Oregon Is Pumping Children Full of Hormones

OMG, for a minute I thought the state was helping the kids juice for competitive sports. Hey, maybe that's a good idea?

Oregon Is Pumping Children Full of Hormones

The state pushes teens toward ‘transgender-related diagnoses’ and dangerous treatments.

By Leor Sapir and Paul Terdal

July 17, 2026

If you live in Oregon and your child is confused about her sex, the state is ready to medicate her and perhaps even put her under the knife. The Beaver State has become a national leader in providing life-altering hormones to minors.

According to a new study published in Research Connections, at age 17, roughly 1 in every 240 girls and 1 in every 630 boys in Oregon received cross-sex hormones for “gender dysphoria” between 2016 and 2023. These figures are triple and double the national average for girls and boys, respectively. For younger children the disparity is even greater: Cross-sex hormone use in the study was four to five times the national rate among 14- and 15-year-olds, and puberty-blocker use was more than five times the national rate at age 14.

Oregon classifies hormones and surgery as “medically necessary” treatments for gender dysphoria, which the Diagnostic and Statistical Manual of Mental Disorders defines as a mismatch between one’s sex and one’s subjective perception of “gender,” accompanied by distress or difficulty functioning.

According to the study, teens in Oregon are being diagnosed with gender dysphoria at alarming rates: 1.51% of girls and 0.46% of boys received a “transgender-related diagnosis,” almost always gender dysphoria, between 2016 and 2023. The figure for both sexes is 0.98%—10 times the prevalence of Type 2 diabetes in this age group and only slightly lower than the share of teens who described themselves as transgender on state surveys in those years (1.18%). In Oregon, calling oneself transgender is a fast track to medical diagnosis, drugs and in some cases even surgery. About 1 in 4 diagnosed minors in Oregon received such interventions, the study finds.

“Gender transition” involves the disruption of an adolescent’s natural hormone production and regulation. The goal is to mimic the appearance of the opposite sex or attain a sexually ambiguous appearance, all at the expense of the body’s healthy functioning. The known and suspected harms of these interventions include infertility, sexual dysfunction, cognitive impairment, cardiovascular disease, bone health problems and cancer.

Health authorities in several European countries have banned or restricted access to hormonal interventions for minors following rigorous evidence reviews. In Oregon the trend has been one of reckless acceleration. The apparent ease with which distressed Oregon teens go from transgender identification to diagnosis and dangerous medical intervention is no accident. It flows from deliberate choices made by state health authorities a decade ago.

Oregon is the only U.S. state that has formally adopted the medical recommendations, called standards of care, of the World Professional Association for Transgender Health, or WPATH. That 2014 decision has spillover effects for commercial insurance. In 2023, Oregon updated its Medicaid policies to incorporate WPATH’s eighth and latest Standards of Care, known as SOC-8.

WPATH has been in critics’ cross hairs for years, but in 2024 controversy reached a crescendo as internal WPATH communications obtained by the Alabama attorney general while defending a lawsuit against the state’s limits on so-called gender-affirming care for minors revealed evidence of medical scandal.

These documents showed that when developing SOC-8, WPATH commissioned evidence reviews, but it suppressed them after finding “little or no evidence about children and adolescents.” It then claimed that a systematic review of evidence was “not possible.” WPATH also initially recommended age minimums for nearly all “gender transition” procedures, enlisted almost exclusively authors with financial or other conflicts of interest, and sprinkled “medical necessity” statements to guarantee insurance coverage for procedures despite acknowledging privately in an email that “all of us are painfully aware that there are many gaps in research to back up our recommendations.” Last month the Federal Trade Commission sued WPATH, alleging consumer fraud via unfair or deceptive practices. (WPATH called the lawsuit “baseless,” disputed the FTC’s jurisdiction, and said its activities are protected under the First Amendment.)

In Oregon, where WPATH’s influence has been institutionalized, thousands of teens have already been exposed to life-altering drugs and surgery. Authorities likely believed they were responding to demand, but the numbers suggest they were creating it. Some objecting parents faced child-welfare investigations.

When the state first approved Medicaid coverage for “gender transition” procedures in 2015, officials projected that only about 175 people—adults and minors combined—would use the services each year, with costs not exceeding $200,000. In the first year alone, costs exceeded $720,000. By 2024, the figure had risen to more than $12.3 million—over 60 times the original projection. The number of Oregonians receiving covered procedures was roughly 10 times the anticipated number in 2015 and 80 times by 2023.

Among minors, transgender-related diagnoses in Oregon rose threefold between 2017 and 2023, according to a Manhattan Institute insurance database analysis. Hormone prescriptions soared, and surgery became more common. In 2019 alone, 33 minors had double mastectomies and two had hysterectomies, according to data from the Oregon Health Authority’s All Payer All Claims Reporting Program.

Oregon has slightly more than 1% of America’s teens, but between 2019 and 2023 its clinics accounted for at least 7% of all “gender” mastectomies on teen girls. During those years 26 minors had “bottom surgery”—23 hysterectomies and three castrations.

Videos from WPATH conferences, also obtained through the Alabama lawsuit, revealed that clinicians at the Oregon Health and Science University’s Transgender Health Program were pushing the field to extremes, denouncing medical gatekeeping, offering young patients “nonbinary” body configurations with no parallel in nature, and basing medical decisions on “embodiment goals,” regardless of medical history or mental health. (WPATH, which wasn’t a party to the Alabama suit, issued a statement defending the quality of SOC-8 “and the process through which it was developed.”)

Public-record requests, meantime, revealed that Oregon health authorities have known for years about the lack of evidence for these interventions. In 2012, a state-commissioned evidence review found “very poor evidence of the benefit” from puberty blockers. After regulators added “transition” procedures with no age minimums to state Medicaid benefits, a follow-up report co-authored by unnamed gender clinicians at OHSU affirmed the policy despite acknowledging the “paucity of data.”

Oregon’s extreme liberal culture, one-party politics and activist-captured medical and child-welfare systems illustrate the “gender affirmation” model taken toward its logical conclusion.

Mr. Sapir is a senior fellow at the Manhattan Institute. Mr. Terdal is Portland-based management consultant and a visiting fellow with Do No Harm.