White House issues follow-up statement after criticism over position on gender-affirming care for youth

President Joe Biden walks across the South Lawn of the White House in Washington, Sunday, July 7, 2024, after returning from a trip to Pennsylvania.
President Joe Biden walks across the South Lawn of the White House in Washington, Sunday, July 7, 2024, after returning from a trip to Pennsylvania.
AP Photo/Susan Walsh

The Biden administration received criticism from LGBTQ groups in response to a White House statement expressing opposition to gender-affirming surgery for youth, prompting White House officials to issue a follow-up clarification.

Neera Tanden, who serves as the director of the White House Domestic Policy Council, emailed Human Rights Campaign (HRC) president Kelley Robinson to elaborate on the administration’s position days after Robinson described the administration’s statement as a harmful one, saying it was an example of government overreach.

“We continue to fight state and national bans on gender-affirming care, which represents a continuum of care, and respect the role of parents, families, and doctors — not politicians — in these decisions,” Tanden said, according to The Advocate. “Gender-affirming surgeries are typically reserved for adults, and we believe they should be.”

Tanden further added that “families should have the freedom to make the medical decisions that they and their doctors determine are best for them” and clarified that the Biden administration opposes attempts to limit healthcare for transgender individuals — including through legal or legislative means.

The controversy first emerged in response to reporting about the administration by the New York Times and The 19th, a non-profit publication.

A New York Times story detailed court documents outlining efforts by the Biden administration’s assistant secretary of the Department of Health and Human Services, Dr. Rachel Levine, to remove age limits for treatments and surgeries associated with gender-affirming care out of apparent fear of political backlash. Initial draft guidelines from 2021 sought to reduce age minimums for hormonal treatments to 14 and set the age limit for mastectomies or facial surgeries at 15, according to the Times, while genital surgeries or hysterectomies would have been set at 17. The proposed age limits were eliminated in the final guidelines outlining standards of care, according to the New York Times.

Subsequent reporting by The 19th, a non-profit publication, shed further light on the issue as the Biden administration initially sought to clarify its position. While the Biden administration maintained the position that gender-affirming “surgeries should be limited to adults,” a White House spokesperson told The 19th that the Biden administration continues “to support gender-affirming care for minors, which represents a continuum of care, and respect the role of parents, families, and doctors in these decisions.”

A Biden administration spokesperson did not respond to Gay City News’ request for comment about the statement. 

Robinson, who recently delivered remarks on the same stage as the president at the opening of the new Stonewall National Monument Visitor Center, initially described the administration’s statement as a harmful one, saying it was an example of government overreach.

“The Biden administration is flat wrong on this,” Robinson said. “It’s wrong on the science and wrong on the substance. It’s also inconsistent with other steps the administration has taken to support transgender youth. The Biden administration, and every elected official, need to leave these decisions to families, doctors and patients — where they belong. Although transgender young people make up an extremely small percentage of youth in this country, the care they receive is based on decades of clinical research and is backed by every major medical association in the U.S. representing over 1.3 million doctors. The administration has committed to fight any ban on healthcare for transgender youth and must continue this without hesitation — the entire community is watching. No parent should ever be put in the position where they and their doctor agree on one course of action, supported by the overwhelming majority of medical experts, but the government forbids it.”

In a follow-up statement to The Advovate after the administration’s most recent clarification, Robinson said, “We appreciate that the administration has clarified that its position on healthcare for the transgender community has not changed—that it opposes any and all bans on access to care and will continue to fight these bans both in the courts and at the legislative level,”

The issue comes as the Supreme Court recently announced that it would take up a case — led in large part by the Biden administration — challenging a Tennessee law targeting gender-affirming care for youth at a time when dozens of states have targeted access to gender-affirming care. 

According to the New York Times, a two-page document administered by the Department of Health and Human Services’ Office of Population Affairs notes that gender-affirming surgeries have primarily been limited to adults, but can also be utilized among adolescents on a limited, case-by-case basis. 

Like Robinson, many of those who criticize the administration’s position emphasized that the government should not be interfering in medical decisions surrounding gender-affirming care.

“Living authentically and free from boxes requires courage,” the Transgender Law Center said in a written statement. “What it calls for from us as allies is engaging in every possible action to ensure that the bodily autonomy of trans youth, and by extension all of ours, is respected. This terrible mistake by the Biden administration could have been avoided by listening to trans youth themselves.

In an interview with Gay City News earlier this year, Levine underscored the need for policies geared towards bolstering gender-affirming care for youth, but she said those efforts have been hindered by the amount of disinformation about trans medicine and anti-trans laws that have passed in many states.

“It is literally suicide prevention care and it has been shown to improve the quality of life and save lives,” Levine said, referring to gender-affirming care. “Trans medicine for youth has evolved over the last 10 to 20 years and it is not different from any other medical care. You have evidence-based guidelines that have been vilified.”