An insurance-claims analysis found Oregon minors diagnosed with gender dysphoria received puberty blockers and cross-sex hormones at rates far above national averages, while separate state data showed no obvious population-level decline in suicide-related emergency visits.
By yourNEWS Media Newsroom
Oregon has emerged as one of the states with unusually high rates of puberty blocker and cross-sex hormone use among minors diagnosed with gender dysphoria, according to a new insurance-claims study highlighted in a Just the News report.
The findings come as access to pediatric gender medicine faces growing limits in Republican-led states, as well as pressure in some Democratic jurisdictions, federal scrutiny and increasing malpractice concerns. The Oregon data suggest some states continue to function as major access points for medicalized gender-transition treatments for minors.
The study examined nearly 900,000 adolescents ages 8 to 17 in Oregon using a database representing about 80% of insured residents in the state. Researchers found that nearly 1% of the minors were diagnosed with gender dysphoria between 2016 and 2023, with girls accounting for about three-quarters of those diagnoses.
Among minors diagnosed with gender dysphoria, about 22% of girls and 28% of boys received puberty blockers or hormones. Boys made up a smaller overall population but were three times more likely to receive blockers, at 17%. Hormone use was closer between the sexes, with 19% of girls and 22% of boys receiving cross-sex hormones, according to the Comagine Health multi-payer claims database.
The sex disparity in diagnoses differs from earlier generations of gender-dysphoric youth and has been cited by proponents of the rapid-onset gender dysphoria theory, which argues that social influences play an important role in adolescent gender distress, particularly among girls and peer groups. Researchers and commentators who have advanced that theory have often faced professional backlash.
The Oregon study was published last month in Research Connections, an Oxford University Press journal. The authors were affiliated with Comagine and Oregon Health and Science University, which Just the News described as a major provider of gender-related care for minors, including surgery.
The study drew broader public attention after gender medicine journalist Ben Ryan featured it in his newsletter Tuesday. Ryan wrote that the findings translate to roughly 1 in 240 girls receiving testosterone and 1 in 630 boys receiving estrogen. He said those figures likely understate the true numbers by 2023 because the study period showed a “steady rate of increase” and the prescription rates by age were averaged over time.
Ryan also noted that the study did not provide detailed yearly figures, including in the supplementary tables. Just the News said it asked corresponding author Mary Gray, director of research methods and design at Comagine, whether she had the annual figures, but received an auto-reply saying Gray was at a conference until June 18.
Given Oregon’s political makeup and OHSU’s role in the field, Ryan wrote that “It is perhaps unsurprising that the state should have what appear to be disproportionately high rates of prescribing of gender-transition treatment to minors.”
Oregon has also taken a prominent role in legal fights over pediatric gender medicine. The state led a Democratic coalition that successfully challenged Health and Human Services Secretary Robert F. Kennedy Jr.’s declaration that providers who medically transition minors fail to meet “professionally recognized standards.”
In another Oregon case, the 9th U.S. Circuit Court of Appeals last year blocked the state from denying an adoption application by foster mother Jessica Bates because she would not agree to treat “hypothetical adopted children” as the opposite sex, including through medicalized transitions.
Federal authorities have also been pressuring pediatric gender clinics. The Justice Department reached an agreement this month with Cleveland Clinic and the state of Ohio that requires the medical center to close its clinic and dedicate $2 million to detransition care for people affected by what the agreement calls “sex-rejecting procedures.” The arrangement follows a similar settlement with Texas Children’s Hospital this spring.
Cleveland Clinic also agreed to pay DOJ and Ohio a combined $308,000 to resolve allegations that it submitted insurance claims for sex-rejecting procedures using diagnosis codes that did not accurately reflect their purpose. Texas Children’s paid a $10 million penalty, while Cleveland Clinic paid a smaller amount because it remained “cooperative, proactive, and solution-driven,” the Justice Department said.
The Oregon rates stand well above national figures reported in a Harvard study using a private insurance claims database covering 5.2 million children ages 8 to 17 from 2018 to 2022. Puberty blockers are not administered before age 8 for gender dysphoria, according to the report.
That study, published in JAMA Pediatrics 17 months ago and also flagged by Ryan, found that about 1 in 1,000 minors were receiving cross-sex hormones. The national figures translated to about 140 girls receiving testosterone and 82 boys receiving estrogen per 100,000.
Leor Sapir, a gender medicine researcher at the Manhattan Institute, commented on the Oregon numbers, noting that gender dysphoria as defined in the 2013 Diagnostic and Statistical Manual of Mental Disorders had historically been observed in about 1 in 20,000 men and 1 in 50,000 women.
The Society for Evidence-Based Gender Medicine said the hormone rate among Oregon 14- and 15-year-olds was about four to five times the national rate, with the gap narrowing to two to three times the national rate by age 17.
The elevated Oregon figures have prompted questions from critics of pediatric gender medicine about claims that such interventions reduce suicide risk. Supporters of gender-affirming care have argued that the care is life-saving for youth experiencing gender distress.
Canadian economist Yuan Zhang shared Oregon Health Authority data showing “suicide-related visits” to emergency rooms and urgent care facilities going back to 2019, the earliest year available. The number has remained in the low to mid-5,000s each year, except in 2020, when it fell to about 4,500 during the pandemic.
“At the population level, these trends do not show an obvious corresponding decline in suicide outcomes,” wrote Zhang, founder of the health policy nonprofit Evidence Bridge. “It is, from an ecological level, access to ‘lifesaving’ gender affirming care has no impact on suicide.”
Other recent research has also challenged claims about mental health benefits. Just the News cited a three-decade Finnish youth study that found mental health worsened after medicalized gender transitions. It also cited a taxpayer-funded study by Children’s Hospital Los Angeles pediatrician Johanna Olsen-Kennedy that found no improvement in mental health, with critics saying the results were withheld for years.
The debate over medicalized gender transitions for minors is also shifting outside the United States. In New Zealand, gender-critical group Genspect New Zealand said a Curia poll it commissioned found that 56% of respondents oppose “hormone interventions to treat distress about one’s sex” for minors, while 23% support them. The poll was not posted on Curia’s website, according to the report.
Genspect New Zealand said younger adults were the most likely to support a ban, 61% to 19%, and that across every political party, more respondents agreed the treatments should not be available than disagreed. The group compared the findings to public sentiment in the United Kingdom. A prior government review on puberty blockers for gender dysphoria found low-quality evidence that the drugs improve mental health.
The Oregon study adds new state-level evidence to a national and international dispute over pediatric gender medicine, medical risk, suicide claims and whether state and federal regulators should restrict, permit or monitor access to blockers, hormones and related care for minors.
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