Transgender Youth Deserve Healthcare, Too: Why Legal Protections Are Necessary to Guarantee Gender-Affirming Care for Minors
People across the nation continue to fight for the rights of transgender youth and adults. It’s now time for governments to follow suit. (Photo courtesy of Ted Eytan)
Children end up at the doctor’s office for a slew of reasons. Whether they broke their foot running down the stairs, are due for their yearly checkup, or need hormone replacement therapy in order to make a gender transition, one thing is clear: each scenario requires essential healthcare. Unfortunately, not everyone thinks so.
It is time to challenge those threatening to strip trans youth of their basic right to healthcare and outweigh the risks they exacerbate. UCLA’s Williams Institute found that with the number of bills proposing to restrict or ban care, over 58,000 transgender children and young adults are at risk of losing access to the treatment and services they need, including puberty blockers and hormone replacement therapy. This is a regulatory landscape with disastrous impacts for mental health. According to the Trevor Project, 70% of transgender and non-binary youth experience symptoms of major depressive disorder, and 52% go so far as to consider suicide. No child should have to sacrifice their physical and mental well-being due to a state ban on essential healthcare. Research has proven that gender-affirming care improves the overall wellbeing of and increases positive outcomes for transgender and nonbinary children and young adults.
As transgender healthcare becomes a topic of national debate, the decision to provide youth access to gender-affirming care frequently falls into the hands of state governments. President Biden is focusing his efforts mainly on protecting LGBTQ+ adults from discrimination, but without federal protection it is up to local officials to provide effective access to gender-affirming care for minors. Despite this obligation, states are making different decisions, many of which are harmful and rooted in problematic historical ideological leanings and public opinion.
Many state governments have moved to deprive trans youth of accessible healthcare, setting an alarming precedent. More than 40 bills proposed in 20 different states restrict access to gender-affirming care for transgender youth. In 2021, Arkansas became the first state to comprehensively ban access to gender-affirming care for minors, actively codifying into law unsafe and unstable environments for trans youth. Now, states like Oklahoma, Arizona, and Alabama have introduced extensive bills in their own legislatures, fueling ongoing attempts to criminalize the reception and provision of gender-affirming care for youths and their providers. Namely, the Alabama Vulnerable Child Compassion and Protection Act that made it all the way through the Alabama Senate in May of 2022. The act made gender-affirming care for minors a felony charge punishable by up to ten years in prison. Similar concerning trends have been seen in Texas. On September 16, a Texas directive ordered the state’s Child Protective Services department to investigate parents who sought out gender-affirming healthcare for their children. Luckily, Texas courts, because of the American Civil Liberties Union (ACLU), have temporarily blocked the directive, but the proposal further cements the dangerous implications of restrictive state laws. The potential repercussions of legislative measures restricting access to treatment are egregious—children risk being placed in foster care and parents risk facing criminal charges of child abuse for providing necessary mental and physical care for their children.
A stark contrast to these restrictive legal environments, several states have adopted the mission of strengthening key rights for trans youth. On September 29, California Governor Gavin Newsom signed into law a Senate bill that legally protects any minor who travels to California to receive gender-affirming care and the physicians that care for them. The bill’s specific aim is to protect children receiving care from a parent or guardian who may be resisting or refusing to cooperate with their child’s transition. The bill faced significant opposition from members of the California Family Council and Republican party in California, as well as Democratic senators in the state, like Richard Pan of Sacramento. Those in opposition to the bill claim that children are too young to make decisions for themselves, and that gender-affirming surgery under the age of 18 is not recommended medically. This logic is flawed, though, as young children, arguably, have an easier time understanding and articulating aspects of their own identity as they are developing them. Research has shown that children who decide to transition medically very rarely change their minds. In a study published by the Journal of the American Academy of Pediatrics, 94% of youth continued to identify as transgender five years after their initial transition. Keeping these arguments in mind, the bill was passed with a 60-19 vote from the Assembly. The bill effectively makes California a safe haven for transgender youth across the globe and has set its own precedent for other states in America. This year, while Alabama was criminalizing gender affirming care, 21 LGBTQ+ lawmakers in 16 different states announced that they would introduce “trans refuge state” bills. However, despite these pledges from state lawmakers, few bills have actually been proposed, approved, and implemented in the 16 states. Empty promises leave room for the same risks restrictive legislation sustains. Concrete action is the only path forward for states to ensure that youth across the nation have open access to essential care.
To be silent is to be complicit in the active denial of basic healthcare for individuals who most need it. Legislators across America must prioritize physical and mental health over the bigotry of others in power. The Movement Advancement Project directly claims that, “gender affirming health care can be lifesaving and is supported by every major medical association in the United States.” It’s time for state legislatures to take heed of the research and provide legal protection for minors receiving care, regardless of whether or not it’s their home state. The 21 lawmakers committed to making their states a refuge for trans children must sponsor a bill and fight for its passage—now. Every state, especially those that have criminalized the identities of transgender youth must implement effective measures in order to to protect at-risk youth. Transgender healthcare is essential healthcare, and transgender children are no less deserving of care than anyone else.
Kira Ratan is a first-year in Columbia College intending to study Political Science and African American Studies. On a good day, her favorite spot on campus is Law Bridge. On a bad day, it’s Avery Library.