Anti-transgender bills threaten to harm the health of trans youth by limiting access to health care, denying access to athletic activities, and contributing to stigma and discrimination

In 2021, lawmakers from 33 state legislatures and assemblies representing every region of the country filed 98 bills that seek to restrict of the ability of transgender and gender diverse youth (TGD) to access health care, school facilities, and school athletics. A policy brief released by Fenway Health examines the potential harms to health that these bills pose to TGD youth—regardless of whether they are enacted into law or not.

You can download a PDF of the brief here.

“We are midway through National Transgender Awareness Month, which is a time to honor, celebrate, and advocate for transgender and gender diverse people,” said Carrie Richgels, lead author of the study and Manager of Policy and Advocacy at Fenway Health. “Despite the many barriers to health and well-being that transgender people face, many politicians are all too willing to play politics with the lives of transgender and gender diverse children and teenagers. We hope this policy brief can be used as a tool by health and legal advocates working to defeat these discriminatory bills.”

Approximately one-third of the bills filed in 2021 relating to TGD youth seek to prohibit or limit access to health care. The remainder seek to prohibit or limit the participation of transgender youth in school sports, with some also seeking to restrict access to public facilities such as school locker rooms and bathrooms.

“It is deeply concerning that at least six Arkansas TGD youth attempted suicide following passage of that state’s new law banning the practice of gender-affirming health care for youth,” said Julie Thompson, PA-C, Medical Director of Trans Health at Fenway Health. “Research shows that public debate about the rights of people who have been marginalized, including TGD youth, can have a significant negative impact on mental health, and these bills harm the health of TGD children and adolescents in three distinct ways. The first is by denying access to medically-necessary health care. The second is by subjecting TGD youth to government-sanctioned stigma and discrimination. The third is by denying access to educational activities and depriving TGD youth of the social, emotional, and health benefits such activities bring. Most troubling is that we now know that that lack of access to gender-affirming health care during childhood and adolescence can harm the mental health of TGD people over the course of their lifetimes, so the impact of these bills to the health of TGD youth will extend well into adulthood.”

“Without exception, these bills are based on bad science, and ignore the consensus of experts in medicine—including endocrinology, psychiatry, and psychology—in support of gender-affirming medical care,” said Sean Cahill, Director of Health Policy Research at Fenway Health.

The American Medical Association, the American Psychological Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the Endocrine Society, and the World Professional Association for Transgender Health have each issued formal, public statements opposing passage of these bills.

“In stark contrast with states like Texas and Idaho that have enacted laws prohibiting transgender youth from participating in sports, the most elite athletic organizations in the world allow transgender athletes to compete in accordance with their gender identity,” Cahill added. “The National College Athletics Association adopted a policy in 2011 that allows transgender women to participate in women’s sports after one year of testosterone suppression. The International Olympic Committee requires transgender women to demonstrate that their total serum testosterone level has been below 10 nmol/L for at least one year prior to competition.”

Lawsuits have been filed in state and district courts challenging the legality of the SAFE Act in Arkansas and other anti-transgender bills that have been enacted into law,” said Mason J. Dunn, JD, Deputy Director, Division of Education and Training at The Fenway Institute at Fenway Health. “While this legal advocacy continues, it is incumbent upon school officials to remember that every child has a right to public education in this country and educators must create school cultures that support all youth, including TGD youth.”

The policy brief, titled “State bills restricting access of transgender youth to health care, school facilities, and school athletics threaten health and well-being,” outlines recommendations for clinicians, parents and other caregivers, school officials, and lawmakers. They include the following:

· Medical providers have a responsibility to be familiar with the most up-to-date scientific and clinical information.

· Parent and other caregivers should create a supportive home environment, connect their child or adolescent with gender affirming health care providers, and collaborate with school officials to create a plan to support your child.

· School officials must

  • Incorporate LGBTQIA+ history into the curriculum for all students.
  • Ensure that all students hear from LGBTQIA+ people, so that young people have a human face and experience to reference and relate to.
  • Establish firm policies around harassment to prevent bullying with clear procedures staff can follow.
  • Create space for kids to meet and interact with other kids like them. Gender-Sexuality Alliance programs allow LGBTQIA+ students and allies to come together in a protected space to share experiences.

“State bills restricting access of transgender youth to health care, school facilities, and school athletics threaten health and well-being” is available here.

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