Independent presidential candidate Robert F. Kennedy Jr. is taking a more conservative stance on gender-affirming care, though he says it won’t be a central issue in his campaign.

“It’s abortion, it’s the border, it’s trans rights. These issues are all important,” he said at a rally in Austin last week. “None of them are the issues that really matter to you, to me, to our children.”

Kennedy recently called gender-affirming care a “non-existential” issue, but he has weighed in on it, backing a ban on certain treatments, including puberty blockers and hormone therapy, for minors. His running mate, Nicole Shanahan, agrees.

Shanahan, a former California lawyer, joined a podcast hosted by Riley Gaines, a former college swimmer who opposes allowing trans women athletes to compete in women’s sports, and said medical professionals were being reckless with puberty-blocking prescriptions. 

“We’ve all been there,” Shanahan said on “Gaines for Girls,” downplaying the impact of gender dysphoria experienced by some children as merely the “awkward years” that are a part of any adolescence. 

Last Saturday, Shanahan backed Kennedy’s stance, posting on X, “Just to be clear: You can be supportive of LGBTQ causes AND ALSO believe that children are too young to be able to consent to puberty blockers.”

While Kennedy said he sympathizes with those who have been diagnosed with gender dysphoria, he’s also said he’s recently become “troubled” by the idea of giving puberty blockers to minors, labeling them as “castration drugs.” He also referred to sex-change procedures as “surgical mutilation” and said that such treatments should be postponed until adulthood.

“Minors cannot drive, vote, join the army, get a tattoo, smoke, or drink, because we know that children do not fully understand the consequences of decisions with life-long ramifications,” he wrote on X earlier this month.

Kennedy has in the past spread misinformation related to LGBTQ issues, including conspiracies that chemicals in the environment could be making children gay or transgender, which has no basis in scientific research.

Chemicals, he said on a 2022 episode of his podcast, “are raining down on our children” that “will disrupt normal sexual development and neurological development.”

The Kennedy campaign did not respond to requests for comment.

Many medical experts from leading institutions consider gender-affirming care a medical necessity, which can be exceedingly difficult to access due to prohibitions enacted by some states. Currently, there are bans across 23 states, making comprehensive care limited and mainly available primarily in large metropolitan areas, leading to long wait times for those seeking specialized care.

Once seen, experts say, the decision-making process for any treatment or procedure typically involves multiple visits and consultations with medical and mental health experts, as well as the parents or guardians. As for gender-affirming surgeries for minors, experts say these procedures are extremely rare and are largely viewed as adult procedures.

According to Dr. Meredithe McNamara, assistant professor of pediatrics at the Yale School of Medicine who specializes in adolescent care, only about 3% of young people experiencing gender dysphoria are prescribed puberty blockers. And there is no evidence to suggest this treatment causes long-lasting or irreversible damage to a minor’s physical or cognitive development. 

But when transgender and gender-diverse young people lack access to essential healthcare, their health and well-being suffer and families are destabilized, she said.

“So this candidate supposes that young people can wait until 18, but that would mean going an inordinately long period of time, without evidence-based treatment,” said McNamara. “I can’t think of a good reason for that.”