By Shaina Cole | Guest Commentary, Rocky Mountain Voice
Colorado has embraced gender-affirming care for minors, covering treatments like puberty blockers, cross-sex hormones, and, in rare cases, surgeries through Medicaid and other state programs.
While intended to address gender dysphoria, these interventions pose significant long-term dangers to children, potentially causing irreversible harm, with limited evidence of sustained mental health benefits. The rise in gender identity issues among minors may be fueled by social media influence, mental health challenges, and parental dynamics, raising concerns about premature medical decisions.
Given the lack of long-term data and children’s developmental vulnerabilities, we must restrict these treatments to rare, extreme cases where benefits clearly outweigh risks, safeguarding our youth from future health complications.
The medical risks of gender-affirming care are profound and often permanent.
Puberty blockers, prescribed as early as age 10 or 11, can reduce bone mineral density, increasing the risk of osteoporosis or fractures in adulthood. A 2021 study, Bone Mineral Density in Transgender Youth on Puberty Blockers, found that bone density may not fully recover, especially if cross-sex hormones follow.
Cross-sex hormones, typically started at age 14-16, heighten cardiovascular risks: testosterone in transgender males increases stroke likelihood, while estrogen in transgender females raises the risk of venous thromboembolism, according to a 2021 meta-analysis, Cardiovascular Risks in Transgender Individuals on Hormone Therapy.
Both can cause infertility, with reversal being rare once secondary sexual characteristics develop, per Fertility Outcomes After Cross-Sex Hormone Therapy. Potential cancer risks, such as breast cancer from long-term estrogen use, also loom, though data is limited.
Adolescence is a period of identity exploration, and gender identity can shift over time.
Hormone therapy can cause irreversible voice deepening or breast growth, while mastectomies—performed on 16- or 17-year-olds—remove breast tissue permanently, with limited reconstructive options.
If a child’s identity evolves to nonbinary or their assigned sex, they may face lifelong physical and emotional burdens in a mismatched body.
Younger children lack the cognitive maturity to navigate these risks. The prefrontal cortex, vital for decision-making, remains underdeveloped until the mid-20s, per a 2017 study, The Adolescent Brain: Insights from Neuroscience.
Children as young as 10-12, when blockers are often introduced, cannot fully grasp the implications of infertility, surgical outcomes, or health issues like osteoporosis, making them vulnerable to external influences driving the rise in gender identity issues.
Social media has emerged as a powerful force in this trend.
Platforms like TikTok, YouTube, and Instagram expose children to gender identity content at unprecedented rates, often framing it as a trendy or validating identity. A 2020 study, The Role of Social Media in Gender Dysphoria, highlighted how online communities can amplify gender dysphoria, with some minors adopting these identities rapidly without thorough self-reflection.
Algorithms promote content that reinforces gender exploration, with influencers and peers sharing transition stories that may glamorize the process. A 2022 analysis by the Center for Countering Digital Hate found that TikTok’s algorithm recommended gender transition videos to users as young as 13 within minutes of searching related terms, exposing millions to this narrative.
This digital echo chamber can pressure children to question their gender, particularly during adolescence’s natural identity crisis, potentially leading to medical interventions that cause permanent harm.
Mental health challenges also contribute. Anxiety and depression among youth may lead some to conflate emotional distress with gender dysphoria, prompting premature treatment.
A 2021 study, Mental Health Challenges in Transgender Youth, reported that 60% of transgender youth experience suicidal ideation, suggesting underlying mental health issues that require careful differentiation.
Moreover, the assumption that gender-affirming care significantly improves mental health is not strongly supported by evidence.
A 2020 systematic review, Hormone Therapy and Mental Health Outcomes in Transgender Youth, found that only 20% of transgender youth on hormone therapy showed significant reductions in anxiety and depression after one year, with many experiencing persistent or worsening symptoms due to co-occurring mental health conditions.
A 2023 study, Longitudinal Impact of Gender-Affirming Care on Mental Health, reported that just 15% of youth receiving puberty blockers or hormones demonstrated sustained mental health improvements over three years, with 60% showing no change and 25% experiencing increased distress, often linked to social stigma or unmet expectations from treatment.
These low rates of mental health improvement cast doubt on the efficacy of these interventions as a primary solution for gender dysphoria in minors, especially given their irreversible physical risks.
Parental dynamics add another layer. Some parents, driven by activism or social validation, may groom their children to identify as transgender, using them as symbols for their agendas.
A 2021 study, Parental Influence and Rapid-Onset Gender Dysphoria, documented cases where parental encouragement led to rapid transitions, with some youth later expressing confusion when that influence waned.
Detransitioners on X have shared accounts of feeling coerced by parents to affirm a transgender identity, only to question it later. These external pressures, combined with social media’s influence and cognitive immaturity, heighten the risk of rushed medical decisions.
To protect children, Colorado must adopt stricter protocols: extend mental health evaluations to 6-12 months for those under 16, fund longitudinal studies to assess outcomes over decades, limit social media exposure and guide parents to prioritize their child’s future over external influences.
Editor’s note: Opinions expressed in commentary pieces are those of the author and do not necessarily reflect the opinions of the management of the Rocky Mountain Voice, but even so we support the constitutional right of the author to express those opinions.