Puberty blockers, anti-androgens that block the effects of testosterone, and hormone treatments are far more common than surgery. Doctors typically guide kids toward therapy or voice coaching long before medical intervention. Yet those operations are rarely performed on minors. Those who oppose gender-affirming care raise fears about the long-term effects treatments have on teens, argue research is limited and focus particularly on irreversible procedures such as genital surgery or mastectomies.
Restrictions have gone into effect in eight states this year - including conservative Utah and South Dakota - and are slated to in at least nine more by next year.
Protections in blue states are being baked into law as Republican-led states take steps to bar access to gender-affirming care for transgender minors, which for people under 18 typically involves puberty blockers or other hormone treatments.
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