Since anything relating to trans youth and medical treatment almost inevitably brings out the "kids are being castrated!" and "90% of trans kids desist and will regret transition!" concern trolling in defense of terrible legislation like this:

No, that is not how this works. That's not how any of this works.

The recent surge of attacks on gender affirming care for trans youth have been condemned by the American Academy of Pediatrics [services.aap.org] and the American Medical Association [www.ama-assn.org], and are out of line with the medical recommendations of the American Medical Association [www.ama-assn.org], the Endocrine Society [www.endocrine.org] and Pediatric Endocrine Society [www.endocrine.org], the American Academy of Pediatrics [services.aap.org], the American Psychological Association [www.psychiatry.org], and the American Academy of Child and Adolescent Psychiatry [www.aacap.org].

This article [www.nytimes.com] has a pretty good overview of why. Psychology Today has one too [www.psychologytoday.com], and here [assets2.hrc.org] are the guidelines from the AAP. TL;DR version - yes, young children can identify their own gender, and some of those young kids are trans. A child who is Gender A but who is assumed to be Gender B based on their visible anatomy at birth can suffer debilitating distress over this conflict. The "90% desist" claim is a myth based on debunked studies, and transition is a very long, slow, cautious process for trans youth.

According to the American Academy of Pediatrics [www.healthychildren.org], gender is typically expressed by around age 4. It probably forms much earlier [www.ncbi.nlm.nih.gov], but it's hard to tell with pre-verbal infants. And sometimes the gender expressed is not the one typically associated with the child's appearance. The genders of trans children are as stable [pediatrics.aappublications.org] as those of cisgender children [journals.sagepub.com].

For preadolescents transition is entirely social, and for adolescents the first line of medical care is 100% temporary puberty delaying treatment that has no long term effects. Hormone therapy isn't an option until their mid teens, by which point the chances that they will "desist" are close to zero. Reconstructive genital surgery is not an option until their late teens/early 20's at the youngest. And transition-related medical care is recognized as medically necessary, frequently life saving medical care by every major medical authority.

Withholding medical care from an adolescent who needs it is not a ♥♥♥♥♥♥♥ neutral option. Transition is absolutely necessary to keep many trans kids alive. Without transition a hell of a lot of them commit suicide. When able to transition rates of suicide attempts drop to the national average. And when prevented from transitioning or starting treatment until adulthood, those who survive long enough to start at 18+ enter adulthood facing thousands of dollars reconstructive surgery to repair damage that should have been prevented by starting treatment when they needed it.

And not all that damage can be repaired. They will carry physical and psychological scars from being forced through the wrong puberty for the rest of their lives. They were robbed of their adolescence, forced to spend it dealing with the living hell of untreated dysphoria and the wrong puberty, trying to remain sane and alive while their bodies were warped in indescribably horrifying ways. Even with treatment as adults, some of them will be left permanently, visibly trans. In addition to the sheer horror of permanently having anatomy inappropriate to your gender, this means they will never have the option of blending into a crowd or keeping their medical history private. They will be exposed to vastly higher rates of anti-trans harassment, discrimination, abuse, and violence, all because they were denied the treatment they needed when they were young.

This is very literally life saving medical care. If there is even a chance that an adolescent may be trans, there is absolutely no reason to withhold 100% temporary and fully reversible hormone blockers to delay puberty for a little while until they're sure. This treatment is 100% temporary and fully reversible; it does nothing but buy time by delaying the onset of permanent physical changes.

This treatment is very safe and well known, because it has been used for decades to delay puberty in children who would have otherwise started it inappropriately young. If an adolescent starts this treatment then realizes medical transition isn't what they need, they stop treatment and puberty picks up where it left off. There are no permanent effects, and it significantly improves trans youth's mental health and lowers suicidality [pediatrics.aappublications.org].

But if an adolescent starts this treatment, socially transitions (or continues if they have already done so), and by their early/mid-teens they still strongly identify as a gender atypical to their appearance at birth, the chances of them changing their minds later are basically zero. At that point hormone therapy becomes an option, and even that is still mostly reversible, especially in its early stages. The only really irreversible step is reconstructive genital surgery and/or the removal of one's gonads, which isn't an option until the patient is in their late teens at the earliest.

This specter of little kids being pressured into transition and rapidly pushed into permanent physical changes is a complete myth. It just isn't happening. And this fear-mongering results in nothing except trans youth who desperately do need to transition being discouraged and prevented from doing so. Withholding medical treatment from an adolescent who desperately needs it is not a neutral option.

The only disorders more common among trans people are those associated with abuse and discrimination - mainly anxiety and depression. Early transition virtually eliminates these higher rates of depression and low self-worth [www.jaacap.com], and dramatically improves trans youth's mental health [thinkprogress.org]. When prevented from transitioning about 40% of trans kids will attempt suicide. When able to transition that rate drops to the national ave