In schools and statehouses across the country, the cultural shifts over sexual and gender identity are forcing legislators to seek ways to address these sensitive issues that best serve minors and their families without exacerbating the culture war. 

Many schools now include lessons on gender and sexual identity in their curriculum, as a growing number of children identify as LGBTQ and particularly as transgender. But whether and how to teach children about these issues in the classroom has divided parents and politicized the nation’s education system and its classrooms. 

Recent estimates place the number of teens in the U.S. who identify as transgender at 300,000, while a smaller number seek out medical interventions. Research done by Reuters suggests the number of teens receiving a diagnosis of gender dysphoria tripled between 2017 and 2021. 

As the number of children and youth who identify as transgender or who experience gender dysphoria grows, so has the use of treatments like hormone therapy, puberty blockers and gender reassignment surgery. In the face of this, state lawmakers have started to look at whether and how to regulate the way the medical community treats children and teens. The proposed laws being considered by different states range from making it a felony for doctors to give young patients hormones or puberty blockers, to a law in California that attempts to shield parents who approve medical interventions for their children.

New polling by HarrisX for Deseret News further exposes the fault lines that have developed among Americans on how to treat the growing number of children who identify as transgender, and on how schools should address these issues. 

Children and teens who identify as transgender are much more likely to struggle with suicidal ideation. They are also more often diagnosed with depression and anxiety. Some medical professionals, as well as the American Academy of Pediatrics, say the best way to treat children and teens with gender dysphoria is to provide them with medical interventions sometimes referred to as affirming care.

But the long-term effects of the use of cross-sex hormones, puberty blockers and gender reassignment surgery to treat gender dysphoria in minors are still largely unknown. In Europe, several countries have paused or slowed the use of medical interventions while exploring what those effects might be. Research in this area is scant, but there are some indications that early use of puberty blockers and cross-sex hormones can affect the development of reproductive organs and sexual function, as well as cognitive development and bone density. A growing number of vocal “detransitioners” — people who medically transitioned from one gender to another when they were young and then regretted their choice — have also raised complex ethical issues over whether young people have the ability to consent to their transitions at an age when they can’t legally vote or consume alcohol. 

Politics have, unsurprisingly, complicated the discussions on these issues. From whether to talk about gender identity in schools to whether lawmakers should make some treatments illegal, Americans remain deeply divided largely along partisan lines. 

Alex Cochran, Deseret News

The new Deseret News/HarrisX poll, conducted from Jan. 6-10 among 1,828 voters, shows Americans are split almost down the middle when asked whether public school teachers should be allowed or prevented from teaching about gender and sexual identity in schools — 49% said it should be allowed while 51% said it should be prevented. The partisan split on this subject is extreme, with 7 in 10 Democrats approving, while almost 8 in 10 Republicans disapprove of teachers or other school personnel discussing sexual or gender identity with students. Young people were more likely to say it should be allowed. 

Among those who say schools and teachers should be allowed to discuss these topics, there is more agreement about when to introduce them, with 7 in 10 voters saying students should be middle school age or older. Even a majority of young people and Democrats disapprove of teaching students in fourth grade or younger about sexual or gender identity in schools. 

In an interview with Deseret News, Jay Richards, director of the DeVos Center for Life, Religion and Family and a senior research fellow at the Heritage Foundation, said that for children with gender dysphoria, social transition often begins in school, at times without parental consent or knowledge. And the lessons schools teach on gender ideology may make kids feel more alienated, he said. 

“If you look at the details of gender ideology, it depends, ironically, on overly rigid stereotypes of what it means to be a boy or girl,” said Richards. “If you look at some of the questionnaires for helping kids explore their gender identity that are used in schools, it might ask questions like, do you like to play with dolls or trucks? Do you like pink or blue?” 

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But the Rev. Marian Edmonds-Allen, executive director of Parity, a nonprofit organization that works at the intersection of faith and LGTBQ concerns, said if parents reject children when they express confusion over their gender or sexual identity, teachers and other school personnel may be a place they can turn. In an interview with Deseret News, the Rev. Edmonds-Allen said when she was running a center for LGBTQ youth, a teenager was found sleeping in a snowbank outside a Davis County high school after she was kicked out of her family home because of her sexual identity. The teen had tried to turn to school personnel, but laws at the time kept them from helping her.

“When I think talking about LGBT things in the school, I think about that story,” she said. “As a mom, I don’t necessarily think it’s appropriate to talk about intimate things in school, that’s something you talk about at home and at church. But if a child needs resources, that’s what is important.”

The Rev. Edmonds-Allen, who has worked in Utah and elsewhere trying to find legislative solutions that bring people together across political divides, is also a mom to four children, including two transgender children. When surveying the political landscape, she said she is concerned that legislation is “fought about more than talked about.” 

Utah is among several states considering how to regulate the way the medical community treats children and teens with gender dysphoria. In a few states, including Alabama, lawmakers have made it a felony for doctors to prescribe hormones or puberty blockers to children and teens. Alabama’s law was partially blocked by a judge last May. In Texas, where it is illegal for children to undergo gender transition surgeries or to take hormones or puberty blockers, Gov. Greg Abbott asked the state’s Department of Family and Protective Services to investigate parents who allow their children to participate in these procedures.

The recent Deseret News/HarrisX poll shows 55% of voters think hormone therapy should be banned for young people, even with parental approval. On gender reassignment surgery, 61% of all voters said it should be banned for minors, compared to 39% who said it should be legal. That was true for independent and Republican voters, but a majority of Democrats — 68% for hormone therapy and 57% for surgery — said the procedures should be legal. Young voters and voters who know a transgender person were also more likely to say the procedures should be legal. 

Alex Cochran, Deseret News

Richards said he believes state lawmakers who take this issue up are “responding to aggression” from those who support medical interventions with young people who have gender dysphoria. “We are essentially conducting a poorly controlled experiment on American teenagers,” he said.  

Even though he thinks lawmakers are right to contemplate legislation, Richards said there are “better and worse ways of handling it.” After pointing out that Alabama’s legislation is hung up in court, he said there are other bills that don’t criminalize treatments but instead create civil mechanisms, including by increasing the statute of limitations for patients to bring claims against their doctors. 

“I like that approach,” he said, “because it basically empowers the people who would be most affected by it, and it respects the fact that at the moment this is complicated and controversial.”

He also praised Florida’s approach. Last November, two medical boards in Florida banned the use of puberty blockers, cross-sex hormones or surgery for youth experiencing gender dysphoria who are minors, unless they were already receiving the treatments. A small number of teens will be allowed to participate in medical studies on the use of these treatments. 

Both Richards and the Rev. Edmonds-Allen agree that the U.S. is currently the “Wild West” when it comes to how to treat children with gender dysphoria. But the Rev. Edmonds-Allen expressed concern over putting a “blanket stop” to available therapies. 

“There needs to be thoughtful and measured consideration that may need to be case by case,” she said. “We’re not there yet to have any type of legislation that can provide more than that.” 

The Rev. Edmonds-Allen said she feels sadness over this issue because she knows it comes from a place of concern on both sides. But she encouraged Utah lawmakers to facilitate discussion and to find a way through, similar to what was done with the Utah Compromise, when the state passed legislation protecting both LGBTQ and religious rights. 

“At the end of the day, we’re people who love our families, we love our kids, we worry about our schools and community. We can figure out ways that we can navigate things as difficult as this is,” she said. “To me, it’s difficult for a couple of reasons. It has faith at the center of it and people have different religious beliefs, and I completely understand that. And it also has medical science that isn’t complete yet, and that makes it hard too because there are people who are very sure of one thing, and other people who are very sure of the opposite, and the reality is the medical science just isn’t there yet. 

“Particularly, in these circumstances, we need to try extra hard to listen with love and to share our stories as best we can and really try to work together,” she said.