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Gender-Affirming Health Care Bans Also Impact Families and Medical Providers

Essential providers like children’s hospitals offering care to trans kids have been targeted for harassment and threats.

People rally in support of trans-children and gender affirmation treatments outside Boston Children's Hospital in Boston, Massachusetts, on September 18, 2022.

Trans activists are warning that recent legislation banning gender-affirming care threatens an onslaught of devastating health complications and mental health struggles for transgender youth nationwide.

Teenage access to vital gender-affirming health care has been restricted or banned in 10 states: Alabama, Arkansas, Arizona, Florida, Mississippi, South Dakota, Tennessee, Utah, West Virginia, and Kentucky. Legislators are introducing similar policies across the country in states like North Carolina and Missouri, and activists are warning restricted access to care has harmful implications that could endanger the lives of transgender youth.

“Every single major medical organization agrees that gender-affirming care is life-saving care and that this is medically necessary and sound treatment,” said American Civil Liberties Union transgender justice advocate Henry Seaton.

Gender-affirming care entails a wide range of procedures that include hormone therapy, genital surgeries, puberty blockers, and therapy, all of which have been proven to greatly reduce mental health crises among adolescents.

In a study published in American Medical Association’s journal JAMA Network Open, youth who received gender-affirming hormones or puberty blockers reported 60% lower chance of developing moderate or severe depression and reduced suicidality by 73%.

Banning such life-saving health care, Seaton said, would force transgender youth to “get off all of their medications, which can lead to a lot of health complications and also a lot of mental health issues,” including worsening the high rate of suicidal ideation and suicide attempts by transgender youth.

“We see that gender-affirming medical treatment is not only a tried-and-true method to alleviate gender dysphoria, [but] that it is the only evidence-based method to do so,” Seaton said.

Taking away such an important medical practice for youth under the age of 18 results in damaging consequences that extend beyond patients. Members of the medical community and families of transgender youth are also affected by such bans.

The detrimental impacts of gender-affirming care bans intrude upon the privacy and rights of transgender youth and damage open communication between physicians and patients.

For Seaton, who transitioned as a minor, his primary care doctor prescribed him hormone treatments. Had he been a minor during the bans, “I would have potentially lost my entire primary care provider because she was doing one specific thing for me,” he said.

Although the ban will not take effect until July 1 in Tennessee, Seaton has already witnessed people seeking gender-affirming care being denied appointments.

“Doctors are really worried about proceeding with this care and are not taking in new patients, so there’s a huge blockade for people who are seeking this care now.”

Some doctors have resolved to leave the state entirely, leaving an absence of necessary medical professionals.

“I’ve already heard some doctors [are] leaving the state, and people [who] won’t want to continue on with their medical career in Tennessee,” Seaton said, adding that the impact can be “really worrisome for the entirety of the medical community, not just people providing gender-affirming care.”

Gender-affirming care providers, many being children’s hospitals, have been targeted by anti-trans harassment and threats. Between August and November 2022 alone, 24 hospitals and health care providers received threats, including bomb threats, organized by online harassment campaigns. Many hospitals and health care providers have resolved to remove staff information from websites, resulting in further barriers to access to gender-affirming care in states without such bans.

“It’s a really dangerous time to be a gender-affirming care provider from a privacy and security standpoint, to [continue] to be a doctor,” Seaton said.

Devastation on the entire community

Families with transgender children who need access to gender-affirming care have been forced to relocate or travel out-of-state, which Seaton describes as a “huge burden.”

“I don’t even have the words to describe how bad it’s had an effect on the mental health of trans kids across the state,” Seaton said. “[The legislation] can lead to horrifying repercussions, including suicide and other mental health disorders, and we’ve already seen how this impact can happen.”

Grassroots organizations nationwide have become overwhelmed with pressure to assist communities targeted by recent legislation as more youths turn to such programs for support.

Nashville’s Just Us, a branch of the nationally recognized LGBTQIA+ support organization the Oasis Center, provides support programs tailored toward youth of all gender identities and sexualities. Its therapy services programs for transgender youth have been overloaded with an uptick in cases.

“[Our] Just Us therapist has a full caseload of LGBTQ+ youth and has a waiting list that we often need to refer out to other providers in the community,” said Joseph Clark, program manager of the organization.

Even in the wake of policies with unparalleled detrimental impact, “our greatest advocacy comes from simply existing and keeping our doors open,” Clark said, referring to the organization’s collaborations with other agencies within the community to “develop and facilitate trainings to those who work with LGBTQ+ youth on how to create and support open and affirming spaces.”

Calls for change in communities

Seaton stresses the importance of allyship in light of the recent policy changes, urging people to give their time to local organizations.

“Show up as a volunteer, even show up if you have financial resources to donate to local organizations,” he said.

Many of these organizations also curate programs for youth and “are looking for volunteers to help support trans youth, so get connected in that way,” Seaton said.

Beyond volunteering for local initiatives, vocalizing against anti-LGBTQIA+ rhetoric fosters safer spaces for open communication.

“Showing up to committee meetings tends to help so that legislators see that there is a flourishing and thriving LGBT community that’s watching them and is holding them accountable,” Seaton said. “And it is changing the way that a lot of anti-trans [supporters] are thinking, and they’re not as willing to kind of pursue these measures.”

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