Laura Ladekarl. Class of 2025

Gender-affirming care (GAC) has been increasingly accepted all over the world, including social transition support, puberty blockers, hormone therapy, and surgeries. At the same time, there has been a rise in legal restrictions on the same care for minors. Dr. Wuest from Mount Holyoke College and Dr. Last from Stony Brook University argue that these bans are deliberately produced using claims of scientific uncertainty as an excuse by political and legal organizations to justify the bans on GAC for minors. They aim to examine how scientific uncertainty has been used to justify the legal restrictions on GAC. 

The researchers started with 375 possible articles to analyze relevant to the federal litigations over the 2022 Arkansas SAFE Act, which was the first state-level ban on GAC for minors, and they narrowed down the analysis pool to 10 articles through a deductive process. These 10 legal documents included 4 expert witness declarations and 6 amicus curiae briefs (submitted to the court by a non-party). The documents represented the main scientific claims made by those who advocated for the ban. 

Of the 4 expert witness declarations, 3 of these experts lacked the relevant clinical or research experience in GAC. 8 key legal arguments were made against GAC: uncertainty results, regret, drugs/surgery side effects, suicidality, informed consent, social contagion, sex as innate, and political/ financial interest in GAC advocacy. The researchers found that these arguments came from four types of people: former experts whose views have since become outdated, people who are skeptical of scientific consensus, small medical associations that oppose mainstream medical organizations, and organizations that focused on individuals who de-transitioned. None of these organizations represents the larger scientific and medical community. This led the researchers to conclude that scientific uncertainties were used to justify the ban on GAC for minors. 

The Arkansas SAFE Act was taken down in 2023, and the eastern district of Arkansas deemed the testimonies ideological, not scientific. However, other courts have accepted the arguments, such as Tennessee. These findings are important because scientific uncertainty being used as an argument against GAC for minors has legal implications. They also show how there needs to be vigilance regarding medical misinformation, as medical decisions must be based on facts for the protection of transgender youth. The researchers suggest that future research should be conducted to determine the best practices for GAC on minors instead of letting scientific uncertainty ban the practice. 

Figure 1. Transgender pride flags line the front porch of a house

Works Cited:

Wuest, Joanna, and Briana S Last. “Agents of Scientific Uncertainty: Conflicts over Evidence and Expertise in Gender- Affirming Care Bans for Minors.” Social Science & Medicine, vol. 344, 1 Dec. 2023, pp. 116533–116533, https://doi.org/10.1016/j.socscimed.2023.116533