Imagine that you are a parent to a child who needs medical treatment for a serious medical condition that impacts their daily life. Your child’s medical providers all agree that this treatment is the best way to ameliorate the symptoms of your child’s condition, and the risks are low. But you can’t get the treatment, because your state made it illegal to provide that treatment to children like yours, despite the fact that your child’s health care provider recommends it, and is the course of treatment recognized by major medical professional associations nationally and globally. You would probably feel angry that your child is being discriminated against.
This discrimination is arising in several states that are attempting to make it illegal for providers to deliver gender-affirming care for transgender and gender-expansive youth under age 18 and their families, often imposing serious penalties that would accrue to providers who deliver this care. Despite what their proponents claim, these proposed bans are inconsistent with science and the best interests of children. The evidence confirms that providing youth with gender-affirming care is clinically sound and the most effective way to alleviate symptoms of gender dysphoria, which can cause serious mental distress, anxiety, and depression when untreated.
Moreover, delaying treatment can exacerbate symptoms and stressors, which exposes transgender and gender-expansive youth to high rates of bullying and trauma. That is why major medical associations, including the American Medical Association, the American Psychiatric Association, and American Academy of Pediatrics support comprehensive care for transgender and gender-expansive youth and oppose efforts to ban their access to care. The World Professional Association for Transgender Health and other professional associations across the globe have also expressed their belief that efforts to limit gender-affirming care for youth will result in significant harm.
Health care providers can take numerous actions to affirm a young person’s gender, including supporting their social transition such as, changing their name and pronouns. Other options for youth include modifying their gender expression by wearing different clothing or altering their style. There are also several treatments that health care providers may deliver to transgender and gender-expansive youth, depending on their age, symptoms, and level of reversibility. Sometimes treatment may involve medical intervention such as puberty suppression, hormone therapy, and surgical interventions. Interventions for younger children are more likely to be focused on social transition and support, while adolescents may benefit from hormone therapy and puberty suppression. Surgical interventions are rarely permitted for minors under age 18, except in certain circumstances. For example, transmasculine youth may pursue chest reconstruction surgery after sufficient time in their identity before they turn 18.
Most importantly, these treatments are clinically appropriate, safe, and effective. These options give youth a chance to explore which treatment is best for them. They are not only used to treat youth with gender dysphoria, but also to treat youth with other conditions as well. For example, “puberty blockers” are the same medications that endocrinologists use to treat central precocious puberty and other hormone disorders. Unfortunately, data about transgender and gender-expansive youth is abysmal compared to data on their cisgender counterparts.
Efforts to stop health care providers from delivering gender-affirming health care prioritizes fear-based misinformation and harmful narratives over scientific and evidence-based treatment. Criminalizing certain services for transgender and gender-expansive youth but allowing them for cisgender children is discriminatory and contrary to the standard of care. These attacks deny transgender and gender-expansive youth of their humanity and safety to live healthy and happy lives.
These proposed laws also perpetuate and compound the painful violence transgender and gender-expansive youth face in their daily lives. As a result of society’s deeply ingrained prejudice against transgender and gender non-conforming people, transgender youth are significantly more likely than their cisgender peers to experience threats of violence, depression, sexual violence, and suicidal thoughts. In addition, transgender youth may face family rejection that often leads to homelessness, barriers to education, and chronic health conditions. Despite ongoing violence and hardships, transgender and gender-expansive youth continue to thrive and fight for their dignity and recognition. In fact, a recent poll showed that more Generation Z adults identify as LGBTQ than in any other generation.
Laws should not serve as a weapon to criminalize and discriminate against our transgender and gender-expansive youth by preventing access to the health services they need. Instead, laws must preclude discrimination and support our youth and empower them to make decisions about their gender identity, including obtaining appropriate medical treatment that will allow them to live authentically. As Robyn Kanner wrote: “Society has done nothing for trans youth for so many years. People have to trust that the youth who sway in the breeze of gender will land on their feet when they’re ready. Wherever that is, it’ll be beautiful.” Now is the time stand up for transgender and gender-expansive youth.
