Wisconsin lawmaker's claim that young children can receive gender transition treatment is false

Wisconsin Assembly Speaker Robin Vos says it is possible for children as young as three years old to get medical gender transition treatment despite medical guidelines saying otherwise.

Vos, R-Rochester, made the assertion in an Oct. 12 Assembly floor speech as lawmakers debated a bill that would bar Wisconsin doctors from providing gender-transition treatment for minors.

"So, you say that kids aren’t old enough to know right from wrong when they commit a crime, but somehow permanent bodily changes, that, when you’re 3 years old, you’ve got it all figured out?" Vos said. 

"Stop using that empty rhetoric and start talking about the reality of why you believe that mutilating kids who don’t even know what day it is or their colors can decide to permanently change themselves in a way that harms them for the rest of their lives," he added.

Vos is wrong. Practice standards and recommendations from Wisconsin health providers indicate that getting medical gender transition treatment for young, prepubescent children is effectively impossible.

When asked to provide evidence to back up the claim, Vos spokesperson Angela Joyce pointed to a document from Children’s Hospital of Wisconsin’s Gender Health Clinic that provides information on medical gender transition treatments for patients and families.

The document, as Joyce correctly pointed out, has no hard age limits for medical gender transition treatments, including puberty blockers and hormone therapy.

It included three criteria for getting treatment: A written "letter of support" from a knowledgeable mental health provider, reasonable control of any medical and mental health problems a child may have and informed written consent from a legal guardian.

And, in a section that walked through treatment procedures for children who had not started puberty or were in early-to-mid-puberty, Children’s Wisconsin mentions both puberty blockers and medical interventions as treatment options.

"This demonstrates that medical gender-transition treatment may be done for children who have not gone through puberty yet," Joyce said in an email. 

But that’s not the full story.

Some Wisconsin health providers, like others nationwide, offer medical transition treatments to treat gender dysphoria, which occurs when people have a mismatch between their biological sex and their gender identity. These options include gender-affirming hormone treatments, chest masculinization ("top surgery") and genital surgery ("bottom surgery"). 

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But Wisconsin clinics do not provide these procedures for young children, in accordance with guidelines set by the World Professional Association for Transgender Health (WPATH) that prohibit such practices. 

Under the guidelines, partially reversible and irreversible treatments in particular are reserved for adolescents and adults who meet specific criteria, and genital surgery is limited to patients who reach the legal age of medical consent.

Puberty blockers, a reversible treatment that delays puberty, come with their own WPATH guidelines. 

These guidelines instruct health providers to offer puberty blockers only for adolescents who demonstrate a "long-lasting and intense pattern" of gender incongruity and reach Tanner stage 2 of puberty, among other criteria. Stage 2 typically occurs between ages 9 and 11 for children assigned female at birth and around 11 for children assigned male at birth.

A Children’s Wisconsin spokesperson told us the clinic follows WPATH guidelines, which means Children’s Wisconsin does not provide medical gender-affirming treatments to children prior to the onset of puberty.

As for the "what to expect" document, it is not a comprehensive policy, but rather a guide for families who are looking for more information about treatment.

Other Wisconsin gender health providers follow similar guidelines, and some set strict age limits.

UW Health does not perform genital surgery on patients younger than 18, and both UW Health and Children’s Wisconsin require parental consent and letters of support from mental health providers before considering top surgery or hormone treatments for older adolescents.

Froedert Hospital’s Inclusion Health Clinic in Milwaukee, which provides gender-affirming hormone therapy, only sees patients 15 and older. Planned Parenthood of Wisconsin provides gender-affirming hormone therapy to patients 18 and older.

Vos claimed that "kids who don’t even know what day it is or their colors can decide to permanently change themselves" through medical gender transition.

Although Wisconsin gender health clinics offer an array of treatment options for transgender youth, none offer medical transition treatments for prepubescent youth, in accordance with professional guidelines.

We rate this claim False.