If you want to protect trans youth, don’t pass laws that pretend to keep them safe

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When a child comes out as transgender, what they yearn for most is affirmation and acceptance. Yet statehouses across the country seem determined to make them feel like outcasts.

In the first half of this year, during a historic pandemic, legislators have introduced several dozen bills that target trans youth, according to the LGBTQ advocacy group Human Rights Campaign. These proposals include prohibiting trans youth from participating on sports teams consistent with their gender identity, refusing access to the appropriate bathroom facilities, and banning gender-affirming medical care.

Limiting access to sports and bathrooms have long been part of a conservative effort that makes pariahs out of trans children — and draws voters into a battle over who deserves full rights. In the past, they’ve argued such policies were necessary to prevent harm to other children, whether that’s a cisgender female athlete competing against a trans girl, or a student who feels uncomfortable sharing a bathroom or locker room with a trans peer. Sadly, these tactics have pitted children against each other, and educators and parents against a relatively small number of kids who must fully express their gender identity to survive.

Now, conservatives have decided to champion the mental health and well-being of trans children themselves by arguing that they shouldn’t be allowed to medically transition as minors. It might be a surprising turn if it didn’t echo a similar strategy deployed by anti-abortion advocates, who cherry pick questionable research findings to claim that ending a pregnancy harms a woman’s mental health, and thus shouldn’t be permitted. Major medical and mental health organizations, along with advocates, children, and their families, have a straightforward message when it comes to trans youth: Affirming their identity is a form of suicide prevention.

Laws banning access to gender-affirming care, one of which passed in Arkansas this spring after overriding the governor’s veto, often argue that children who receive puberty blockers, hormones, or surgery are the subject of medical experimentation, not medical care. Their premise is that gender dysphoria cannot be treated with physical transition because such an approach amounts to liberal ideology run amok. The churn of disinformation can make it difficult to hear the voices of trans children and their caregivers, but they are indeed shouting to be heard.

When the Arkansas legislature held testimony on its bill, pediatric endocrinologist Dr. Michele Hutchinson told politicians: “Do you know how many phone calls I’ve had to field in the last week of children calling me saying, ‘Dr. Hutchinson, if this happens I’m going to kill myself.’ Multiple. So I guarantee you if this bill passes, children will die and I will call you guys every single time one does.”

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That may strike some as dramatic, but the evidence is mounting. When a child’s gender identity goes unacknowledged, or is systematically and structurally rejected, it can have devastating consequences similar to the kind that proponents of laws banning gender-affirming care say they want to prevent. The Trevor Project’s 2021 survey of nearly 35,000 youth between the ages of 13 and 24 found that transgender and nonbinary youth benefited immensely when their identity was affirmed. They had lower rates of attempting suicide when their household respected their pronouns, they could change their name and/or gender marker on legal documents, and had access to spaces supportive of their sexual orientation and gender identity.

A recent study found that anti-trans legislation on its own may be associated with poorer mental health for transgender adults in the U.S. The researchers surveyed 301 trans participants about whether they knew about bills in their city, county, or state that restricted access to bathrooms or locker rooms or required proof of gender-confirmation surgery in order to change their gender marker on their identification. The quarter of respondents who knew of such efforts reported greater depressive symptoms and decreased sense of belonging. The researchers, who published their results in the journal Psychology of Sexual Orientation and Gender Diversity, found that those respondents also experienced increased hopelessness.

Of course, the emotional and psychological burden of discriminatory laws and policies disproportionately affect the most marginalized trans folks. Though trans youth are at a higher risk for mental health conditions and suicide, an outcome related to the relentless bigotry they face at home, school, work, and elsewhere, trans youth of color attempt suicide at higher rates. These children often receive negative messages about their worth related to their racial or ethnic identity and their limited access to financial stability, education, healthcare, food, housing, and safety. That compounding trauma will push them to a breaking point, and it might just be learning that they have no chance of receiving gender-affirming medical care because their state has banned it.

At the very least, politicians could decline to appoint themselves arbiters of what medical care is appropriate for trans youth. If they really wanted to protect the mental health and well-being of trans youth, they would take a radically different path of affirmation. That doesn’t require mandatory medical interventions. After all, those decisions should be left up to children, their caregivers, and trusted medical experts.

But this battle clearly isn’t about the welfare of trans youth; it’s about the values of conservative legislators who wield far more power than the kids whose lives they want to regulate.

If you want to talk to someone or are experiencing suicidal thoughts, Crisis Text Line provides free, confidential support 24/7. Text CRISIS to 741741 to be connected to a crisis counselor. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 8:00 p.m. ET, or email [email protected]. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is a list of international resources.