A third of trans youth are at risk of losing gender-affirming care, study says

March 21st, 2022

Republican-pushed bills are seeking to deny minors access to hormone therapy and puberty blockers. Both are treatments that have been vetted and peer-reviewed by mainstream medical organizations, including the American Academy of Pediatrics.
Robyn Beck / Robyn Beck

The recent wave of Republican-led bans attempting to block transgender minors from accessing gender-affirming medical care may be fertile political ground for conservatives in an election year, but a new study shows the bans are putting tens of thousands of vulnerable young people in jeopardy.

A report from the Williams Institute at UCLA School of Law estimates that more than 54,000 transitioning transgender youth ages 13 through 17 are at risk of losing access to gender-affirming medical care, even in cases where doctors, therapists and parents concur with the need for those treatments. And in at least three states — Alabama, North Carolina and Oklahoma — lawmakers are pushing legislation that would impact about 4,000 18-to-20-year-olds.

The figures are staggering considering that only about 150,000 American youth identify as transgender.

According to the institute, which tracks such legislation, as of Friday a total of 15 states have enacted or are considering laws that would restrict access to gender-affirming care. That includes bills meant to deny access to hormone therapy and puberty blockers, the latter of which are given to transgender teens and preteens to delay the onset of puberty. Both are treatments that have been vetted and peer-reviewed by mainstream medical organizations.

“In each of these states, the bills would either criminalize health care providers who provide gender-affirming care to minors or subject them to discipline from state licensing boards,” the report states.

About half of those bills seek to restrict gender-affirming care by banning some insurance providers from covering such care and by limiting how state funds and state facilities can be used to provide this type of care.

Meanwhile, conservative leaders in six states hope to implement penalties for parents who facilitate minors’ access to gender-affirming medical care. Ten states would also allow so-called bounty hunter lawsuits in which private citizens could file civil suits for damages against medical providers who violated the proposed laws.

The most extreme of those measures was recently passed by the Idaho House of Representatives, which voted to add anti-trans-care language to an existing law banning female genital mutilation. While Idaho Senate leaders decided not to take up the bill, the measure would have made it a felony to perform gender-affirming surgery on transgender youth, and it would have also made it illegal for parents or anyone else to take a minor across state lines for gender-affirming treatment.

The study also notes a new tactic being employed in Texas, where Gov. Greg Abbott has circumvented the lawmaking process by issuing an order classifying gender-affirming care as child abuse. Abbot subsequently called on state employees, teachers and doctors to report parents who try to obtain the treatments for their children. He also threatened that there will be consequences for those who fail to report. The Williams Institute estimates nearly 14,000 young people in the state could be affected by the order.

The move has served as a template for Missouri leaders, who are now seeking to implement a similar workaround, which could affect approximately 1,500 transgender youth in the state.

All these efforts go against the advice of medical organizations, including the American Psychiatric Association, the American Medical Association and the American Academy of Pediatrics.

“A growing body of research shows that gender-affirming care improves mental health and overall well-being of transgender people, including youth,” lead study author Kerith Conron, the Blachford-Cooper distinguished scholar and research director at the Williams Institute, said in a statement.

“Efforts that support transgender youth in living according to their gender identity are associated with better mental health.”

The American Academy of Pediatrics found that transgender teens have dramatically higher rates of suicide attempts and self-injury. Adolescents using puberty blockers have been found to have a reduced risk of suicidal thoughts.