Laws banning gender-affirming treatments can block trans youth from receiving other care
In some states, new laws banning gender-affirming care for transgender youth are dissuading health care providers from offering mental health services and other medical care that isn’t explicitly banned by those laws.
In the first few weeks after Mississippi’s law went into effect in February, nurse practitioner Stacie Pace said she was fielding calls and emails from parents of trans youth who said their children’s pediatricians would no longer see them for routine care. Pace offers gender-affirming care at a clinic in Hattiesburg.
“(Parents) weren’t able to bring their kids to the pediatrician they were seeing before because the ban scared the pediatrician,” said Pace.
She said the vague language in Mississippi’s law scared primary, mental health and other providers from seeing trans youth and even adults. One parent told her their child needed a refill on asthma medication and their doctor refused to see them.
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But state bans on services such as hormone therapies and surgery can create a climate of fear and confusion for trans youth, families and care providers that can have a chilling effect on all types of care, said Elana Redfield, federal policy director at UCLA School of Law’s Williams Institute, a public policy think tank focused on sexual orientation and gender identity issues.
“If you’re a young person who is trans or a parent of that young person, you might feel concerned about asking for any kind of care for fear it might come back to hurt you or your family,” Redfield said.
Heather Stone, a licensed counselor in Huntsville, Alabama, who sees trans patients, saw that chilling effect after Alabama passed its law last year, even though a court order is currently preventing it from taking effect.
“Mental health treatment for trans youth is not illegal in Alabama,” said Stone, “but the law is so vague that it makes parents and children more hesitant to even seek mental health treatment because they’re confused whether” that treatment has been banned.
Across the country, legislators in at least 21 Republican-led states have passed laws banning or restricting gender-affirming care for minors, according to the Movement Advancement Project, a nonprofit think tank that tracks LGBTQ+ state policies. Similar laws have been considered in at least seven other states this year.
The raft of new legislation is part of a recent nationwide effort by GOP-led state legislatures to place new restrictions on transgender people. Multiple states have enacted laws that bar transgender girls from competing on girls sports teams, prohibit discussions of gender identity in classrooms and outlaw drag shows when minors are present.
The laws restricting gender-affirming health care vary by state, but mainly prohibit hormone therapy and gender-affirming surgery for transgender minors. Implementation has been patchy, as many of the laws face court challenges and some aren’t scheduled to go into effect until later this year.
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The U.S. Department of Health and Human Services describes gender-affirming care as a spectrum of medical and non-medical services that can include social affirmation, hormone therapy, mental health services and surgery.
Gender-affirming surgery is rarely performed on patients under 18. Puberty-blocking drugs and hormone treatments are prescribed by physicians to some children and adolescents struggling with gender dysphoria, a condition in which a person’s gender identity doesn’t align with their sex assigned at birth.
Major U.S. medical organizations — including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association — oppose bans on gender-affirming care and support care for minors when administered appropriately.