Calls to one helpline spiked after President Trump announced he planned to ban transgender people from serving in the military.

Medical and mental health experts are warning that President Donald Trump’s statements about transgender people could be especially harmful for young people.

Medical organizations, including the American Academy of Pediatrics (AAP), spoke out quickly after the president announced last week via Twitter that he would ban transgender people from serving in the military.

“As pediatricians, we know that transgender children fare much better when they feel supported by their family, school, and larger community,” AAP officials said in a statement. “Shaming children based on their gender identity or expression is harmful to their social-emotional health and may have lifelong consequences. This includes public discourse that delegitimizes the contributions that transgender individuals make to society.”

For experts who specialize in working with transgender teens or young adults, the headlines made by President Trump’s tweets made them wary.

They warn that the president’s tweets can be especially harmful for young transgender teens and young adults who many not have publicly transitioned or are struggling with their gender identity.

Calls to helplines dedicated to counseling young LGBT people spiked immediately after the tweets, according to Trevor Project Chief Executive Officer, Amit Paley.

“We heard from a higher number [of] LGBT youth,” Paley told Healthline. “We’re still crunching the numbers … We can say there was significant increase in overall call volume.”

Paley said that many of the callers brought up concerns about Trump and his tweets potentially affecting military policy.

“What was so devastating and heartbreaking … the message it sent to trans young people across the country,” Paley said.

Diane Ehrensaft, PhD, director of mental health at the Child and Adolescent Gender Center at UCSF Benioff Children’s Hospital Oakland, said everyone was on “high alert” for signs that their patients were in crisis.

“It’s like a trauma ward. First thing is to figure out is how it’s affecting the person and what they need right then, and then to stabilize them and we go from there,” she told Healthline. “It’s pretty traumatic for people to know they’re being targeted like this.”

She said many families were on alert for signs of transphobia after the election. Some families were so afraid for their children that they considered leaving the country or at least getting passports ready in case they felt their children would be persecuted.

“[With] the president’s tweets, you might as well put up a billboard of transphobia and put it on every street corner,” she told Healthline.

Ehrensaft said she’s especially worried that the current political climate, including the recent “bathroom bills” focused on keeping transgender people in bathrooms that correspond with their sex at birth, could lead to young teens having feelings of “worthlessness.”

As soon as she saw the news about Trump’s tweets, Ehrensaft said she prepared for a spike in patients coming in.

“I have to look for people internalizing it, who say ‘I am a sick person and, look, the president said so,’” she said.

Ehrensaft said she works to help her patients feel resilient enough that they can cope with the negative statements coming from the White House.

“I’ve seen absolute fury, outrage, and disbelief,” Ehrensaft said about her patients after the president’s tweets. “Close cousin is they’re terrified, they’re outraged, and wondering what power that I have?”

Ehrensaft said she has focused on giving her patients a safe space to share whatever feelings they have about the tweets and to reassure them.

“Just to be there to listen, part of the listening is also to share … that I am outraged, too,” she said. “Particularly for young kids to know that adults in the world are on it no matter what the president of the United States [said].”

She said she’s encouraged them to take action if they feel able, and to do something as small as write a letter to the president.

Dr. Aron Janssen, child psychiatrist and director of the Gender and Sexuality Service at NYU Langone’s Child Study Center, said that the president’s tweets already magnified the daily discrimination that transgender people face.

“When we have a president who tweets that who they are, that their identity is a burden … it really hammers home that negative self-image that is so problematic,” Janssen told Healthline.

Janssen pointed out that since transgender issues have become more prominent in recent years, the news has been especially disappointing.

“I think it was such a positive momentum,” he said. “To see the giant steps backward it’s really disheartening.”

Janssen said as a counselor and psychiatrist, he can’t simply reassure his patients that everything will be fine, when they can clearly see evidence otherwise. Instead, he focuses on helping them cope.

“We provide tools to build resilience and strength,” said Janssen. “It’s often providing a space where they can talk about it … and not feel like they have to explain why they’re upset.”

Janssen said some of his youngest patients are the ones that have shown the most resilience and action.

“They’re using it as a mechanism to build coalitions and build communities to protest and do all the positive action oriented things,” he said. “I’m not seeing too many people react with hopelessness.”

Military members respond

Paley pointed out that many transgender members of the military took steps under the past administration to become more public about their identities.

Now, however, they are terrified.

“There are many trans people in the military right now and they were told they could be open about who they were,” he said. “It’s not clear now what’s going to happen to those people.”

Matt Thorn the executive director of OutServe-SLDN, an association for LGBT military personnel and veterans, said many of the estimated 15,000 trans military members have felt supported by their fellow service members, but they are concerned about their job security.

“What we’re getting from a lot of service members who are on the ground is a big swell of support from their fellow service members,” Thorn told Healthline. “I don’t think that there is necessarily a concern for them being out.”

Instead, Thorn said they are concerned that they could swiftly be fired from the military due to being transgender.

“The outrage is astronomical in the rank and file,” he said.

Last week Gen. Joseph F. Dunford, Jr., chairman of the Joint Chiefs of Staff, said there would be no current changes to military membership until further direction was given from the president.

“In the meantime, we will continue to treat all of our personnel with respect,” Dunford said in a statement, according to The Washington Post.