and easiest thing to do'
Acting as a liaison between kids and parents can also be part of the job.
Young people often struggle to tell their parents what they're feeling, so the news they're questioning their gender can feel like it comes out of nowhere, Narr said. Parents also don't always do the best job explaining their feelings, so confusion or fear for their child's future can come off as rejection, they said.
"Even if the parents are supportive, it's reasonable to have some fear and grief" for the life they imagined for their child, they said.
While discussion about affirming care focuses on puberty blockers, hormones and surgeries, just using the right pronouns for someone can be important affirmation, Mikovits said.
"It's the most basic and easiest thing to do, to refer to people the way they want to be referred to," he said.
Everyone wants others to see them the way they see themselves, and if that isn't happening, it can bring shame and hopelessness, Wolf said. When someone says they aren't wrong or sick because of how they see themselves, that can bring back some hope that the problem is their environment, and they may be able to change it, she said.
"That's the beginning," she said.
_____
Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.

Try Our AI Features

Explore what Daily8 AI can do for you:

Learn with AIFact CheckingText to SpeechAI Summary

Related Articles

CNBC

21 minutes ago

• CNBC

The Israel-Iran conflict and the other big thing that drove the stock market this week

It's been a tense and dynamic week for the world at large. The market action on Wall Street over the past four sessions was been anything but that. For the week, the S & P 500 lost 0.15%, the tech-heavy Nasdaq ticked up 0.21%, and the Dow Jones Industrial Average was basically flat, up a mere 0.02%. Beneath the surface, though, there was plenty of news for investors to digest. Here's a closer look at the biggest market themes during the holiday-shortened trading week. 1. Geopolitics: The major news story was — and still is — the intensifying war between Israel and Iran. The big question on everyone's mind is whether the U.S. will get involved. As of Friday, reports indicate that while President Donald Trump is actively reviewing options to attack Iran, nothing has been authorized. The White House has said Trump he will make a decision in the "next two weeks". As a result of the Israel-Iran conflict, investors spent the week keeping an extra close eye on the movement in safe-haven assets like gold and the dollar, as well as risk assets such as oil. Gold prices pulled back this week after their initial spike last Friday, which is when Israel's first attack on Iranian nuclear infrastructure jolted markets. The U.S. dollar index , meanwhile, strengthened this week but still remains near multiyear lows. Oil rose again for the week, with international benchmark Brent crude climbing nearly 4%. For those looking to gauge what the market thinks will happen with Iran, look to oil. The commodity is currently acting as something of proxy on the odds of the conflict intensifying and America directly entering the fray. 2. Fed updates: The other big theme of the week centered on the health of the U.S. economy in the lead up to Wednesday afternoon, when we got the Federal Reserve's latest interest rate decision and revised economic projections. Ultimately, the Fed kept its benchmark lending rate unchanged on Wednesday following its two-day policy meeting. The decision followed lackluster updates on the state of the consumer and the housing market , along with lower-than-expected inflation readings the week prior. As we outlined earlier this week , the Fed is in a tough spot when it comes to abiding by its dual mandate of ensuring price stability and low unemployment. The state of play requires nuance. On the one hand, there is evidence in support of rate cuts, namely some cracks in the consumer — even if the consumer has remained largely and impressively resilient — and the Fed's own updated outlook for lower real GDP growth and higher unemployment this year. On the other hand, the Fed is now expecting higher inflation this year than it did in March, which would support the need for higher interest rates. Given these dueling dynamics and the uncertainty around tariff impacts, the central bank's decision to keep interest rates steady makes sense. While the Fed certainly doesn't want to wait too long and make the same mistake we saw coming out of the Covid-19 pandemic, we must acknowledge that the causes of a potential rebound in inflation are different this time around. Tariffs will likely push up prices, but that may be a one-time increase, as opposed to the sustained inflation we saw exiting the pandemic, which was driven by massive supply chain disruptions and shifts in consumer behavior. As a result, we believe the apparent bias to be more worried about the job market and overall economic growth — and therefore cut rates later this year — makes sense, too. Indeed, the Fed's updated projections still pencil in two rate cuts in 2025, the same as in March despite the aforementioned revisions to its inflation and growth outlook. Fed Governor Christopher Waller made the case Friday that the cuts should start as early as July, arguing that the inflation risk posed by tariffs is not significant and ensuring resiliency in the labor market should be a higher priority. Waller's argument is basically that it's better to move now than wait for a jump in unemployment. Our biggest focus at the Club is staying nimble, given the highly volatile nature of geopolitics at the moment. No doubt, rate decisions are important to think about, but they're only one small part of the investing puzzle to navigate each day. For this reason, we continue to focus more on individual company fundamentals and industry trends rather than higher-level dynamics, important as they are to shaping our worldview. Cybersecurity stocks are one example that we highlighted this week. Another example would be the news we got from Club names Meta Platforms and Amazon this week on their artificial intelligence efforts. We think the implications that AI will have on the cost structures, revenue opportunities and efficiency gains should weigh far more heavily in the minds' of long-term investors than whether the Fed will cut in July or September. (Jim Cramer's Charitable Trust is long META, AMZN. See here for a full list of the stocks.) As a subscriber to the CNBC Investing Club with Jim Cramer, you will receive a trade alert before Jim makes a trade. Jim waits 45 minutes after sending a trade alert before buying or selling a stock in his charitable trust's portfolio. If Jim has talked about a stock on CNBC TV, he waits 72 hours after issuing the trade alert before executing the trade. THE ABOVE INVESTING CLUB INFORMATION IS SUBJECT TO OUR TERMS AND CONDITIONS AND PRIVACY POLICY , TOGETHER WITH OUR DISCLAIMER . NO FIDUCIARY OBLIGATION OR DUTY EXISTS, OR IS CREATED, BY VIRTUE OF YOUR RECEIPT OF ANY INFORMATION PROVIDED IN CONNECTION WITH THE INVESTING CLUB. NO SPECIFIC OUTCOME OR PROFIT IS GUARANTEED.

New York Times

21 minutes ago

• New York Times

B-2 bombers head across the Pacific and Trump is scheduled to return to the White House as he considers strike on Iran.

Multiple U.S. Air Force B-2 bombers appeared to be airborne and heading west from the United States across the Pacific, and President Trump is scheduled to return to the White House late on Saturday afternoon from New Jersey as he deliberates about whether to join Israel's efforts to destroy Iran's nuclear sites. Air traffic control communications indicated that several B-2 aircraft — the planes that could be equipped to carry the 30,000-pound bunker-buster bombs that Mr. Trump is considering deploying against Iran's underground nuclear facilities in Fordo — had taken off from Whiteman Air Force Base in Missouri. Some flight trackers said on social media that the destination of the aircraft is Guam, the U.S. territory, which has several military installations, although that could not be independently confirmed. The bombers appeared to be accompanied by refueling tankers for portions of the journey, the flight tracking data showed. Moving planes does not mean a final decision has been made about whether to strike. It is not unusual to shift military assets into position to provide options to the president and military commanders even if they are not ultimately deployed. The White House schedule for the weekend said that Mr. Trump would return from his golf club in Bedminster, N.J., and would meet with his national security team at 6 p.m. on Saturday and again on Sunday. Mr. Trump typically spends both weekend days out of town at one of his properties. A White House spokeswoman declined to comment. Mr. Trump has made clear he is weighing whether to have the U.S. join Israel's effort to curtail Iran's ability to acquire a nuclear weapon, a line he has drawn repeatedly over the years. Want all of The Times? Subscribe.

The Hill

29 minutes ago

• The Hill

Why tariffs are already driving some healthcare premiums higher

Related video above: How patients and doctors can reduce healthcare costs (NEXSTAR) – Despite the focus on the price of cars, iPhones and other consumer goods, the Trump administration's tariffs are starting to drive up prices in an entirely different industry – healthcare. On Monday, Matt McGough, with nonprofit health policy organization KFF, wrote that several individual insurance companies have already notified state regulators that they will be raising premiums to offset the potential impact of tariffs on pharmaceuticals. Trump hasn't yet targeted pharmaceuticals with tariffs, but has repeatedly brought it up, including on Monday aboard Air Force One. 'We're going to be doing pharmaceuticals very soon,' Trump said, according to Reuters. 'That's going to bring all the companies back, into America.' In a May filing, the Independent Health Benefits Corporation (IHBC) said it was submitting a premium rate change of 38.4% for 2026, 'primarily due to increased costs due to inflation and tariffs, and changes in risk adjustment.' An IHBC spokesperson told Axios that roughly 3% of that increase was to directly account for the impact of tariffs, specifically on drug prices. McGough notes that there are other insurers who either haven't specifically mentioned the potential effect of tariffs or who declined to include an offsetting increase in 2026 premium rates. 'A large proportion of medical goods currently comes from international sources, including pharmaceuticals, medical devices and personal protective equipment, as well as other low-margin, high-use essentials like syringes, needles and blood pressure cuffs,' Tina Freese Decker, board chair of the American Hospital Association, wrote in a May post. 'Tariffs on these items could impact patient care by jeopardizing the availability of vital medications and essential health care devices. They also could raise costs for hospitals and heighten shortages and supply chain disruptions.' Meantime, millions of Affordable Care Act (ACA) enrollees could see an over 75% average increase in premiums if Biden-era subsidies aren't extended by Congress before they expire at the end of the year, according to KFF estimates. How much tariffs are weighing on the calculations of insurers will become a bit more clear on Aug. 1, Axios notes, when proposed 2026 premium rates are posted.