Editor’s Note (2/24/22): Last week Texas Governor Greg Abbott ordered state agencies to investigate gender-affirming medical care for transgender youth as “child abuse.” This editorial from June 2021 is being republished to highlight the ways that anti-trans legislation is harmful and unscientific.
On April 6, the Arkansas state legislature passed a law that would prohibit transgender youth from receiving gender-affirming medical care. It was not alone: before 2021 had even reached the halfway point, at least 35 similar bills—all of them in Republican-controlled states—had been proposed or passed, setting a regrettable record. Advocates for these laws argue that such treatments, which usually involve hormones that delay the changes associated with puberty, are unproven and dangerous and that the legislation is necessary to protect children. That is unscientific and cruel.
The actual danger comes from denying trans people the medical care they need. A 2020 study in the journal Pediatrics found that trans kids who wanted hormone treatments and did not receive them faced greater lifetime odds of suicidal thoughts than those who received “puberty blockers.” These blockers, known as gonadotropin-releasing hormone analogues, are medically safe, and their effects are reversible. The medications have been in use for decades, most often in children who begin puberty too early. For trans kids, they buy some time for young people to explore their gender identity before their bodies develop permanent secondary sex characteristics such as breasts or Adam’s apples. When they are ready, adolescents can decide whether to stop taking the blockers and continue to develop into the gender they were assigned at birth or to take gender-affirming hormones—testosterone or estrogen—to develop the features that match their gender identity.
Anti-trans laws play on fears that children may irreversibly alter their bodies and then come to regret it. But such scare tactics ignore reality for the vast majority of people who receive treatment. Under current guidelines from the Endocrine Society, none of these medical interventions can happen before the onset of puberty. Gender-affirming hormones are usually given in the teen years and only when patients have shown persistent, well-documented distress at the mismatch between their gender identity and their physical sex characteristics, according to the standards of care set by the World Professional Association for Transgender Health. And when it comes to the more significant step of genital surgery, the organization stipulates that it should be an option only for adults who have lived continuously for at least a year in the gender role congruent with their gender identity.
These laws would deny people safe treatments when getting them is already too hard. Many trans people—especially people of color, those from lower-income backgrounds and those who are homeless—do not have the financial resources or support they need to receive care. “If lawmakers are interested in improving the health of young people, including transgender youth, as they often claim in these debates, a better use of their time might be to focus on improving access to high-quality medical health care for all rather than restricting it for some,” Kristina R. Olson, a Princeton University psychologist who studies the experiences of trans youth, wrote in a Scientific American opinion essay.
The statehouse war on trans people is not limited to bills restricting health-care access. At least 66 proposed laws would prohibit trans students from participating on sports teams consistent with their gender identity, and 15 would block trans people from using restrooms or locker rooms that match their gender identity, according to the Human Rights Campaign, an LGBTQ rights organization. These callous regulations are just the latest in a long barrage of Republican attacks on gay and trans people. The Trump White House rolled back many LGBTQ protections and even refused to acknowledge Pride Month, traditionally celebrated in June.
In contrast, President Joe Biden issued a presidential proclamation recognizing Pride Month and signed an executive order on his first day in office combating discrimination, on the federal level, on the basis of gender identity or sexual orientation. These and other acts by the Biden-Harris administration have increased desperately needed protections for the LGBTQ community, but they are just a start. Congress must pass the Equality Act, legislation that would establish nondiscrimination protections for LGBTQ people in employment, housing, credit, education, and other areas. The bill was passed by the House of Representatives in February but had not cleared the Senate at the time of this writing. And state lawmakers would do better to address the many real issues that hurt their constituents rather than enacting laws to combat nonexistent dangers.