A comprehensive new report commissioned by the Utah Department of Health and Human Services provides one of the most detailed and exhaustive assessments to date on the medical safety, effectiveness, and long-term outcomes of gender-affirming care for transgender and nonbinary youth. And despite recent political rhetoric suggesting otherwise, the findings are clear: gender-affirming medical treatment, when guided by evidence-based protocols, helps transgender adolescents thrive.
The report “Gender-Affirming Medical Treatments for Pediatric Patients with Gender Dysphoria” was produced by the University of Utah’s College of Pharmacy Drug Regimen Review Center and submitted to the state in August 2024. It arrives in the wake of Utah’s controversial Senate Bill 16, which placed a moratorium on gender-affirming medical care for minors and tasked health officials with conducting a review to determine whether the ban should remain in place.
Rather than validating the restrictions, the 900-page report systematically debunks the narrative that these treatments are experimental or dangerous. Instead, it affirms what many healthcare professionals, families, and transgender individuals already know from lived experience: that access to gender-affirming hormone therapy and puberty blockers reduces psychological distress, improves quality of life, and is supported by decades of research.
A Groundbreaking Review of the Evidence
The Utah report is among the most thorough reviews conducted by a state agency. It draws on more than 270 clinical studies from the U.S., Canada, the Netherlands, Australia, and Europe, spanning observational studies, randomized controlled trials, and long-term descriptive research. These studies examined the mental and physical health outcomes of transgender youth who underwent gender-affirming medical care, including puberty blockers (GnRH analogs), cross-sex hormones (testosterone or estrogen), and related medications.
Key findings include:
- Significant mental health improvement in adolescents undergoing gender-affirming care, including reductions in depression, anxiety, suicidality, and eating disorders.
- Improved quality of life and self-image reported by TGNB youth after starting hormone therapy.
- Low rates of regret or treatment discontinuation, especially when care is delivered through comprehensive, multidisciplinary teams.
- No serious long-term health risks found in monitored populations receiving hormone therapy, including studies with follow-ups as long as 40 years.
The authors conclude that there is more evidence supporting gender-affirming care than there is for many high-risk new drugs approved for children in the U.S., including recent gene therapies.
In other words, gender-affirming care for adolescents is not a scientific unknown; it’s a rigorously studied area of medicine.
Setting the Record Straight on Off-Label Use
One political argument used to restrict transgender health care for minors centers around the fact that many of the medications used, such as puberty blockers or hormone therapies, are prescribed off-label. However, the report makes it clear that off-label prescribing is common, legal, and medically accepted in pediatric care.
In fact, the authors note that nearly 40% of all prescriptions for U.S. children are off-label, including many antibiotics, asthma medications, and psychiatric drugs. The only reason gender-affirming care appears to be singled out is because of stigma, not science.
The report also explains that pharmaceutical companies have little incentive to pursue FDA approval for pediatric gender-affirming uses, particularly since most of the medications are generic or long off-patent, making the expensive approval process financially unviable.
Not Just Binary, Not Just Youth
Importantly, the report uses inclusive language throughout, referring to patients as transgender, nonbinary, or gender diverse (TGNB). It challenges outdated assumptions that gender transition is always from male to female or female to male, acknowledging that many people seek care that supports nonbinary embodiment or gender fluidity.
It also points out that the term “pediatric” in the context of this study refers to adolescents, young people who have entered puberty, not prepubescent children. Contrary to frequent misinformation campaigns, the evidence synthesis found no pharmacologic or hormonal interventions being offered to children before the onset of puberty.
Families, Not Politics, Should Guide Care
For many transgender adolescents, puberty is the trigger point for the most intense gender dysphoria. It’s the moment when a young person’s body begins to change in ways that feel distressingly misaligned with their identity. Puberty blockers offer a reversible and safe option to pause that process and give families time to explore next steps under medical supervision.
Cross-sex hormones, which are generally not prescribed until mid-to-late adolescence, offer further alignment for those who choose to continue their transition. These treatments don’t push young people toward transition; they are tools that help affirm the path they’ve already identified as right for them.
Crucially, the report emphasizes that access to these treatments does not result in widespread regret or detransition. The data show that most TGNB youth who access care do so after considerable evaluation, and when provided support, they overwhelmingly report satisfaction with their outcomes.
A Call for Evidence-Based Policy
The timing of this report matters. Across the United States, more than 20 states have passed laws limiting or banning access to gender-affirming care for minors. These laws are often based on political ideologies, not on the lived experiences of transgender youth or the guidance of major medical institutions.
The University of Utah’s findings put pressure on policymakers to reconsider those decisions.
Rather than justifying the continued denial of care, the data make it clear: gender-affirming medical treatment is evidence-based, life-saving, and crucial to the well-being of transgender youth. Efforts to block access to this care are not grounded in science; they are grounded in fear and misinformation.
The Bottom Line
To transgender youth reading this: your identity is valid. The healthcare you need is real, studied, and supported by science. You are not alone, even when the law tries to say otherwise.
To families and allies: this report confirms what many of you have witnessed firsthand: when transgender adolescents are supported and affirmed, they flourish. With access to compassionate, evidence-based care, they grow into healthy, confident adults.
And to legislators and public health officials: listen to the data. Let medical professionals, not politics, guide decisions about healthcare. The lives of thousands of young people are not up for debate—they are asking to be heard, and this report speaks volumes.
