Over the last two years, legislators in at least 21 states have tried to limit or block gender-affirming health care for trans, non-binary, and questioning kids. Last month, Texas became the latest state to make a move, with Governor Greg Abbott declaring that providing gender-affirming care to adolescents was child abuse.
These policies not only take away our rights; they’re also, at a very basic level, telling us how to raise our kids. This, despite excessive scientific evidence that such laws directly harm the health of our children.
The most recent study published by the Journal of the American Medical Association last week found that giving teens aged 13-18 gender-affirming medical care slashed their rate of moderate to severe depression by 60 percent, and their odds of suicidality by 73 percent over a 12-month period. To put it another way: gender-affirming health care literally saves kids’ lives.
This was just the latest in a string of studies that show that gender-diverse kids thrive under gender-affirming care. A 2021 study conducted by the Trevor Project found that gender-affirming care cut depression and suicide in teens by 40%.
Read more: What This Mom Of A Trans Kid Wants You To Know
Scary Mommy spoke with Gina Sequeira, MD, MS, the Co-Director of the Seattle Children’s Gender Clinic, about what gender-affirming care is, how it’s implemented by doctors, and how it can help gender diverse kids (while Sequeira currently works at the same clinic where the study was conducted, she was not part of the research).
What is gender-affirming care?
Non-medical gender-affirming care is any care that makes kids comfortable embracing their own gender identity, including listening to and accepting your child, using their preferred pronouns, or making sure they have clothes they feel comfy in, Sequeira explains.
Gender-affirming medical care is an offshoot of gender-affirming care that helps adolescent kids define or actualize their gender. In younger teens, this might mean the use of a puberty blocker. In older teens, it could mean receiving estrogen or testosterone.
It’s extremely important to understand that while younger kids often receive non-medical gender-affirming care (like love and acceptance), gender-affirming medical care is only appropriate beginning with adolescents who are starting puberty.
Why are trans kids at such high risk for suicide and depression?
When researchers say that gender-affirming care significantly cuts down on depression and suicidal thoughts in teens, they aren’t just talking about normal levels of mental health issues for all teens (although depression and suicide are extremely important issues at that age in development).
The fact is that trans and non-binary teens suffer from these issues at much higher rates than other kids. How scary is it? According to a study by Trevor Project, a horrifying 52% of LGBTQ teens contemplated suicide in 2020.
“Being an adolescent in general is hard. But being an adolescent that’s trying to fight for being able to play sports or go to the bathroom — these kids are having to fight for some of those basic rights that their cisgender peers are not,” Sequeira explains.
Gender-diverse kids also live under the constant threat of violence and ongoing fear of non-acceptance.
“There’s good data to suggest that trans and gender-diverse kids and adolescents are at higher risk of experiencing harassment, discrimination and outright violence,” continues Dr. Sequeira. “It’s important that we acknowledge when we talk about health disparities, they are rooted in discrimination and violence.”
And this discrimination goes beyond gender identity and sexual orientation — Black and Latinx trans and nonbinary folk are in even more danger and face even more barriers.
Why are people against gender-affirming care?
If research makes it pretty clear that gender-affirming care saves teen lives, why are so many lawmakers rushing to label it as child abuse?
Much like the wave of book banning that’s sweeping the nation, politicians pushing for laws that take away trans rights wish to force their moral views on others regardless of what we know for sure about the topic.
“It’s the ignorance on the part of legislators and outright discrimination,” Dr. Sequeira says bluntly. “The medical guidelines as it relates to the provision of gender-affirming care are very clearly in support of access to this care for youth as is every large major medical organization, including the American Academy of Pediatrics.”
While these politicians say they are acting in the best interests of families or kids, the science and the experts disagree. The laws also take power away from parents and doctors.
“It is so, so clearly not right,” says Sequeira. “It’s removing a parent’s right to be able to make medical decisions for their child in partnership with their physician. It’s horrifying to see.”
What should parents of trans and non-binary teens do?
The two best things you can do are pretty easy: You love your kid and you talk to your pediatrician about what to do next. And what to do next varies greatly depending on a lot of factors, including your kid’s age, their feelings, their environment, and their wishes.
“[Medical providers] make sure that we’re sitting down with a young person and their family to understand their individual goals of care — what distress they’re experiencing related to puberty and then having really thoughtful conversations on an ongoing basis with that young person and with their family about what medical options are available to them,” says Sequeira.
But the love piece is vital to have in place throughout the process.
“First and foremost, love your kid,” says Dr. Sequeira. “But what does that look like in practice? It’s listening to your child and letting them to take the lead, letting them know that regardless of how they identify, you’re going to love them and support them. That you have their back and you’re going to do everything that you can to make sure that the environments that they’re in — be that at home, at school, in their communities, during activities —that you’re going to do everything you can to create affirming and supportive environments.”
Parents can also make sure their kids are called by the right name and pronouns, that they have access to clothes that reflect their identity, or that they have the simple opportunity to get a different haircut.
And make sure you’re enlisting your friends and family to surround your kid with support. In fact, even if you don’t have gender diverse kids, one of the best things you can do right now is support those kids in your life.
“I think knowing that they have other adults in their life that are gonna do everything in their power to fight against [discrimination] is really an important thing for trans and gender diverse kids right now,” she says.
If you are currently having suicidal thoughts, please call the National Suicide Prevention Hotline: 1-800-273-TALK (8255).
