Lori Falce: UPMC decision slams door on trans youths

UPMC will not be providing gender-affirming care to those 18 and under after this month.

The move comes after President Donald Trump’s executive order in January titled “Protecting Children from Chemical and Surgical Mutilation.”

The wording of the order is no doubt purposeful. Politically, it’s an old favorite of both parties to use verbiage that makes you sound like a monster if you stand opposed, or a hero if you support it.

Despite the vehement argument in the political arena, gender-affirming surgery for children is not as common as tonsillectomies and ear tubes.

According to the National Institutes of Health, in 2019, in the whole country there was one such procedure performed out of a million children 13 to 14 years old and 21 per a million kids 15 to 17 years old. There were none on children younger than that.

Of those that were performed, most were not connected to a transgender identification. For example, 97% of breast reduction surgeries for gender-affirming reasons among minors were performed on cisgender teenage males.

As someone with transgender friends and mom friends who have children who identify as nonbinary or transgender, I have to be honest. I don’t necessarily believe it is helpful to have surgical interventions freely available at a young age. This isn’t a questionable tattoo you can laser off down the road. It isn’t a piercing that will heal over if you just take out the stud.

But I am also not a doctor. I am not a mental health professional. I believe that, like most medical decisions, these situations should be reviewed on an individual basis.

The human body and a person’s psyche are not one-size-fits-all. Look at something as simple as an infection. The antibiotic that works for one person may not work for the next, leading to trial and error to find what does the job.

One would think UPMC could do the same, finding a way to support families with transgender children.

And let’s not ignore the fact we are also talking about transgender adults. The hospital system’s decision mirrors the Trump order, placing its threshold at 18 and younger, meaning that legal adults in Pennsylvania will be denied care. Indeed, the NIH numbers suggest that most surgeries in question may well be for “kids” who could vote and join the military.

For UPMC to do this during June and the LGBTQ communities’ celebration of Pride may be coincidence, but even if that’s true, it feels like an added insult. It is the twist of a knife, ironic in that they decline to use a scalpel.

Gender-affirming care comes in so many shapes and sizes. It doesn’t have to be the pharmaceutical and surgical interventions the White House and now UPMC are denying. But by saying “this will no longer be allowed,” a black cloud is thrown over all care.

Transgender minors can use other supports, including mental health care. The need to reach out for help and know that they will be welcome at their medical providers. A hospital should always be seen as a refuge for a child in need. UPMC’s decision does not feel like sanctuary. It feels like a slammed door.