- Several states have enacted policies that restrict access to gender-affirming care.
- At the same time, doctors and scientists are working on new technologies aimed at trans patients.
In 2022, a growing number of states took steps to prevent young, LBGTQ+ individuals from accessing gender-affirming healthcare.
Several studies have found that access to supportive healthcare — which may include medical, surgical, and mental health services — improves the mental health and overall wellbeing of gender-diverse individuals, including transgender youth.
Still, legislators in 20 states have passed or introduced policies restricting youth access to gender-affirming care, and in some cases, penalizing adults who help kids access this kind of care. While legal challenges have kept these policies from taking effect, other states have adopted policies meant to protect gender-diverse people in the meantime.
The political climate has not slowed the pace of research in transgender medicine; in fact, doctors and scientists have popularized new surgical techniques aimed at bringing "gender euphoria" to trans patients. Here are some of the biggest developments in transgender healthcare that came out of 2022.
Gender-affirming care supports youth mental health
Several studies have investigated how gender-affirming care may impact mental health outcomes for transgender and non-binary kids and teens.
Gender-affirming care is "patient-centered and treats individuals holistically, aligning their outward, physical traits with their gender identity," according to the Office of Population Affairs at the US Department of Health and Human Services. This may include medical, surgical, mental health, and non-medical services for transgender and nonbinary people.
Past research has underscored the importance of gender-affirming care, particularly surgical interventions, for transgender adults. The same is true for non-surgical interventions in transgender youth, according to a landmark JAMA study published in February.
The study found that access to gender-affirming care, including puberty blockers and gender-affirming hormones, was associated with mitigation of mental health disparities among transgender and nonbinary children and adolescents.
Researchers established hormone reference intervals for trans people
An underlooked aspect of gender-affirming care is hormone reference intervals, which are used to determine whether individual lab results are normal or concerning.
Reference intervals are important for medical testing, as an inaccurate read on lab results could lead to misdiagnosis or mistreatment. However, existing reference intervals are based on the cisgender population, leaving out transgender people who may undergo hormone therapy.
Clinicians who treat transgender people have had to guess at this information until recently. A study published in The Journal of Applied Laboratory Medicine in May finally established hormone reference intervals for transgender people, based on data from healthy individuals who took estradiol or testosterone to affirm their gender.
This research could lead to significant improvements in healthcare for a vulnerable patient population, the authors concluded.
Studies on genital anatomy led to innovations in gender-affirming surgery
Doctors and researchers have made exciting discoveries about sexual anatomy this year. For instance, one gender-affirming surgeon became the first to count the more than 10,000 nerve fibers in the human clitoris.
Dr. Blair Peters performs phalloplasties, or the surgical creation of a penis, on transmasculine patients at Oregon Health and Science University. Seven of his patients allowed him to study their clitoral tissue under a microscope, which led Peters to a wealth of nerve fibers.
Armed with new knowledge of clitoral anatomy, Peters told Insider he hopes to apply his research to preserve sexual pleasure sensations in future phalloplasties.
Those seeking vaginas may also have access to cutting-edge surgical options, such as the peritoneal pull through (PPT) vaginoplasty.
While the standard vaginoplasty involves an inversion of the penis, PPT uses bits of abdominal lining to line surgically developed vaginal walls. The technique was originally developed to build vaginas in cases of congenital defects, but it is now gaining popularity in the field of gender-affirming surgery.
Compared to penile inversion, PPT may offer less scarring, more natural lubrication, and greater depth of the vaginal canal, according to Dr. Shubham Gupta. He's one of the few surgeons in Cleveland, Ohio, who offers the procedure (which is becoming more common in trans medicine).