Research shows that limiting gender-affirming medical care for young people can have a negative effect on their health.
Late last month, Texas lawmakers made a disturbing announcement that has been part of an ongoing wave of recent anti-LGBTQIA+ policies and proposed legislation in the United States.
Through an opinion released by Attorney General Ken Paxton and a letter from Texas Governor Greg Abbott to the Texas Department of Family and Protective Services, state politicians revealed a proposed policy that declared the act of offering gender-affirming medical care to transgender and nonbinary teenagers should be investigated as “child abuse.”
Medical providers as well as LGBTQIA+ activists and allies have decried this policy as not just transphobic but damaging to the well-being and safety of trans and nonbinary young people.
They assert that gender-affirming care isn’t child abuse. In fact, research has shown that it can save lives.
In his announcement, Abbott stated that those subject to being reported for “child abuse” would include nurses, teachers, and doctors. This guidance doesn’t “change Texas law,” and it’s currently unclear exactly how these orders would be enforced, reported The New York Times.
However, it appears some of these proposals are affecting people in the state.
This week, the American Civil Liberties Union (ACLU) filed a lawsuit on the behalf of a parent of a transgender child who was placed on leave from her position at the Texas Department of Family and Protective Services. An investigator from the department is currently seeking medical records tied to her child’s care, which the family has refused to turn over, reported The New York Times.
Recent research from The Trevor Project underscored just how crucial access to gender-affirming care can be for transgender and nonbinary youth.
The research released in December 2021 showed that trans and nonbinary youth under 18 who received gender-affirming hormone therapy (GAHT) had almost 40 percent lower odds of depression in the past year and close to 40 percent lower likelihood of suicide attempts, for example.
When asked about these new policies, Jonah DeChants, PhD, a research scientist at The Trevor Project, pointed to other research that has shown how greater national anti-LGBTQIA+ social and political conversations can harm young people and their mental and physical health.
“A recent poll conducted by Morning Consult on behalf of The Trevor Project found that 85 percent of transgender and nonbinary youth — and two-thirds of all LGBTQ youth (66 percent) — said recent debates about state laws restricting the rights of transgender people have negatively impacted their mental health,” DeChants told Healthline.
“It’s important to note that these bills, regardless of whether or not they become law, are already negatively impacting LGBTQ youth across the country — a group that faces disproportionate rates of bullying, depression, and suicide risk compared to their peers,” he added.
Dr. Jack Turban, a fellow in child and adolescent psychiatry at Stanford University School of Medicine where he researches the mental health of transgender youth, states that the
“Similarly, parents supporting a young person in their gender identity has been linked to lower rates of suicidality and mental health problems. Criminalizing love and acceptance is both absurd and incredibly dangerous,” Turban told Healthline.
“I’m hopeful Texas governor and attorney general will quickly correct course, given that
DeChants said that, while this opinion isn’t legally binding and doesn’t change or create any laws, anti-trans efforts throughout the nation “can cause fear and confusion and could deter a young person and their family from seeking the gender-affirming care they want.”
“However, our research emphasizes that we should be increasing access to gender-affirming care, not restricting it. A 2021 peer-reviewed study by The Trevor Project, published in the Journal of Adolescent Health, found that access to gender-affirming hormone therapy (GAHT) is significantly related to lower rates of depression, suicidal thoughts, and suicide attempts among transgender and nonbinary youth,” DeChants said, citing the research from earlier this winter.
“Specifically for young people under age 18, receiving GAHT was associated with nearly 40 percent lower odds of recent depression and of a past-year suicide attempt.”
Turban echoed those thoughts, adding that losing access to gender-affirming medical care “could cause serious mental health problems” as a result of worsening gender dysphoria.
“Even the conversations we’re having around these bills are damaging. Transgender youth are hearing powerful politicians stigmatize and attack them, and this, of course, leads to anxiety and depression as well,” Turban explained.
“To make matters worse, we already have a national shortage of physicians trained in providing gender-affirming care and a national shortage of pediatric mental health providers. I cannot overstate the dangers of what the governor and attorney general are doing,” he added.
DeChants emphasizes that these efforts to ban gender-affirming medical care for trans and nonbinary youth are at odds with accepted medical care and practices and “professional guidelines from major medical and mental health associations across the country.”
Turban added that all major medical organizations oppose legislative bans on gender-affirming care for young people, including The American Medical Association, The American Academy of Pediatrics, The American Psychiatric Association, and The American Academy of Child & Adolescent Psychiatry, among others.
Essentially, these experts highlight that the efforts from these Texas lawmakers and their peers in other states are completely divorced from the guidance, recommendation, and research-backed understanding of how beneficial this care can be for a transgender or nonbinary young person.
In an era of hostile political rhetoric that can be easily dispersed across social media, the announcement from Texas has only compounded the misinformation around LGBTQIA+ health and identities.
In many ways, policy proposals can drive home assumptions about trans and nonbinary young people, with their identities flattened to media talking points.
Both Turban and DeChants said that this dynamic is dangerous for young people.
“These anti-trans political stunts are meant to cause fear and confusion. One of the biggest tools that we have to oppose inaccurate and politically motivated assumptions about gender-affirming medical care is data,” DeChants said.
“Data demonstrate that gender-affirming care, such as gender-affirming hormone therapy, is strongly associated with lower risk of depression and suicide among trans and nonbinary youth.”
Turban explained that many of the anti-trans and anti-nonbinary media narratives we see that spring up around these policies and talking points come from “politicians, celebrities, and political pundits instead of from transgender people, their families, and the doctors who take care of them.”
“Because of this, misinformation has been spreading like wildfire. It’s truly unfortunate that individual political pundits have louder voices in these conversations than major medical organizations, but this is sadly the reality,” Turban added.
“My hope is that voters and policymakers will reach out to people who have expertise in this area. Public policy should be based on evidence, not political rhetoric and misinformation.”
What can young people, and the adults and allies in their corner, who are affected by these policies do?
What resources are out there if you are living in a state that might be proposing anti-trans and anti-LGBTQIA+ legislation and policy guidance?
“At this point, no states have active legislation prohibiting gender-affirming medical care for transgender adolescents. I’m hoping it will stay that way,” Turban said.
“The law in Arkansas is not being enforced due to a preliminary injunction, and the law in Tennessee only applies to prepubertal children — who aren’t candidates for gender-affirming medical interventions under any existing medical protocols anyway.”
Turban stressed that he wants to “remind transgender young people that they are valid and loved and that there are people out there who want to help and support them.”
He pointed to The Trevor Project as one clear resource that provides mental health crisis services through browser-based chat, texting services, and a phone hotline.
DeChants also recommended his organization’s resources. He said that now is a time for parents and allies to educate themselves on how to help the young people in their lives.
“We encourage allies, parents, and guardians to first educate themselves on the benefits that gender-affirming care can have for trans and nonbinary youth as described by research and medical experts, not politicians,” he said.
“Next, we urge everyone to learn if there are laws being introduced in their states to restrict this type of care and, if so, to speak out against them. Folks can contact their lawmakers, show up at hearings in support of the transgender community, make noise on social media, and provide direct support to the trans and nonbinary young people in their lives.”