Medical entities have criticized the Federal Council of Medicine’s decision to ban hormone therapy for transgender minors, warning that “postponing hormone therapy for another two years without scientific justification could cause emotional and psychiatric harm.”
In a joint statement, societies representing specialists in fields related to the care of transgender individuals expressed “concern over the ban on pubertal blockers and hormone therapy for adolescents with gender incongruence (GI).”
According to experts, this could still result in the use of hormones without medical supervision—“a common occurrence in this population due to longstanding difficulties in accessing healthcare.”
Experts note that most transgender individuals become aware of their gender identity during childhood or adolescence.
Resolution
The resolution by the Federal Council of Medicine, published on April 16, prohibits the use of hormone blockers in children and adolescents with gender incongruence and/or dysphoria. It also states that cross-sex hormone therapy — used to induce physical traits aligned with a person’s gender identity — may only begin at the age of 18.
The resolution also restricts access to gender reassignment surgery for transgender individuals under 18, and for procedures with a potential sterilizing effect, under 21.
Finally, the resolution stipulates that trans individuals who retain their biological reproductive organs should seek preventive or therapeutic medical care from specialists based on their biological sex, rather than their gender identity.
Vulnerability
The organizations assert that the measures outlined by the Council of Medicine “could severely harm the health of this population, which already faces vulnerable conditions,” according to the statement.
The document is endorsed by the Brazilian Society of Endocrinology and Metabolism (SBEM), the Brazilian Association for Studies in Medicine and Sexual Health (Abemss), the Brazilian Society of Urology (SBU), the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), and the Brazilian Association of Obstetrics and Gynecology for Children and Adolescents (Sogia-BR).
The statement also highlights that hormone therapy is a crucial step in the gender affirmation process, typically administered after thorough evaluation and ongoing monitoring by a multidisciplinary team.
Quality of life
The organizations argue that hormone therapy is associated with improved quality of life and a reduction in psychological issues, including depressed mood, depression, anxiety, and social isolation.
“Prohibiting this path should not be the solution proposed to improve care for transgender individuals,” the statement argues. The note also criticizes the new resolution for insisting on the need for robust evidence as a justification to minimize potential harm.
“In this regard, it is important to note that numerous studies already demonstrate low rates of regret and significant improvements in quality of life among transgender individuals who undergo hormone therapy or surgical procedures,” the statement adds.
Expanding research
The organizations emphasized the importance of ensuring that new research can continue to move forward.
“International guidelines recommend that hormone therapy may be initiated from the age of 16 for individuals who demonstrate sufficient mental capacity to understand and consent to the treatment, in collaboration with their parents and/or legal guardians.”
Another direct criticism of the decision is that the new measure proposes delaying surgical interventions for three years, even for individuals who have already reached the age of legal majority. The statement counters this by noting that these individuals “have been under multidisciplinary monitoring for at least a year and are fully capable of consenting to treatment.”
The document also highlights that, in transgender individuals, puberty blockers provide additional time for the consolidation of gender identity. The treatment is described as “fully reversible, as discontinuation leads to the resumption of pubertal development in accordance with the sex assigned at birth.”
Legality
Brazil’s Federal Prosecutor’s Office has launched an investigation into the legality of the resolution. In a statement, the organization points out that the publication alters the regulations governing the care and medical procedures provided to trans individuals, including children and adolescents.
According to the Prosecutor’s Office, the investigation was initiated following a complaint from the Mothers for Diversity Association and a technical note issued by the National Association of Transvestites and Transsexuals (Antra, in Portuguese), a national network comprising 127 institutions across Brazil that work to promote the citizenship of the transvestite and transsexual population.
Original article published in Agência Brasil.
