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The majority of Americans believe adults, but not minors, should be able to access gender-affirming care — and opinions are significantly influenced by whether they personally know someone who is transgender, a new 19th News/SurveyMonkey poll finds.

But only 17 percent of Americans think that restricting access to gender-affirming care should be a focus for politicians, even as political rhetoric against transgender people continues to rise, and more states restrict gender-affirming care for both minors and adults. 

Fifty-seven percent of Americans expressed support for adults to access any kind of care designed to support and affirm their gender identity, including therapy, consultations with doctors, hormones or other medication, and surgery. Only 39 percent voiced support for trans minors to do the same. Surgery is rare for minors, and respondents were given that information beforehand.  

Karen Belanger, a Democrat who splits her time between Oregon and Mazatlán, Mexico, thinks that transgender adults should be able to access gender-affirming care but that anyone under 18 is too young to commit to physical changes. 

What gender-affirming care looks like for trans youth varies, and the youngest kids are not receiving hormones or surgery. Best practices set by major medical organizations call for an intentionally lengthy process for minors accessing care. After discussions between a family and their doctor, puberty blockers, which temporarily delay hormones that cause puberty, are the first option to cause physical changes. Blockers are prescribed for kids entering adolescence.

Belanger, 57, is a member of the Church of Jesus Christ of Latter-Day Saints. Although she believes that traditional male and female gender roles are important, including for procreation, she said she also knows that someone’s inner self, or “inner soul,” sometimes doesn’t align with the body that they were born with.    

“I don’t fully understand why. I don’t think we’re meant to,” she said. 

The government should not tell trans people what kind of health care they can access, she said, but politicians still need to be involved and protect transgender people. Stopping care altogether can’t be a solution, she said.

“I don’t want the government saying that women can’t have access to reproductive care. I absolutely do not want the government telling me what I can and can’t do with my body. So I also don’t think that nonbinary, transgender people should have the government telling them what to do with their bodies, either,” she said. 

Crucially, Belanger is one of the poll respondents who personally knows someone who is trans or nonbinary, something research and poll results indicate is influential in determining views on gender identity. 

The 19th News/SurveyMonkey poll shows that Americans’ support for gender-affirming care for adults and minors is higher if they personally know a trans person. However, the poll also suggests that knowing a trans person does not guarantee as much support for minors to access such care as for adults. 

About two-thirds of those who personally know a trans person support the right of adults to access gender-affirming care; it’s 48 percent for those who do not know someone who is trans. Forty-seven percent of Americans who know someone who is trans support gender-affirming care for minors, while 33 percent of those who do not know someone who is trans.

Belanger said her genderqueer half-sister, Yaz Amirsoleymani, has influenced her own understanding of gender identity, as well as her feelings on gender-affirming care for minors. 

As Belanger has watched her sister’s identity evolve over time, she’s thought that if her sister had started a medical transition at a young age, it would have stifled that exploration. 

Amirsoleymani said they see where Belanger is coming from but disagrees. 

“If I felt like at 5, 6, 7 years old that I felt like I was in the wrong body … I would like to think that I could safely explore that or talk to a child psychologist who advocates for gender-affirming care and has done their research,” they said. 

Amirsoleymani, who’s 35 and lives in Portland, said that gender-affirming care is so much more than puberty blockers and hormones — both of which she supports — and that it often depends on the context of the family and what the child needs. They also feel that it is hypocritical for adults to oppose gender-affirming care for trans youth, when children already receive treatments that can have long-lasting effects or that they may not be able to consent to. 

Lyall Crites, a nonbinary and gender-nonconforming person living in the Midwest, has been taking hormone replacement therapy, including estrogen and testosterone blockers, since 2017. The misinformation being spread about the kind of care she receives, and the care that trans minors receive, frustrates her. 

“I don't really think anyone should be having reassignment surgery while they're a minor because that's a growing stage. But reassignment surgery is not the same as gender-affirming care,” she said. 

Crites, who is 25 and politically independent, has no regrets about the health care that allowed her to feel comfortable in her body. Studies show that regret rates among trans people receiving gender-affirming care — levels that were already scant — have declined through the years as treatments improve. 

A majority of Republicans in the poll opposed gender-affirming care for adults and minors, with more voicing support for adults’ access to the care than for youth. However, when asked if they believe politicians should focus on restricting gender-affirming care, protecting trans people or dropping the issue entirely, most Republicans — 58 percent — said that they do not want politicians to focus on transgender issues. 

Only 17 percent of Americans say that politicians should focus on restricting gender-affirming care. Most Democrats want politicians to get involved by protecting trans people. Meanwhile, 44 percent of Americans say politicians should not focus on trans issues at all. 

SurveyMonkey conducted this poll online from August 24 to 31 among a national sample of 20,191 adults, with a modeled error estimate of plus or minus 1.0 percentage points.

Sal Cossari, a Republican living in New Jersey with his long-term girlfriend and his young son, said he does not think that politicians are informed enough about gender-affirming care in general — let alone informed enough to make policy decisions. 

“Each side needs to leave it alone,” he said, referring to Democrats and Republicans. He’s not the only one who thinks so: 72 percent of Americans said that politicians are not informed enough about gender-affirming care for minors to make fair policies. 

When a member of Cossari’s family came out as transgender at the age of 20, he did some research, he said. He learned about deadnaming and misgendering and what could impact someone who’s coming out and transitioning. He feels like he learned a lot from her, or because of her — and that his research was prompted by trans issues affecting him more closely.  

They get together on major holidays and at least once during the summer, he said, especially when he’s at the boardwalk with his son. He asked to keep his family member anonymous to protect her privacy. 

“My son knows her. She hangs out with us. I don’t think twice about it,” he said. “I say to my son, she’s a woman.” 

Cossari, who’s 37 and does not follow a religion, supports the right of transgender adults to access gender-affirming care. But for transgender minors, he’s strongly opposed. He doesn’t think that everyone who transitions, even at a young age, will regret it later on — but he still believes that young people should wait. 

Despite varying support, nearly half of Americans believe that gender-affirming care will become more accessible in their lifetime, including 42 percent of Republicans and 57 percent of Democrats. 

Crites said she believes that access to gender-affirming care will continue to improve — despite the current legislative onslaught and rampant misinformation about what the health care is. 

“I think it’s gonna get better. I’m optimistic,” she said. “People need to understand that they're more together, and they have more things in common with more people, than they think they do.”

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