Transgender children are under political attack, with their rights to evidence-based healthcare being stripped across the U.S. and other countries. But this battle isn’t just political; there has also been significant controversy over journalism covering gender-affirming care for trans youth. More than 1,200 New York Times contributors, as a prominent example, have signed a letter opposing the publication’s flawed coverage of medical care for trans youth and adults. Previous coverage of this topic by the Times has used stigmatizing language, framed gender-affirming healthcare for trans children as controversial, and failed to disclose key anti-trans connections of quoted sources, the letter authors state. Other major publications have followed a similar problematic pattern.
Despite the prevalence of poor reporting on this matter, there are steps journalists can take to make sure their coverage is both accurate and respectful. “If journalists stick to what information we have that’s established by physicians and rooted in science, they’re going to do a great job,” says Kate Sosin, an LGBTQ+ reporter at The 19th. “There’s an abundance of information at this point that is solid, and there’s wide consensus about how that care is backed by science,” they say.
Editors should first turn to transgender journalists to write stories on trans youth, but it’s crucial that cis reporters also cover this topic to help counter misinformation and inaccurate reporting. Many of the fundamentals of good journalism—checking the affiliations of sources, not giving false balance in the name of representing “both sides,” and including the experiences of the people seeking the treatments you’re writing about—are at the core of what it means to responsibly report on healthcare for trans youth. But there are additional considerations to keep in mind, such as the terminology you use and the delicate nature of interviewing minors, particularly for reporters who don’t regularly report on transgender issues.
Getting a Handle on the Beat
Before jumping into covering healthcare for trans children—or any story involving the trans community—journalists should take the time to familiarize themselves with the nuances of this beat. “They can’t do it without doing a lot of research,” says Sabrina Imbler, a staff writer at Defector. “It just is such an enormously sensitive and often misrepresented issue, and I think that requires a very careful and sensitive approach,” they say.
Read prior coverage, especially from journalists and publications you respect. “Do your due diligence and research ahead of time, just like if you were learning about work in physics that you’ve never learned about,” says science journalist Helen Santoro. Pay particular attention to the vocabulary surrounding trans issues, which is ever-evolving. Make sure you know which terms are appropriate before conducting interviews so you don’t stigmatize trans and allied sources. For example, use the phrase “gender-affirming surgery” or “transition-related surgery” instead of an outdated and potentially offensive term like “sex reassignment surgery.” To get up-to-date information on accepted language, consult style guides such as The Trans Journalists Association’s Style and Coverage Guide, the Stylebook on LGBTQ+ Terminology from NLGJA: The Association of LGBTQ+ Journalists, and the GLAAD Media Reference Guide.
Gender-affirming care has been studied for more than 100 years, and that research has consistently demonstrated that it improves the mental health of trans youth, including by reducing suicidality.
Imbler also recommends working with trans journalists who have reported on the issue to vet story ideas, check your language and tone, and assess the overall framing of your pieces. Consider hiring a sensitivity reader or consultant with relevant expertise, such as Tuck Woodstock, who co-runs a consulting firm dedicated to helping journalists write trans-inclusive stories.
Keep in mind, too, that your words aren’t the only ones that will appear when a story is published. Get information on the packaging of the article, Imbler says. Push for an accurate headline that uses appropriate terminology. Be sure that any “further reading” articles linked on your article’s webpage are stories you would want yours to be associated with. Request to review any social media promotion for sensitivity and accuracy, as well as art, which should feature actual transgender people with positive framing when appropriate.
It may feel like painstaking work to make sure your stories and any copy associated with them reflect the dignity of trans people. But it’s better to publish affirming, humanizing stories than to issue corrections and apologies after the damage of a poorly reported piece has been done. “People need to be holding themselves to a high standard and understanding that if they’re getting it wrong, that can have really serious consequences,” says Evan Urquhart, founder of Assigned, where he reports on anti-trans propaganda.
Avoid “Bothsidesism”
One of those most important aspects of reporting on gender-affirming care is ditching the “both sides” approach, says Heather Boerner, a former journalist and science communicator. Science is strongly on the side of allowing trans kids to transition. Gender-affirming care has been studied for more than 100 years, and that research has consistently demonstrated that it improves the mental health of trans youth, including by reducing suicidality. Numerous major medical organizations have also issued widespread support of gender-affirming care. Only in the past several years has this issue come under significant fire. And the pushback is largely fueled by political forces, rather than medical concerns, as a recent Mother Jones investigation revealed.
Journalists should report these facts without couching them with the concerns of healthcare providers in the minority who disagree on the merits of gender-affirming care and back their opinions with questionable science. “Some of the worst trans coverage I’ve seen only quotes the researchers who are the outliers,” Boerner says.
Journalists can combat bothsidesism in these stories by seeking to interview trans children themselves whenever possible.
Avoiding bothsidesism doesn’t just mean avoiding presenting fringe medical providers’ concerns about this care as common and legitimate. Many stories may not include such sources, but center parents’ concerns surrounding gender-affirming care for their trans child. “I think we need to ask ourselves, are these concerns legitimate based on the science? And the science would say no,” Boerner says. “The science would say parents denying their kids transgender care is what’s harmful.”
That bias toward parent perspectives isn’t surprising. Being adults, and the majority being cisgender, most reporters find it easier to empathize with cis parents concerned about their child’s transition rather than the trans children themselves, Urquhart says. “That’s the bias that I really want reporters to be aware of,” he says. “And it does shape which quotes you use, which stories get more time.”
Interview Transgender Sources
Journalists can further combat bothsidesism in these stories by seeking to interview trans children themselves whenever possible. A surprising number of stories on healthcare for transgender youth don’t include input from them. “People are experts on their own experience, and it seems to me a biased story to only talk to parents and doctors and not speak to a single adolescent or young person who has transitioned,” Imbler says.
Including a trans young person in a story is, of course, a major decision that reporters and parents of minors should think through carefully. Appearing in a story can open doors for a child to receive hateful comments and threats to their safety, Sosin says. Allow families to take their time as they consider having a child participate in an interview. In some cases, LGBTQ+ advocacy organizations can walk a child and their family through that decision and help them determine which details they’re comfortable revealing. It’s also a good idea to get written parental consent before interviewing a minor.
During interviews, it’s especially important to make sure young sources feel comfortable. Be sensitive and take extra care to avoid adding to any trauma or transphobia your sources might have experienced.
It can be difficult to find transgender youth to interview. Imbler recommends reaching out to people who have been involved in lawsuits related to anti-trans bills because they’ve already been in the spotlight, likely have had media training, and probably have supportive families who can help them through the interview process. Organizations such as GLAAD and PFLAG can also help journalists set up interviews with trans kids. Talking to trans adults about their experiences as children is a good alternative if you’re unable to find a child to interview.
During interviews, it’s especially important to make sure young sources feel comfortable. Be sensitive and take extra care to avoid adding to any trauma or transphobia your sources might have experienced. Ask what the child needs to feel at ease, such as having a parent present, or even a friend for emotional support, Imbler says. And make it clear that they can refuse to answer any question. After the interview, check with a parent about including any personal details and anecdotes the child shares.
Vet Sources and Studies
When including other sources, journalists can run into the pitfall of featuring people without relevant expertise or failing to point out potential conflicts of interest. This may mean leaving out important context for a person quoted in the story. For example, a 2022 New York Times article referred to Grace Lidinsky-Smith as an individual who chose to detransition, but did not mention that she was president of an anti-trans advocacy organization.
Dig into a potential source’s connections to uncover any possible agendas or sources of bias. “Do your diligence as a journalist and try to figure out everyone’s ties,” Imbler says. “Are they a part of this larger movement that is trying to use trans people as a cudgel?” they say. “As a journalist, you shouldn’t be played by those people.”
Beware of quoting healthcare providers and representatives of groups who sound like legitimate, unbiased experts but don’t actually have the credentials to back that up. “There are a lot of copycat organizations out there—organizations claiming to be scientific that are not actually,” Boerner says. When vetting an organization that you’re unfamiliar with, check how many members it has, she says, and look closely at any studies it references on its website. Are they rigorous or largely disproven?
When covering the risks of a specific gender-affirming treatment, such as an increased risk of blood thickening when taking testosterone, contextualize it with the risks of not getting that treatment, such as increased risk of depression and suicide.
Prioritize medical organizations known to be reputable, such as the American Medical Association, the American Academy of Pediatrics, the Endocrine Society, and the American College of Obstetricians and Gynecologists. These groups can refer you to relevant experts. As you talk with those experts, ask who they would recommend speaking to and follow the trail, Santoro says.
When it comes to studies, vet them the same way you would any other paper. Look at sample size, potential bias in participant recruitment and data collection, authors’ backgrounds, and funding sources, Santoro says. Check citations, too, Boerner says, to see if the paper only cites articles within the same journal, which can be a sign that the journal is attempting to artificially inflate its credibility. If you’re unsure about the study’s legitimacy, ask a trusted expert to walk you through it, Santoro adds.
Be careful, too, about assuming the results of studies done on one population, such as cisgender people or adults, will apply to another, such as trans folks and kids. When Boerner was reporting on puberty blockers, for example, they found that studies almost entirely focused on very young children with precocious puberty, and most of those kids were cisgender girls. These children would have been on puberty blockers for much longer than a trans child—the type of detail they say journalists should point out in their writing.
Add Key Context
Because of widespread misconceptions about gender-affirming care for trans minors, it’s important to include relevant context in your reporting on these treatments. For example, some people may mistakenly assume that even very young children might receive gender-affirming hormones or surgery when in fact these treatments are not medically recommended until children reach a certain age. The World Professional Association for Transgender Health states that prepubescent children should not take hormone therapy, such as testosterone or estrogen, or puberty blockers. And the international Endocrine Society guidelines state that a transgender minor should not be eligible for bottom surgery, or surgery of the genitals. (Neither of these organizations make specific recommendations around age minimums for chest masculinization surgery but instead state that an individual’s readiness should be determined by their care team.)
Journalists can also work to include the invaluable context of trans minors as human beings—people whose lives might be significantly improved by gender-affirming care.
When covering the risks of a specific gender-affirming treatment, such as an increased risk of blood thickening when taking testosterone, contextualize it with the risks of not getting that treatment, such as increased risk of depression and suicide. Another useful way to frame the risks of certain treatments is to compare them to the risks of procedures cis people are more familiar with. As Santoro wrote in a 2022 Slate article, for instance, “Regret for gender-affirming surgery is drastically lower than the regret rates of people who have had knee replacement surgery, gotten a tattoo, gone to college, or even had a baby.”
Similarly, report on whether the same treatment for gender-affirming care in trans kids is also given to cis kids for different reasons. Puberty blockers, for example, have long been prescribed to cisgender kids for precocious puberty without the same uproar there has been for trans kids. Including these details can help readers better understand the safety and prevalence of such treatments.
Journalists can also work to include the invaluable context of trans minors as human beings—people whose lives might be significantly improved by gender-affirming care. This framing counteracts narratives seeking to condemn these treatments and affirms the dignity of those seeking them out. Find ways to highlight the humanity of your trans sources, what drives them, inspires them, and gives them a sense of purpose. Feature more moments of trans joy—or write entire stories centered around the theme. “Trans-joy stories are really important, because without them, we don’t have that full picture of trans people as complete humans,” Sosin says. “They’re only these little walking tragedies.”
Tyler Santora is a Colorado-based health and science journalist. They are currently the health & science editor at Fatherly, where they lead the site’s coverage of men’s health, child development, parenting, fitness, and wellness. Tyler has also written for publications such as Scientific American, Popular Science, Undark, Nature Medicine, and many more. Follow them on Twitter @Tyler_Santora.
