North Carolina hospitals: We are not ‘transitioning’ toddlers

CLAIM: Three North Carolina health care systems are diagnosing toddlers with gender dysphoria and “transitioning” them.

AP’S ASSESSMENT: False. Officials with Duke Health, University of North Carolina Health and ECU Health say that while they do accept young children as patients, staff only provide general counseling to parents and families at that age. They do not offer medical procedures such as gender-affirming surgeries or hormone treatments to toddlers.

THE FACTS: As North Carolina lawmakers weigh legislation restricting gender-affirming surgeries to adults, some social media users are suggesting some of the state’s most prominent medical institutions are already offering such medical interventions in toddlers.

Many are sharing a graphic that claims Duke Health is “starting gender transitions” at 2 years old while UNC Health begins it at 3 years old and ECU Health at 4 years old.

“Top medical schools in the state are now transitioning toddlers and training future primary care doctors on how to engage in the experimental treatment,” the text included with the graphic reads.

“Yes, you read that correctly,” wrote one Twitter user who shared the graphic in a post that’s been liked or shared more than 56,000 times as of Tuesday. “If a 2-year-old girl picks up a truck instead a Barbie, that is proof to these activist doctors that she’s actually supposed to be a boy.”

The claims stem from a blog post from a conservative group supporting the North Carolina transgender surgery bill, which cites as evidence a 2016 newspaper interview with the head of Duke’s gender clinic in which she referenced having patients as young as 2.

The blog post also cites a patient form used by UNC’s gender clinic which purports to show that children as young as 3 are offered “psychoeducation and support for child and family” and other services.

But Duke Health said clinic staff simply provide support and counsel to families with young children wrestling with their gender identity. For prepubescent children, “there is parental support, but no testing, no treatment, not anything,” officials said in a written statement.

UNC Health, in a separate response, said parents with young children can request a meeting or counseling session, but the psychiatry team won’t meet with the actual child until they’re at least school age.

“To be clear: UNC Health does not offer any gender-transitioning care for toddlers,” the statement read. “We do not perform any gender-affirming surgical procedures or medical interventions on toddlers. Also, we are not doing any gender-affirming research or clinical trials involving children.”

ECU Health similarly rejected the claims as “dangerous misinformation.”

“To be clear: ECU Health does not offer gender affirming surgery to minors nor does the health system offer gender affirming transition care to toddlers,” it said in a written statement.

The health care providers also stressed that a toddler’s toy preference has nothing to do with gender dysphoria, despite what the social media posts suggest.

“It’s dangerous and reckless to post such incendiary claims online, and we are increasingly worried about threats to our providers and patients,” UNC Health said in its statement.

Like providers across the country, the three North Carolina health systems are following medical guidelines that have been in place for decades, according to health care experts and transgender advocates.

Those standards generally call for small, social changes to help pre-adolescent children dealing with gender dysphoria, such as a new haircut, name, clothing or even a change in pronouns, explained Ash Orr, a spokesperson for the National Center on Transgender Equality, a Washington-based advocacy group.

“At a young age, all children need love and encouragement to be who they are, do things that make them happy, and enjoy being a kid,” he wrote in an email, noting that surveys have found that nearly a third of transgender adults say they began to feel different from their assigned gender at birth as early as 5 years old.

Kellan Baker, executive director at the Whitman-Walker Institute, a Washington, D.C., research group focused on LGBTQ+ health issues, agreed.

“The process of gender affirmation is different for each person and is guided by patients and providers working together, and with families for minors, to identify and meet the patient’s medical needs,” he wrote in an email.