Republican lawmakers are increasingly successful in their fight to stop young transgender people from getting medically recommended gender-affirming care.
More than 146,000 transgender young people have lost or are in danger of losing access to gender-affirming care in the United States because of active or proposed state bans and policies, a national research center has found.
In all, 32 states have restricted access to gender-affirming care or were considering laws that would do so, according to a recent report from the Williams Institute at UCLA School of Law, which monitors law and public policy surrounding issues of sexual orientation and gender identity. The majority of these states are led by Republican lawmakers, many of whom do not support gender-affirming care for children.
“An unprecedented number of bills have been filed this year to restrict access to gender-affirming care for transgender youth,” said Elana Redfield, the institute’s federal policy director. “States are exploring every avenue to prevent access to care.”
Many proposals wield strict penalties for health care providers and even family members who provide or make efforts to seek out gender-affirming care for minors. Some prohibit insurance carriers from offering coverage or restrict use of state funds for such care.
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What is gender-affirming care?
Gender-affirming care includes the use of hormones to delay puberty and promote physical development that aligns with a child’s gender identity. While proponents of laws prohibiting such care for youths say the bans are a means to protect children, such care has been endorsed by major health groups such as the American Medical Association, the Endocrine Society and the American Academy of Pediatrics.
“Research shows that gender-affirming care improves mental health and overall wellbeing for transgender people, including youth,” said Kerith J. Conron, the institute's research director who, like Redfield, was among the authors of the study.
Where are transgender youths affected?
About 85,700 transgender youths live in 15 states that have enacted bans or taken executive actions to limit access to care, the authors said – including West Virginia, where Gov. Jim Justice signed such a bill on March 29, the same day that GOP legislators in Kentucky voted to override Democratic Gov. Andy Beshear’s veto of a similar bill there.
An additional 60,600 youths in 15 other states – including Indiana, Kansas, North Carolina and Oklahoma – risk losing gender-affirming care should pending legislation be passed. That includes Montana and North Dakota, where bills have been sent to governors but have yet to be signed.
Proposed bans were defeated in Virginia and Wyoming earlier this year.
In addition to Kentucky, West Virginia and Idaho, legislative bans have been recently passed in states such as Georgia, Iowa, Mississippi, South Dakota, Tennessee and Utah. Legislative bans previously existed in Alabama, Arizona and Arkansas, while Florida and Texas enacted bans through executive orders last year.
Anti-LGBTQ laws prey on misinformation, critics say
The Human Rights Campaign, an LGBTQ+ civil rights organization based in Washington, D.C., recently published a map with related data showing that just over half of transgender youth nationwide aged 13 to 17 have lost or are in danger of losing access to gender-affirming care.
Critics say such laws play off fears and misinformation while jeopardizing the emotional and physical well-being of a small and vulnerable population and putting doctors in the ethically difficult position of providing care at the risk of losing their careers.
The Williams Institute previously found that access to gender-affirming care is associated with lower rates of suicidal thoughts and suicide attempts.