Last year we wrote that “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. . . . Now is the time [to] stand up for transgender and gender-expansive youth.” Unfortunately, legislators in several states did not heed our words, and have continued to propose laws that would make it harder for transgender and gender-expansive youth to access the care they need.
Once again this year, several states are attempting to limit or completely eliminate access to gender-affirming care for transgender and gender-expansive youth under age 18, often imposing serious penalties that would accrue to providers who deliver this care, including criminal liability in some cases. Despite what their proponents claim, these proposed laws 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, the social invalidation and stigma towards trans people contributes to and exacerbates gender dysphoria. The effects of accessing or being denied gender-affirming care impacts lifelong well-being for transgender individuals; a recent groundbreaking study found that accessing gender-affirming hormones during adolescence is associated with improved mental health outcomes for transgender adults.
Despite this research, legislators’ efforts again this year to prevent health care providers from delivering gender-affirming health care prioritizes fear-based misinformation and harmful narratives over scientific and evidence-based treatment. As a result of these laws and 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.
Rather than serve as a weapon to criminalize and discriminate against transgender and gender-expansive youth by preventing access to the health services they need, laws should preclude discrimination and support youth and empower them to make decisions about their gender identity, including obtaining appropriate medical treatment that will allow them to live authentically. Advocates should monitor legislation pending in their state that would make it harder for youth to access gender-affirming services, and educate policymakers in their states about why restricting youth’s access to medically necessary gender-affirming care is bad policy.
