Politicians in at least two states in the United States are using a recent ruling in England that limits gender transitions for minors as justification for their similar proposals.

Other countries, particularly in Europe, have already been looked to for policies and research concepts by those who’ve introduced or supported state-specific bills in the U.S. These lawmakers have referenced foreign research or policies to justify their efforts to restrict or eliminate access to transgender healthcare for minors in at least 23 states.

Yet leading health organizations in the United States and Europe continue to decisively endorse gender-affirming care for both transgender youths and adults.

Some people believe that limiting access to treatments like hormone therapy unfairly targets transgender teenagers, despite the fact that other young individuals could also find these treatments beneficial. Transgender activists and supporters view this as a deliberate effort to invalidate their identities, disguised as a concern for children.

Here are some insights and viewpoints about the varied collection of global health and public policies concerning gender-affirming care.

Through regulations implemented by its national healthcare system, England is restricting individuals under the age of 16 from undergoing a medical gender transition.

The National Health Service England has officially established a policy that was first implemented temporarily nearly a year ago. This policy outlines a minimum age requirement for beginning puberty blockers and includes several other stipulations. According to NHS England, there is insufficient evidence regarding the long-term impacts of these blockers, such as their effects on sexual, cognitive, or overall developmental outcomes.

Beginning on April 1st, NHS England will no longer provide puberty blockers as a standard treatment option for children and teenagers who are seeking to transition genders. This decision also extends to Wales, where there are no NHS gender clinics for minors. Northern Ireland has announced its plan to follow England’s policy, while Scotland is currently considering its stance.

It is not a universal regulation, applicable nationwide. NHS England is only one healthcare provider in the country, although a significant one.

Adolescence inhibitors can be obtained for a fee at select private clinics. Those who are currently receiving them through NHS, which is less than 100 people in England, can still receive them. Individuals involved in clinical trials will also have access to the medication.

The Conservative government in Britain, which has expressed concerns about young people undergoing gender transitions, supported the decision by NHS England. However, a proposed law in Parliament that would ban the use of puberty blockers for those under 16 is not expected to pass.

Puberty blockers can be used for more than just gender transitions; they can also be a preliminary step in the process. They can delay the onset of puberty for individuals questioning their gender identity, giving them time to make informed decisions with their families and healthcare providers about options for longer-lasting changes.

Legislation and proposed state laws in the United States have frequently referenced scientific research and policies from European countries such as Finland, France, Sweden, Norway, and the United Kingdom when attempting to limit transgender health care.

Senator Beverly Gossage of Kansas referenced a recent policy change in England while discussing a bill to prohibit gender-affirming care for minors with her Republican colleagues.

Gossage claimed, in remarks that distorted the guidelines of NHS England, that in England, only therapy is allowed as gender-affirming care for children due to a lack of scientific evidence. However, the guidelines do recommend beginning with counseling, along with other prominent health organizations’ guidelines.

GOP leaders anticipate the ban to be approved this week and are optimistic about being able to surpass any potential veto by Democratic Gov. Laura Kelly.

Senator Ben Watson from Georgia referenced Europe as he advocated for a prohibition on gender-affirming treatment for minors, stating “based on the current situation and developments in not only Europe and the U.K. but also in the United States, this is the reform I am proposing.”

Puberty suppressing medications, which are supported by prominent medical organizations in the United States and the World Professional Association for Transgender Health, are considered appropriate when given correctly to qualifying adolescents. These qualifications do not specify a minimum age.

“In the past 40 years, puberty blockers have been utilized as a safe and successful solution for medical issues like early puberty. However, the selective application of this policy by NHS England solely to trans and gender diverse youth is worrisome and raises concerns about the potential for hostility and harm towards LGBTQ+ individuals and their families,” stated WPATH and the European Association for Transgender Health in a recent announcement.

It was further stated that healthcare decisions should be based on medical evidence, not political motivations. The NHS has not revealed how it will assess any potential harm resulting from its decision, ultimately putting young people and families at great danger without any valid medical reasoning.

In the previous year, the American Academy of Pediatrics, which consists of 67,000 pediatricians, voted unanimously to reconfirm its support for gender-affirming care for transgender minors, which may include the use of hormone treatments when deemed necessary.

Iridescent Riffel, an activist and transgender woman, who is 27 years old and from Lawrence, Kansas, believes that the English policy is overly conservative.

Puberty blockers help prevent people from developing physical features not in line with their gender identity, such as beards or breasts. For most teenagers, puberty is well underway or nearly complete by age 16. Treatments to alter physical features later in life to align with one’s identity can be costly and painful.

Adolescents who identify as transgender may face more challenges when starting social transitioning, which involves modifying their presentation to others, after they have begun puberty.

She expressed that it goes beyond feeling uncomfortable with her body, as she also worries about how others view her and potential judgment and safety issues when she goes out in a way that may not conform with societal norms.

According to Riffel, the true intention is not to ban gender-affirming care, but rather to completely eradicate the presence of transgender individuals in society.

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Reporting from northeastern Pennsylvania was McMillan. Associated Press writers Jill Lawless in London, John Hanna in Topeka, Kansas, and Jeff Amy in Atlanta also contributed to this report.