On this year’s Transgender Day Visibility Day, we must celebrate accomplishment, respect resilience, and stand up for the rights of transgender people. Yet there are fears that the day will be overshadowed by the growing onslaught of anti-transit laws targeting healthcare decisions made by families with their doctors.
About a year ago I lost a family member to the traumatic trauma of transgender discrimination, so I speak from a place of seeing my loved one without support. These recent and proposed legislation, none of which are based on evidence-based medicine, will affect the mental and physical health of adults and children and the families that support them.
I am in medical school, and I plan to become a psychiatrist, hoping to work with transgender or non-binary people. Instead of being able to serve, the motive behind these laws frightens me for my future patients. The Texas directive, which refers to gender-confirmed health care as “child abuse,” scares me and makes me angry that any state can involve itself in the clinical decision-making process for which we spend thousands of hours over the years. There are very few doctors who treat transgender people, specializing in physical and mental medicine according to their needs. These laws may prevent doctors from entering this line of work.
Instead of enacting legislation denying trans community basic health rights and signaling to trans individuals that they are not safe, accepted, or endorsed policymakers, physicians, and advocates need to work together to enact legislation to prevent health inequality. Which are exacerbated by the perpetual discrimination of this society.
The biggest issue of misinformation in lobbying for these laws is gender-confirmed health care. Gender-confirming care is defined as treatment that delays the physical changes related to puberty and causes physical and physiological changes that confirm one’s gender identity (e.g. hormone therapy or surgery). It is important to note that infection is a spectrum – not everyone who is transgender chooses hormone therapy and not everyone chooses surgery. Yet all options are at stake, including some legislation passed or proposed.
Doctors do not rush to prescribe sex-confirming therapy, and they only prescribe adolescent contraceptives after working with a young transgender person for a long time considering transition. Access to adolescent inhibitors is critical because the effects of adolescence on certain parts of the body cannot be easily reversed by hormone therapy later in life (e.g. the effect of testosterone on sound). Overall, the procedure requires coordinated counseling and medical supervision from a multidisciplinary clinical team that may include a psychiatrist, endocrinologist, and urologist.
About 25 percent of transgender and nonbinary people choose sex-confirmation surgery. Medical guidelines do not recommend surgery (such as facial resection, mastectomy or falloplasty) until a person is 18 years of age, an issue that has been misrepresented by politicians who lie that doctors are operating on young children.
More than 58,000 transgender teens who become infected are at risk of losing access to their medical care, according to a report from the University of California, Los Angeles, School of Law Williams Institute. The consequences of these bills and legislation will be disastrous. A large survey published in Pediatrics in 2018 found that 30 to 50 percent of young trans and nonbinary people had previously attempted suicide, compared to 9 percent less of all adolescents. Experts assume that this greater risk among trans youth is linked to internal rejection and shame. In contrast, transgender young people who have been supported by their families and have received gender-confirming care have significantly lower rates of depression: Gender-confirmed care has seen a nearly 40 percent reduction in depression and suicide attempts over the past year. Furthermore, trans young people who have access to adolescence have a lower risk of lifelong suicide than adults.
As the Texas Legislature debated anti-trance bills last year, the Trevor Project, an organization focused on LGBTQIA + youth suicide prevention, received a total of more than 10,800 crisis contacts. More than 3,900 transgender or nonbinary youth have made troubled contacts, and many of them consider the anti-LGBTQIA + legislation proposed by their state politicians to lead to stress, self-harm and suicide. Between 2020 and 2021, the Trevor Project reported a 150 percent increase in LGBTQIA + youth in Texas who contact an organization in crisis and seek support.