This summer, the World Professional Association for Transgender Health, an international group of health care professionals, plans to release an update to its guidelines for giving care.

The guidelines include a chapter on adolescents that is already generating heat from across the political spectrum. In the decade since the last update, two intersecting forces have transformed the field of transgender health care for preteens and teens.

The first is a large rise in the number of teenagers openly identifying as transgender and seeking care. The second is a right-wing backlash in the United States against allowing medical transitions for minors.