Social media users have shared posts online claiming that five-year-olds can take hormones and change their gender. There is no evidence to support this assertion.
Examples can be seen here and here. The reports contain text that reads: “Can I drink a cigarette? No, you’re 5. Can I have a beer? No, you are 5. Can I drive the car? No, you are 5. Can I take hormones and change my gender? Certainly! You know best! ”
The allegations appeared on Facebook after debates over the rights of children to move on when identifying themselves as transgender, following an exchange between Senator Rand Paul and the new assistant health secretary Rachel Levine (here).
The National Institutes of Health (here) says puberty usually begins in girls between the ages of 8 and 13 and for boys between the ages of 9 and 14. The World Health Organization defines adolescents as those in the age group of 10 to 19 years.
There are various options and stages for menopause, including social menopause, puberty or hormone blockers, sex hormones, and sex reassignment surgery (here).
The Endocrine Society’s Clinical Practice Guidelines for Gender Dysphoria and Sexual Disorder (here) recommend that puberty blocking and sex-confirming hormone treatment occur in prepubertal children. For those who meet the diagnostic criteria, puberty blockers are only recommended as an initial treatment after adolescents show the first signs of physical changes in puberty. The guidelines for sex hormone therapy refer only to adolescents and require that the individual have sufficient mental capacity to give informed consent.
The World Professional Association for Transgender Health (WPATH)’s standard of care (here) advises on physical interventions such as the suppression of puberty hormones only for adolescents when puberty changes have begun. The only type of transition discussed by the association for children is social transition, where a child can change aspects such as their name, clothes, pronouns or hairstyles.
The association recommends that “the shift from one stage to the next should not take place until there has been sufficient time for adolescents and their parents to fully assimilate the consequences of earlier interventions.” Gender surgeries should only take place when the individual has reached the age of majority to give consent in a particular country and has lived in their gender identity for at least 12 consecutive months, the association said.
A 2016 report by the Human Rights Campaign Foundation, American College of Osteopathic Pediatricians and the American Academy of Pediatrics discusses common steps in gender reassignment. The report categorizes puberty blockers, hormone therapy and sex reassignment surgery for ‘early adolescents’, ‘older adolescents’ and ‘adults’, not children. Only ‘social transition’ is recommended for all ages.
In essence, there is no medical guidance that supports five-year-olds who are taking hormones or undergoing gender reassignment procedures. Gender reassignment surgery is widely restricted to adults over 18 years of age. The only guidance for these young children is non-invasive guidelines, such as social transition (here).
VERDICT
Untrue. There is no medical guidance that recommends children from the age of five take hormones or change their gender. The only recommended gender-related transition for preschool children is a social transition.
This article was produced by the Reuters Fact Check team. Read more about our fact-checking work here.