Doctors Agree: Gender-Affirming Care is Life-Saving Care
Medical experts agree: Gender-affirming care is medically necessary care that can be life-saving for transgender youth. Medical decisions belong to trans youth, their parents, and their doctors. Yet politicians are trying come between trans youth and the care they need. In 2020, 15 states introduced legislation that would ban — and in some instances criminalize — access to health care for transgender youth. The Arkansas legislature passed such a bill into law on March 29 — though a federal court blocked the law from going into effect — and 19 other states introduced similar legislation this year.
The “Vulnerable Child Compassion and Protection Act” is a damaging bill that, if passed, will have tremendous and lasting negative effects on youth. I urge other adults — doctors, nurses, teachers, principals, counselors, therapists, and parents and even adolescents to educate others and speak out on the negative impacts that this act will have on the health of adolescents who identify as transgender or have dysphoria. If this bill were to become law, it would set a terrible precedent that could be replicated in other states. It would go against the solemn promise that I made when I became a physician: “first do no harm.”
Pediatrician Dr. Michele Hutchison (Arkansas)
To me, these bills are intended to insinuate that the care I provide to trans youth is harmful and abusive, and they interfere with the doctor-patient relationship. Let’s be clear; I provide lifesaving treatment that improves health, life, and well-being. I approach decisions about treatment carefully over time, with input from an interdisciplinary team, together with youth and their caregivers, and by established guidelines.
Our research team from Harvard Medical School and the Fenway Institute published a study showing that access to puberty blockers during adolescence is associated with lower odds of transgender young adults considering suicide. Despite fearmongering, these are safe medications that doctors have been using for decades for cisgender children who go through puberty too early. They also are reversible — if the medication is stopped, puberty will progress.
These doctors are not alone. Major medical oppose efforts to block this critical care.
The American Academy of Child and Adolescent Psychiatry (AACAP) supports the use of current evidence-based clinical care with minors. AACAP strongly opposes any efforts — legal, legislative, and otherwise — to block access to these recognized interventions. Blocking access to timely care has been shown to increase youths’ risk for suicidal ideation and other negative mental health outcomes.
The American Medical Association views these bills as a dangerous legislative intrusion into the practice of medicine and has been working closely with state medical associations to vigorously oppose them. In letters to legislators, the AMA has emphasized that it is “imperative that transgender minors be given the opportunity to explore their gender identity under the safe and supportive care of a physician.”
These three groups signed onto a along with the American Counseling Association, American Public Health Association, American School Counselor Association, American School Health Association, Child Welfare League of America, Mental Health America, National Association of School Nurses, National Association of School Psychologists, and the National Association of Social Workers:
As organizations committed to serving the best interests of all youth, we are deeply alarmed at the torrent of bills introduced in state legislatures around the country this year that would directly harm transgender people, and particularly transgender youth. These appalling proposals would compromise the safety and well-Âbeing of the young people we all have the duty and obligation to support and protect. All of our nation’s children deserve equal protection and treatment when accessing health care, and when attending school. These anti-Âtransgender bills promote discrimination and do harm to students, their families, and their communities.
Organizations representing over half-a-million medical experts asked Arkansas Governor Asa Hutchinson to veto the anti-trans health bill, HB 1570.
Our organizations, which represent nearly 600,000 physicians and medical students, oppose any laws and regulations that discriminate against transgender and gender-diverse individuals or interfere in the confidential relationship between a patient and their physician. That confidentiality is critical to allow patients to trust physicians to properly counsel, diagnose and treat.
Letter from Child & Adolescent Psychiatry Organizations
To protect the lives of vulnerable youth, the 50 physician members of the Arkansas Council on Child and Adolescent Psychiatry, and the nearly 10,000 members of the American Academy of Child and Adolescent Psychiatry write in strong opposition to HB1570, and we ask that you veto the legislation…Should HB1570 become law, the lives of some of our patients will be put at risk. Gender diverse youth, as well as adults, who identify as transgender have high rates of mental health disorders including depression, anxiety, eating disorders, self-harm, and suicide in large part due to adverse experiences and stigma resulting from their gender identity.
Trans youth know who they are. that providing gender-affirming care is life-saving by dramatically reducing depression and suicidal ideation.
As Cash, a trans man in Arkansas, said to lawmakers before they passed a bill banning care for trans youth:
“Trans people have always been here. We will always be here, and you cannot erase us. Please stop trying.”
Passing these bills won’t stop any trans youth from being trans. They will prevent some trans youth from growing up at all.
Five Things to Know About Gender-Affirming Health Care
Here’s what transgender youth, their parents, and doctors have said about Arkansas’ ban on gender affirming care.
Source: American Civil Liberties Union
If you or someone you know is contemplating suicide, there is help available. Please contact:
Trevor Project: 866-488-7386
Trans Life Line: 877-565-8860
Learn More About the Issues on This Page
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Press ReleaseDec 2024
LGBTQ Rights
President Biden Must Veto Defense Bill Attacking Military Families with Transgender YouthPresident Biden Must Veto Defense Bill Attacking Military Families with Transgender Youth
WASHINGTON — The U.S. Senate today passed a version of the National Defense Authorization Act that would ban coverage for gender-affirming care for transgender youth whose parents are active-duty military personnel. The American Civil Liberties Union is opposing final passage of the defense bill over the inclusion of this health care ban and calling on President Joe Biden to veto the bill. Section 708 of the NDAA would prohibit insurance coverage for “medical interventions for the treatment of gender dysphoria” such as hormone therapy and puberty-suppressant medications, which Speaker Mike Johnson says would “permanently ban transgender medical treatment for minors.” The same treatments would be covered by TRICARE for any medical purpose other than treating gender dysphoria, the clinical diagnosis for the psychological distress experienced by transgender people related to their gender identity. “By passing this bill, the House and Senate are forcing thousands of active-duty service members to choose between their careers in the military and the future of their transgender children,” said Mike Zamore, national director of policy & government affairs at the ACLU. “This unconscionable and unjustifiable attack on those families stands in direct contrast to President Joe Biden’s legacy of defending the civil rights of transgender Americans — including when few in his own party showed the courage to do so. President Biden should cement his legacy by vetoing this bill and sending it back to Congress to pass without Speaker Johnson’s last minute health care ban for servicemembers’ kids.” If signed by President Biden, this health care ban would be the first new anti-LGBTQ provision enacted by Congress and signed into law by the president since the enactment of the military’s since-repealed “Don’t Ask, Don’t Tell” policy for LGBTQ servicemembers and the since-repealed federal law barring recognition of same-sex marriages known as the Defense of Marriage Act. It is unknown how many transgender youth are currently enrolled in TRICARE or how many of those enrolled are currently receiving coverage for gender-affirming care. In one 2022 analysis, 2,500 minor patients sought care for gender dysphoria through TRICARE Prime insurance at military or civilian treatment facilities in 2017, and 900 received puberty suppressants or gender-affirming hormones. Earlier this month, the Supreme Court heard oral arguments in a landmark case brought by the ACLU, the ACLU of Tennessee, Lambda Legal, and Akin Gump on behalf of three families and a medical provider challenging a Tennessee ban on gender-affirming hormonal therapies for transgender youth on the grounds the ban violates the Equal Protection Clause of the U.S. Constitution. -
Press ReleaseDec 2024
LGBTQ Rights
Montana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's LicensesMontana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's Licenses
HELENA, Mont. – A Montana court has granted a preliminary injunction preventing the state of Montana from enforcing policies that bar transgender people from obtaining accurate sex designations on their birth certificates and driver’s licenses. After a prior restriction on amendments of birth certificates was struck down by the courts, in early 2024 the state of Montana enacted a new rule that categorically bars transgender Montanans from correcting the sex designation on their birth certificates. Around the same time, the Montana Department of Justice adopted a policy similarly restricting amendment of driver’s licenses. The plaintiffs challenged these policies in state district court, arguing that they violate various constitutional provisions, including the right to equal protection of the law. In a recent Montana Supreme Court decision, two justices concluded that discrimination on the basis of transgender status – as the state is engaging in here – is a form of sex discrimination that violates the Montana Constitution’s equal protection clause. The plaintiffs, two transgender women, are represented by the American Civil Liberties Union, the ACLU of Montana, and Nixon Peabody LLP. Plaintiff Jessica Kalarchik, a veteran who served in the United States Army for 31 years, said: “After finally being able to live my life openly as the woman I know myself to be, I am frustrated that my birth state, Montana, wants me to carry around a birth certificate that incorrectly lists my sex as male. I live my life openly as a woman, I am treated as a woman in my daily life, and there is no reason I should be forced to carry a birth certificate that incorrectly identifies me as male. Fortunately, the court agrees that this ridiculous policy should not be in effect.” “Once again the State of Montana chose to adopt a draconian policy that is clearly intended to marginalize transgender Montanans, only for that discriminatory action to be blocked by the courts,” said Akilah Deernose, executive director for the ACLU of Montana. “Here in Montana we treasure our right to privacy and to live our lives free from governmental intrusion. The State of Montana clearly has not learned any lessons from the past few years, where courts have repeatedly struck down unconstitutional laws targeting transgender Montanans.” “Forcing anyone to carry documents that contradict their identity unjustly violates their rights to privacy, equal treatment, and not being compelled to convey a government message about their sex that they disagree with,” said Malita Picasso, staff attorney for the ACLU’s LGBTQ & HIV Project. “Such a policy marks transgender people for further mistreatment and discrimination, essentially requiring them to carry papers that out them as transgender any time they need to provide identity documents. Fortunately, the court has refused to allow the state of Montana to subvert the freedom of transgender Montanans to control their own identity as this case goes forward.” In granting the plaintiffs’ motion for a preliminary injunction, the court held, “[i]f the challenged state actions discriminate against transgender individuals on the basis of their transgender status, they also necessarily discriminate the basis of sex.” The state has the option of appealing the district court’s ruling to the Montana Supreme Court, but the underlying case will proceed in district court. A trial has not yet been scheduled. -
FloridaDec 2024
LGBTQ Rights
Keohane v. DixonKeohane v. Dixon
On September 30, 2024, the Florida Department of Corrections rescinded its policy regarding treatment of gender dysphoria, which allowed for hormone therapy when deemed medically necessary, as well as access to clothing and grooming standards that accord with one’s gender identity. Under this new policy, grooming and clothing accommodations have been stripped away, and hormone therapy is not permitted unless an exception is deemed constitutionally required. The ACLU brought a class action challenging the policy. -
IdahoDec 2024
LGBTQ Rights
Robinson v. LabradorRobinson v. Labrador
Two incarcerated transgender women have sued the state of Idaho alleging that HB 688, a 2024 law barring state funding for gender-affirming medical care for transgender people, denies them access to the health care their doctors have prescribed for them and is a violation of their Eighth Amendment right to be free from cruel and unusual punishment. They represent a class of all incarcerated folks within the state of Idaho who face the loss of hormone therapy due to HB 668.