“Today, we honor and celebrate the achievements and resiliency of transgender individuals and communities.”
Those words begin a proclamation issued by the Biden-Harris Administration on March 31, 2021, also known as Transgender Day of Visibility.
Other pro-trans actions by the new administration include a move to allow transgender soldiers to serve openly in the military and to have access to medical treatment for transition-related needs.
However, despite the new president’s best intentions and a new study that shows support for marriage equality at record highs, those determined to further marginalize and persecute the transgender community have come forward in staggering numbers.
Record-Breaking Number of Discriminatory Legislative Proposals
As of mid-April, there were 90 proposed bills in 33 states aimed at restricting the rights and civil liberties of Americans who identify as transgender.
Much of the proposed legislation seems to be in direct response to President Joe Biden’s executive order, which he signed on his very first day in office. The executive order, “Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation”, expanded protection measures in employment law to include schools and other areas which fall under government oversight.
“All persons should receive equal treatment under the law, no matter their gender identity or sexual orientation.” – Executive Order on Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation
Though this seems to leave no room for a wide interpretation, dozens of lawmakers have proposed laws that are aimed at destroying any hope of equal treatment for those in the trans community. While at least a dozen bills have already been killed—meaning its progress in the legislative process is halted—at least five have been passed and will become law. Here’s a quick summary:
HB = House Bill, SB = Senate Bill
- Arkansas SB354 – Bans transgender women and girls from participating in sports (including extracurricular and school sports at the elementary, middle, high school, and collegiate level) consistent with their gender identity.
- Mississippi SB2536 – “Mississippi Fairness Act” – Bans transgender individuals from participating in athletic sports or Olympic events which correlate with their gender identity. Republican Gov. Tate Reeves tweeted that efforts to protect the rights of student-athletes to play sports according to their “chosen” identity were a “push for kids to adopt transgenderism.”
- Arkansas HB1570 – “Save Adolescents From Experimentation (SAFE) Act” – Makes it a felony to provide gender-affirming healthcare to transgender youth under the age of 18. This includes prescribing puberty blockers and hormones as well as gender-affirming surgery. Medical professionals are also prohibited from referring patients to other providers for treatment. However, surgery to place intersex children into the gender binary is permitted. This bill was vetoed by the Arkansas governor, but the legislature voted to overturn the veto the very next day.
- Tennessee HB0003 & SB228 – Requires that a student’s gender for purposes of participation in a public middle school or high school interscholastic athletic activity or event be determined by the student’s sex at the time of the student’s birth, as indicated on the student’s original birth certificate.
Similar to these, the majority of the bills in the legislative pipeline focus on medical treatment and sports. In addition, some of the bills also include:
- Restrictions on transgender persons’ ability to update their identification documents.
- Restrictions on a teachers’ freedom to discuss gender identity in school.
- Requirements to force teachers to misgender or even expose (or “out”) trans students.
One particularly alarming piece of proposed legislation is Arizona’s House Bill 1511. Having made it past the second reading in the state senate, the bill—much like the SAFE Act in Arkansas—would make it against the law to prescribe medication to trans minors. However, in this case, the violation would be considered a Class 2 felony in Arizona with a recommended prison sentence of over 12 years.
In Texas, several bills are in process, including SB1646. In addition to other bills aimed at restricting medical treatment, this bill proposes to change the definition of child abuse to include providing minors with gender-affirming care, meaning any effort to assist your own child would result in a felony charge.
What Are Gender-Affirming Interventions for Minors?
Gender dysphoria is defined by the American Psychiatric Association as “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.” For those in their early teens, going through puberty with a body that does not correspond to their gender can intensify this distress.
The most common way to manage this is through the use of puberty blockers. Puberty blockers (as explained by the Mayo Clinic) are medications that suppress the release of sex hormones and delay the progression of secondary sex characteristics including the growth of facial/body hair, deepening of the voice, breast development, and menstruation.
Puberty blockers are not permanent. They simply press pause on physical changes until the patient—with their families and medical/psychological support—can determine the best course of action moving forward. Medical professionals maintain criteria when considering the use of puberty blockers including:
- Does the patient show a distinct pattern of gender-nonconformity or dysphoria over a long period of time?
- Has gender dysphoria worsened with the start of puberty?
- Are there any other psychological, mental, or social issues that might affect treatment?
Once the minor reaches the age of 16, other interventions are available including hormone replacement therapy (HRT) and surgery.
The Ramifications of Criminalizing Gender-Affirming Medical Care
Several recent studies support the idea that social, medical, and legal support for transgender youth is crucial to their mental health and well-being.
A study published in the journal Pediatrics shows that early access to gender-affirming medical care (GAMC) is vital. They found that trans kids who chose or were forced to wait until they were older before receiving care were more likely to suffer from mental health issues.
Another study in the journal examined the link between access to GAMC and suicidal thoughts. They found that “among transgender adults in the United States who have wanted pubertal suppression, access to this treatment is associated with lower odds of lifetime suicidal ideation.”
According to a 2019 Trevor Project National Survey on LGBTQ Youth Mental Health, 54% of transgender and nonbinary youth reported seriously considering suicide while 29% made at least one suicide attempt.
Yet another study found that among trans adults, nearly 60% knew someone close to them that had contemplated suicide and 25% had experienced the death of someone by suicide. Experiencing the loss of loved ones by suicide has also been shown to have considerable negative effects on the survivor’s mental health.
The list of studies that support the use of GAMC grows longer every year. Other takeaways from the Trevor Project research include:
- When a trans youth’s chosen name is used, suicidal behavior decreases.
- Access to legally changing one’s name and documentation improves access to care—which then improves mental health outcomes.
- Trans youths with a supportive family have remarkably lower suicide attempt rates than those without.
- Gender-affirming hormone treatment decreases suicidality as well as other emotional and behavioral problems.
Experts Agree: Gender-Affirming Interventions Should Not Be Restricted
Experts from fields ranging from child psychology to endocrinology to social work have all agreed that preventing trans youths from accessing care is extremely harmful. In February 2021, nearly 300 medical professionals penned a letter in coordination with the advocacy group Campaign for Southern Equality. The group hopes the letter will help lawmakers realize that the bills being proposed are not backed up by credible science but by ignorance.
An excerpt from the letter reads, “These bills run counter to the growing consensus in the medical community that improving access to gender-affirming care is a central means of improving health outcomes for transgender people. To put it plainly, gender-affirming care saves lives and allows trans young people to thrive.”
Resources for more information:
The Trevor Project – The Trevor Project is the leading national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, queer, and questioning youth.
Crisis hotline: 866-488-7386 (for those ages 13-24)
GLAAD Trans Resources – GLAAD rewrites the script for LGBTQ acceptance. As a dynamic media force, GLAAD tackles tough issues to shape the narrative and provoke dialogue that leads to cultural change. GLAAD protects all that has been accomplished and creates a world where everyone can live the life they love.
National Center for Transgender Equality – The National Center for Transgender Equality advocates changing policies and society to increase understanding and acceptance of transgender people. In the nation’s capital and throughout the country, NCTE works to replace disrespect, discrimination, and violence with empathy, opportunity, and justice.
Human Rights Campaign – By inspiring and engaging individuals and communities, the Human Rights Campaign strives to end discrimination against LGBTQ people and realize a world that achieves fundamental fairness and equality for all. HRC envisions a world where lesbian, gay, bisexual, transgender, and queer people are ensured equality and embraced as full members of society at home, at work, and in every community.