Attacks on the care of transgender teens in Middle Tennessee has prompted calls by conservatives for investigations and new laws. Right now, there isn’t but one related law on the books, and it’d be hard to break.
In the state legislature, there have been several failed attempts in the last few years to restrict or even ban puberty blockers, hormone therapy and surgeries. Lawmakers pushing the bills, often closely aligned with legislation passing in other states, say they’re trying to protect children from making irreversible decisions they might regret.
But the only law that has passed was enacted in 2021 and simply restricts doctors from giving hormone treatment such as puberty blockers to “prepubertal” minors. Dr. Cassandra Brady, a pediatric endocrinologist at Vanderbilt’s transgender health clinic, informed lawmakers last year that puberty blockers would never be given to children that young.
“If you were to do that, it wouldn’t work, so I don’t know why someone would do that,” Brady said, arguing reasons clinical guidelines shouldn’t be solidified in state code, especially since science changes. “No other standards of care that I use are put into code.”
What guides Vanderbilt’s clinic — and those at children’s hospitals across the state — are accepted standards of care, Brady said. The World Professional Association for Transgender Health revises them every few years. The standards are now 260 pages with a new chapter dedicated to adolescents.
The global clinical organization recommends when to start hormones and all the steps leading up to medication such as counseling, mental health screenings and how to handle parental consent. The professional guidelines lay out when it’s appropriate to consider surgeries on minors, though they’re generally recommended for later.
Since the segment by Daily Wire podcaster Matt Walsh caught the attention of Republican leaders, Vanderbilt has not addressed how often it performs what are known as “top” and “bottom” surgeries on minors.
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