Kids on 'lifesaving' cross-sex hormones skyrocket in Oregon, but no corresponding suicide decline

As medicalized gender transitions become more difficult for minors to obtain in red and even some blue jurisdictions, due to federal pressure, state bans and increasing malpractice risk, some states are emerging as havens for cross-sex hormones and puberty blockers.

A study of nearly 900,000 adolescents ages 8-17 in Oregon, based on a database representing about 80% of insured Oregonians, found nearly 1% of them were diagnosed with gender dysphoria from 2016 to 2023, three-quarters of those girls.

About 22% of gender-confused girls and 28% of gender-confused boys, a much smaller population, went on blockers or hormones, with boys three times more likely to go on blockers (17%). The sexes were closer together on taking hormones, 19% of girls and 22% of boys, based on the Comagine Health mult-ipayer claims database.

The sex disparity in diagnoses is the opposite of previous generations of gender-confused youth, affirming the theory known as rapid-onset gender dysphoria, which posits that social factors play a crucial role in adolescent gender confusion, disproportionately in girls and their friend groups. ROGD theorists have often been targeted for professional ruin.

Published a month ago in Research Connections, owned by Oxford University Press, the study by researchers at Comagine and Oregon Health and Science University – a major hub for so-called gender affirming care for minors, including surgery – went seemingly unnoticed until gender medicine journalist Ben Ryan featured it in his newsletter Tuesday.

He emphasized that the math works out to about 1-in-240 girls on testosterone and 1-in-630 boys on estrogen, figures that he thinks probably undercount the true number by 2023, given the "steady rate of increase" in their use over the study period and that the prescription rates by age "represented an average over time."

Ryan noted the study did not provide granular numbers by year, even in the supplementary tables. Just the News asked corresponding author Mary Gray, director of research methods and design at Comagine, if she had the numbers, but received an auto-reply that Gray is at a conference until June 18.

Given the Beaver State's progressive dominance and OHSU's presence, "It is perhaps unsurprising that the state should have what appear to be disproportionately high rates of prescribing of gender-transition treatment to minors," Ryan wrote.

Oregon also led a Democratic state coalition that successfully challenged Health and Human Services Secretary Robert F. Kennedy Jr.'s declaration that healthcare providers who medically transition minors fail to meet "professionally recognized standards."

The state exerts regulatory levers in various ways to compel affirmation of gender confusion. But the 9th U.S. Circuit Court of Appeals blocked one last year, ruling that Oregon cannot deny an adoption application by foster mother Jessica Bates because she refuses to treat "hypothetical adopted children" as the opposite sex, including medicalized transitions.

The Justice Department's crusade against pediatric gender clinics was again successful this month, with the Cleveland Clinic reaching agreement with the feds and Ohio to shutter its clinic and commit $2 million to "detransitioning care" for victims of what the agreement calls "sex-rejecting procedures," similar to this spring's agreement with Texas Children's Hospital.

The acclaimed medical center also agreed to pay DOJ and Ohio a combined $308,000 to settle allegations that it submitted payment claims for sex-rejecting procedures to insurance plans and payors that "used diagnosis codes that failed to appropriately reflect" their purpose.

While Texas Children's paid $10 million penalty, Cleveland Clinic paid a relatively paltry sum for remaining "cooperative, proactive, and solution-driven," DOJ said.

No 'obvious corresponding decline in suicide outcomes'

The Oregon rates are remarkably higher than the national rates for both sexes, as gleaned from a Harvard study of a private insurance claims database of 5.2 million 8- to 17-year-olds from 2018 to 2022. (Puberty blockers aren't given before age 8 for gender confusion.)

Published in the Journal of the American Medical Association Pediatrics 17 months ago, the study – also flagged by Ryan at the time – found about 1-in-1,000 minors were on cross-sex hormones, or around 140 girls on testosterone and 82 boys on estrogen per 100,000.

Gender medicine researcher Leor Sapir at the Manhattan Institute marveled at the Oregon rates, noting gender dysphoria as defined in 2013's Diagnostic and Statistical Manual of Mental Disorders was observed in about 1 in 20,000 men and 50,000 women.

The Society for Evidence-Based Gender Medicine said the hormone rate for 14-15 year olds in Oregon was about 4-5 times the national rate, a gap that narrows to 2-3 times by age 17.

The Oregon figures appear to undermine a core belief for those who support gender-affirming care, that it saves lives by reducing the risk of suicide in gender-confused youth.

Canadian economist Yuan Zhang shared Oregon Health Authority data on "suicide-related visits" to emergency rooms and urgent care going back to 2019, the earliest available. The number has hovered in the low to mid 5,000s each year with the exception of the pandemic year 2020, when they dropped to around 4,500. 

"At the population level, these trends do not show an obvious corresponding decline in suicide outcomes," wrote Zhang, founder of the health policy nonprofit Evidence Bridge. "It is, from an ecological level, access to 'lifesaving' gender affirming care has no impact on suicide."

Recent research has challenged the suicide claim, including a three-decade Finnish youth study that found mental health worsens after medicalized gender transitions. Children's Hospital Los Angeles pediatrician Johanna Olsen-Kennedy found no improvement in mental health in her own taxpayer-funded study, whose results she hid for several years.

The tide may be turning against medicalized gender transitions for kids in relatively liberal countries, even outside Europe, where the trend is toward caution for minors.

Most New Zealanders (56%) oppose "hormone interventions to treat distress about one’s sex" for minors, and only 23% support it, according to gender-critical group Genspect New Zealand, citing a Curia poll it commissioned but hasn't posted. (The poll isn't on Curia's website.)

"Younger adults were the most likely to agree" with a ban, 61% to 19%, and "across supporters of every political party more people agreed that the treatments should not be available than disagreed," as is the case in the U.K., the group said. A previous government review on puberty blockers for gender confusion found low-quality evidence it helps mental health.