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Doctors Say Gender-Affirming Care Bans Are “State-Sanctioned Medical Neglect”

Gender-affirming care bans “amount to state-sanctioned medical neglect and emotional abuse,” a new report says.

Students protest against Katy ISD's new transgender policy outside the school district's educational support complex on August 30, 2023 in Katy, Texas.

A new report published by the American Academy of Pediatrics asserts that restricting transgender youth’s access to gender-affirming care “amount[s] to state-sanctioned medical neglect and emotional abuse.”

The article, written by doctors at the Seattle Children’s Hospital, refutes the claim that gender-affirming care is “child maltreatment,” a false narrative being pushed by conservatives who support gender-affirming care bans. Instead, the doctors contend that denying transgender minors access to gender-affirming care increases suicidal ideation and depression, which “imperils their safety.” The report also argues that attacks on gender-affirming care have also led to spikes in discriminatory rhetoric, which negatively impact the mental health of LGBTQ youth.

The Seattle Children’s Hospital itself has been victim to anti-transgender policies. In November, the hospital system was targeted by Texas Attorney General Ken Paxton, who has been going after out-of-state providers that may have provided gender-affirming care to transgender youth from Texas. Paxton has requested confidential patient information from at least two clinics, including the Seattle Children’s Hospital, which sued in response.

“[T]he Demands are an unconstitutional attempt to investigate and chill potential travel by Texas residents to obtain healthcare in another state,” the Seattle Children’s Hospital states in its petition to the court.

Despite gender-affirming care being endorsed by virtually all major medical organizations, nearly half the states in the country have passed restrictions on gender-affirming care for minors. According to a KFF analysis, an estimated 38 percent of transgender youth in the United States, or 11,400 transgender minors, are currently affected by these laws.

In addition to affecting transgender youth, many gender-affirming care bans also affect medical providers and parents. In 20 states, gender-affirming care bans include professional or civil penalties, such as the loss of a medical license or referral to medical licensing boards, while five states have bans that include felony penalties for providers and eight states have bans that include prohibitions on providers “aiding and abetting” gender-affirming care access for transgender youth by offering referrals.

Additionally, laws in four states include provisions targeting parents. Florida’s law modifies state custody laws, allowing the state to take custody of transgender children who are “at risk” of undergoing gender-affirming care or who are “being subject to” such care. Similarly, a 2022 Texas directive defined gender-affirming care as “child abuse” and gave the state the ability to remove children from affirming parents.

Gender-affirming care bans are part of a wave of anti-LGBTQ legislation endangering the safety of LGBTQ people across the country. In fact, a record number of anti-LGBTQ legislation was filed in 2023, prompting the Human Rights Campaign (HRC) to issue a national state of emergency for LGBTQ Americans.

“In 2023 alone, >495 anti-lesbian, gay, bisexual, transgender, queer or questioning bills have been introduced, many of which have passed into law,” the article says. “These legislative efforts operate under the guise of protecting children. In reality, they punish caregivers and physicians when they choose to support children.”

Advocates believe that 2024 may be an even more dangerous year for LGBTQ people. In fact, since the start of the 2024 legislative session, the ACLU has tracked the introduction of 388 anti-LGBTQ bills in state legislatures across the country.

“Last year was the most damaging and destructive legislative session we have ever seen for the LGBTQ+ community — particularly transgender youth,” Kelley Robinson, President of the HRC, said in a press release. “This year, sadly, we expect more of the same.”

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