Puberty blockers, gender-affirming hormones prescribed to less than 0.1% of US trans and gender diverse (TGD) minors with private insurance. Lower rates would be expected among the uninsured, Medicaid recipients, and those with less comprehensive private insurance.

The Surprising Truth About Gender-Affirming Care for Trans Youth

You’ve probably heard a lot of heated debates about puberty blockers and hormone therapy for transgender teens. But here’s something you might not know: less than 0.1% of insured minors in the U.S. are actually prescribed these treatments. That’s according to a recent study from Harvard. And when you factor in uninsured kids or those on Medicaid, the number is likely even smaller.

So why does this matter? Because the conversation around gender-affirming care often makes it sound like it’s happening everywhere, all the time. But the reality is far more measured.

What the Study Found

The research looked at private insurance data and found that only a tiny fraction of transgender and gender-diverse teens receive medical interventions like puberty blockers or hormones. And while these treatments can be life-saving for some, they’re clearly not being handed out casually.

Think about it—0.1% is roughly 1 in 1,000. That’s not an epidemic. That’s a small group of kids getting carefully considered care with their doctors and families.

The Barriers to Access

Here’s the kicker: even that tiny number might be an overestimate for many. The study only included kids with private insurance, which tends to offer better coverage. For those on Medicaid or without insurance at all, access is even harder.

That means the kids who do get treatment are often the ones with resources—money, supportive families, and doctors who know how to navigate the system. For everyone else, the hurdles are high.

Why This Conversation Matters

When we talk about trans youth and medical care, the loudest voices often drown out the facts. Some politicians paint it as a widespread crisis, while others act like every trans teen is rushing into treatment. Neither is true.

The reality? This is about a small number of kids who need support, and a system that makes it tough for them to get it.

So next time you hear someone say “too many kids are getting hormones,” you’ll know the truth: it’s not even close to 1%. And for many who need it, the bigger problem is getting care at all.

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