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Trump’s False claim: Harris wants to ‘forcibly compel” doctors to give children ‘castration drugs’
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Neither former President Donald Trump nor his spokesperson said what policy he was referring to or cited specific evidence to support his claim.
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A rule prohibiting LGBTQ+ health care discrimination that passed during the Biden administration has been criticized in a similar way. But the rule, paused because of pending litigation, allows doctors to object to providing medical care for religious and clinical reasons.
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People who oppose access to gender-affirming medicine commonly use the phrase "chemical castration" to describe puberty blockers. Puberty blockers lower sex drive while they’re being taken, but that ends when patients stop taking the medication and they do not cause sterilization.
Since Democratic Vice President Kamala Harris announced her presidential candidacy, her opponent, Republican former President Donald Trump, has attacked her stance on gender-affirming care.
"Harris wants to forcibly compel doctors and nurses against their will to give chemical castration drugs to young children," Trump said at a July 26 Turning Point USA event in West Palm Beach, Florida.
PolitiFact contacted Trump’s campaign for comment and received a reply from Republican National Committee spokesperson Anna Kelly, who pointed to instances in which the Biden-Harris administration supported access to gender-affirming care. Kelly provided no evidence to support Trump’s specific claim.
Although neither Trump nor his team specified which policies he referred to, we identified one connected to Harris that has faced similar criticism.
Harris has supported anti-discrimination protections for LGBTQ+ people. But PolitiFact found no evidence that Harris has advocated for doctors to be forced against their will to give medical care to children.
An antidiscrimination regulation the Department of Health and Human Services formalized in 2024 has been similarly described by critics as forcing medical professionals to provide care.
Section 1557 of the 2010 Affordable Care Act is a nondiscrimination clause that prohibits discrimination based on race, color, national origin, disability, age and sex in federally funded health programs and activities.
The scope of one of those definitions, "sex discrimination," has varied across presidential administrations. During the Obama administration, sex discrimination included gender identity and sex stereotypes. The Trump administration’s regulations did not define sex.
In April 2024, during the Biden-Harris administration, the Department of Health and Human Services formalized regulations that again said sexual orientation and gender identity would be included as part of sex discrimination. The change meant that LGBTQ+ people are again included in the Affordable Care Act’s prohibition on sex discrimination.
This means that refusing to treat patients solely because they are gay or transgender could be considered discriminatory.
A 2023 survey by KFF, a health policy research center, showed that LGBTQ+ adults report higher levels of health care discrimination, including disrespect and unfair treatment from providers.The report also found that negative experiences can lead to worse health outcomes among LGBTQ+ patients, and discourage people from seeking medical care.
The inclusion of LGBTQ+ identities under Section 1557 followed a 2020 U.S. Supreme Court decision that determined that discriminating against employees based on sexual orientation and gender identity is a form of sex discrimination. Since the decision, the Biden administration has sought to extend this LGBTQ+-inclusive understanding of sex discrimination to other civil rights laws and agency regulations, but is facing lawsuits from conservative groups and states that seek to stop the expansion.
Trump’s statement could have been referring to this Affordable Care Act rule change. Following the announcement, critics such as the Alliance Defending Freedom, a conservative legal group, expressed concern that doctors would be forced to provide care they disagreed with.
But HHS’ page of frequently asked questions about the rule change says otherwise. It addresses the question: "Does the final rule require the … provision of treatment (e.g., hormone therapy, surgery, etc.) for children and/or adults with gender dysphoria if prescribed by a doctor?"
The answer says providers are not obligated "to offer any health care, including gender-affirming care, that they do not think is clinically appropriate or if religious freedom and conscience protections apply."
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Elana Redfield, federal policy director at the Williams Institute, an LGBTQ+ research and policy center at the UCLA School of Law, said, "In my reading, it's really extremely unlikely that a provider would be unable to get an exemption from Section 1557 if they had any kind of religious or moral objection to providing gender affirming care."
"The Section 1557 rule is very explicit," said Ma’ayan Anafi, senior counsel at the National Women’s Law Center, "Providers can't discriminate against transgender patients, but they're not required to provide any care that is contrary to their judgment or their expertise."
Lawsuits have been filed by states and clinics challenging the rule and arguing that clinicians could be obligated to provide care.
With the lawsuits pending, enforcement of the rule is paused nationwide following a federal district court ruling in Mississippi.
In his comment, Trump referred to "chemical castration drugs" given "to young children."
"Chemical castration" is a phrase people who oppose access to gender-affirming medicine often use to describe puberty blockers.
Gender-affirming care supports transgender and nonbinary people’s gender identity and can go beyond medical interventions. For the small population of transgender youth, this mainly involves support through social transition, puberty blockers and hormones as children become adolescents. Gender-affirming surgery is rarely performed on minors.
Puberty blockers are medications that pause or suppress the release of hormones that lead to bodily changes that accompany puberty.
A lowered sex drive is normal when an adolescent is taking them. But these effects end when adolescents stop taking the medications.
The most common medication for pubertal suppression is gonadotropin-releasing hormone agonists (GnRHa), which signals the pituitary gland to slow production of sex hormones such as testosterone and estrogen.
GnRHa have been FDA-approved since 1985, and they are used in adults to treat prostate cancer and endometriosis. Since 1981, they have also been used to treat "precocious puberty," which is when kids start going through early puberty, around ages 6 or 7.
Use of GnRHa in transgender kids is considered an "off-label" use because the U.S. Food and Drug Administration didn’t approve the medication for that purpose. Physicians first started prescribing blockers to this population in 1997 in the Netherlands.
Experts say that after puberty blockers are stopped, sex hormone production and puberty resumes. For this reason, numerous major medical organizations in the U.S. consider these treatments reversible. Puberty blockers by themselves do not affect fertility.
But if a teen decides to go directly from blockers to cross-sex hormones, which can affect fertility, they can risk not having mature eggs or sperm to preserve, depending on their age when they started treatment.
Surgical interventions in minors are rare and are evaluated on a case-by-case basis.
Trump said, "Harris wants to forcibly compel doctors and nurses against their will to give chemical castration drugs to young children."
An RNC spokesperson provided information about the Biden-Harris administration’s general support for access to gender affirming care for youth, but did not specify what Trump was referring to or a policy that would "force" doctors to provide care.
During Harris’ vice presidency, the Department of Health and Human Services passed a rule that included LGBTQ+ people in the Affordable Care Act’s prohibition on sex discrimination. Medical providers can still object to providing gender-affirming care if it goes against their clinical judgment or religious beliefs. The rule is being litigated and is paused nationwide.
There is no certainty Trump was referring to this policy. Trump’s characterization of puberty blockers also is misleading.
At PolitiFact, the burden of proof is on the speaker. We rate the statement False.
Our Sources
Email Interview with Lindsey Dawson, director of LGBTQ Health Policy at KFF, Aug 14, 2024
Interview with Elana Redfield, federal policy director at the Williams Institute, Aug. 16, 2024
Interview with Scott Bertani, Director of Advocacy at the National Coalition for LGBTQ Health, July 31, 2024
Interview with Ma’ayan Anafi, Senior Counsel for Health Equity and Justice at the National Women’s Law Center, Aug. 15, 2024
Email interview with Julie Marie Blake, Senior Counsel at the Alliance Defending Freedom, Aug. 15, 2024
Email interview with Anna Kelly, RNC National Press Secretary, July 31, 2024
Email interview with Rose Saxe, Deputy Project Director at the ACLU’s LGBT & HIV Project, Aug. 15, 2024
YouTube, "WATCH: Trump speaks at Turning Point USA event summit," July 26, 2024
Department of Health and Human Services, "Section 1557 of the Patient Protection and Affordable Care Act," Aug. 13, 2024
Congressional Research Service, "The Scope of ACA Section 1557: "Health Program or Activity"," May 6, 2024
KFF, "The Biden Administration’s Final Rule on Section 1557 Non-Discrimination Regulations Under the ACA," May 15, 2024
CNN, "Biden administration restores protections for gay and transgender Americans seeking health care," April 27, 2024
The Advocate, "How did the Biden administration just make health care fairer for LGBTQ+ people?," April 29, 2024
The New York Times, "Biden Administration Restores Health Protections for Gay and Transgender People," April 26, 2024
The 19th, "Biden administration strengthens health care protections for LGBTQ+ Americans," April 29, 2024
The Washington Post, "Biden administration reinstates LGBTQ+ protections in health care," April 26, 2024
KFF, "LGBT Adults’ Experiences with Discrimination and Health Care Disparities: Findings from the KFF Survey of Racism, Discrimination, and Health," April 2, 2024
PolitiFact, "This Supreme Court case is reshaping LGBTQ+ rights. You probably haven’t heard about it," May 20, 2024
Alliance Defending Freedom, "Biden Admin Abuses Its Power Again, Redefines ‘Sex’ in Section 1557," July 11, 2024
Department of Health and Human Services, "Section 1557 Final Rule: Frequently Asked Questions," May 20, 2024
Bloomberg News, "Transgender Health Protections Rule Halted by Federal Judge," July 3, 2024
Reuters, "US judge blocks Biden rule adding gender identity protections to healthcare," July 3, 2024
PolitiFact, "Puberty blockers: The facts and the myths," Aug. 28, 2023
Mayo Clinic, "Puberty blockers for transgender and gender-diverse youth," June 14, 2023
Cleveland Clinic, "Gonadotropin-Releasing Hormone (GnRH): Purpose & Testing," March 18, 2022
Food and Drug Administration, "FDA Drug Safety Communication: Ongoing Safety Review of GnRH Agonists and possible increased risk of diabetes and certain cardiovascular diseases," March 8, 2016
National Library of Medicine, "Gonadotropin Releasing Hormone (GnRH) Analogues - LiverTox," March 20, 2018
New England Journal of Medicine, "Short-Term Treatment of Idiopathic Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone: A Preliminary Report," Dec. 24, 1981
Cleveland Clinic, "Precocious Puberty - Early Puberty: Symptoms & Causes," Oct. 20, 2023
The Journal of Sexual Medicine, "Children and adolescents in the Amsterdam Cohort of Gender Dysphoria," Jan. 26, 2023
Endocrine Society, "Gender Dysphoria/Gender Incongruence Guideline Resources," Sept. 1, 2017
American Academy of Pediatrics, "Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents," 2018
World Professional Association for Transgender Health, "SOC8 Homepage," 2022
Oregon Health and Science University, "Preserving your fertility," accessed Aug. 28, 2024
The White House, "Executive Order on Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation," Jan. 20, 2021
Centers for Disease Control and Prevention, "Terminology," Dec. 23, 2022
PolitiFact, "Is all gender-affirming care for children ‘experimental’? Experts say no," Jan. 17, 2023
PolitiFact, "How many trans people are there in the U.S., and why do we overestimate it?," July 13, 2023
PolitiFact, "Why Ron DeSantis’ claim that Sweden ‘shut down’ gender-affirming surgical care is Half True," Dec. 18, 2023
PolitiFact, "Transition-related surgery limited to teens, not 'young kids.' Even then, it's rare," Aug. 10, 2022
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Trump’s False claim: Harris wants to ‘forcibly compel” doctors to give children ‘castration drugs’
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