Layer Five: Gender-Affirming Care Given the amount of conservative hysterics about gender-affirming care, and the corresponding attacks on healthcare, this discussion would be incomplete without at least some mention of trans healthcare. In general, we are living in the healthcare misinformation age. From the belief that vaccines cause autism, to the sometimes comic-book-like origin stories of COVID-19. Not to mention our collective denial about the rapid destruction of our ecosystem due to anthropogenic climate change. I suppose it would be shocking if trans healthcare wasn’t victim to the same mass-produced hokum that is the nicotine of social media. Some claims are flat out nonsense and easily debunked. Like the claim that puberty blockers are irreversible and therefore shouldn’t be given to kids, since they might not understand the consequences. Puberty blockers are meant to delay puberty, not alter it, until they are certain they are trans. It prevents a possibly transgender child from going through the wrong puberty, which has permanent effects So those who want to ban puberty blockers for trans teens because the effects are supposedly permanent, since children shouldn’t make permanent life-altering decisions, have it completely backwards. Puberty blockers are quite literally intended to prevent, and temporarily postpone, permanent life-altering events. Other claims are slightly more complex and insidious, but they’ve been debunked by scientists and activists in detail. I don’t want to get bogged down into debunking a myriad of myopic claims and falsehoods, which would be like emptying a lake with a bucket. Instead, I want to focus on one metric that I think is most revealing: regret rates. Regret rates for gender-affirming care is extraordinarily low. Especially when compared to other surgeries (both necessary and elective) and other major life decisions. There are a good studies on this. A 2021 meta-analysis—meaning it carefully reviews data from multiple studies at once, 27 in this case—found that less than 1 percent of trans people who had gender-affirming surgery expressed regret. One major Dutch study that followed 6,793 trans men and women from 1972 to 2015, found that 0.6 percent of women and 0.3 percent of men expressed regret for getting gender-affirming surgery. Only a half of them, however, expressed “true regret”—what the study defines as people who thought “gender-affirming treatment would be a ‘solution’ for, for example, homosexuality or personal acceptance, but, in retrospect, regretted the diagnosis and treatment.” The others still identified as trans, but had what the study calls “social regret.” They “reported reasons such as ‘ignored by surroundings’ or ‘the loss of relatives is a large sacrifice’ for” de-transitioning. These are golden numbers for any medical treatment. By contrast, between 5 and 14 percent of women who get risk-reducing mastectomies report regret. And roughly 33 percent of people who get knee replacement surgery express regret. The satisfaction rate for gender-affirming treatments is not only way higher than most other surgeries and medical treatments, but even life decisions. A Gallup poll once asked Americans over 45 with children: If you could “do it over again,” how many kids would you like to have? Seven percent said, “no children.” A 2015 study by the American Society for Dermatological Surgery found that 16.2 percent of people regretted getting a tattoo. In short, what this means is that trans people know they are trans, and are not seeking treatment by mistake or because they are “confused.” The treatments work. Furthermore, every year the number of teenagers getting plastic surgeries increases dramatically. The numbers are in the hundreds of thousands, and social media is fueling it. But conservatives never talk about that. When a trans teenage boy wants to remove his breasts, conservatives consider it “maiming” (Jordan Peterson famously said trans actor Elliot Page was “butchered” by “a criminal physician”). But when a teenage girl gets bigger boobs, or fuller lips, or a sharper jawline, as so many of them do, to look more like some digital beauty standard, no conservative is getting on their soapbox for that. Not that it would be helpful if they did, but the contrast is very stark. One last study I’ll mention. In 2017, a group of researchers looked at suicide rates in states that banned gender-affirming healthcare. They published their finding in Nature Human Behavior journal: In states that enacted such bans, “suicide attempts among [transgender and non-binary] young people [increased] by 7-72 percent.” This is the reason why politicians should not be involved in healthcare at all, whether it’s about abortion or trans care. They don’t understand that fundamental part of the Hippocratic oath: “First, do no harm.”