Charlie Apple had seen people questioning his humanity, suggesting he was just a confused child or even a moral aberration. As a transgender teenager, he had accepted that his future could include discrimination, verbal abuse and violence. The sense of peace he said he felt during the physical transition, however, was worth the risk.
Still, it was particularly painful last year, Apple said, when Texas lawmakers used the same kind of dehumanizing language he’d heard on the playground as they debated whether to refuse. to trans children everything from participation in sports to gender-affirming medical care.
“Seeing these people who are supposed to protect you, who are supposed to make laws to protect children, say all these horrible things and make it clear that you’re not worth fighting for?” says Apple, 18, who testified with his parents against several anti-trans bills in Texas. “That’s a whole other thing.”
State legislators across the country have introduced a registration number of anti-transgender bills in 2021, many of which specifically target trans youth. Texas lawmakers proposed nearly 50 such bills, including an unsuccessful bill who could have sent parents to jail and placed their children in foster care if they had approved gender-affirming treatments. In the first week of 2022 alone, lawmakers in at least seven states legislative proposals targeting LGBTQ+ youth. On February 3, South Dakota Governor Kristi Noem signed a bill that would ban transgender girls and college-aged women from playing on women’s sports teams. It becomes the 10and State to enact such a ban.
The debate is not limited to the United States. In 2020, three judges from the United Kingdom the high court ruled against the use of puberty blockers for those 16 and under, saying young people were unlikely to be able to give informed consent. The decision was overthrown in September 2021.
As health care providers continue to discuss best practices, the broader debate outside of medicine amid these legislative efforts to restrict access to care is having a detrimental impact on transgender youth, said Dr. . Aron Janssenvice president of Lurie Children’s Hospitalfrom the Chicago Department of Psychiatry and Behavioral Health.
“These are children who are already quite vulnerable. We know that suicide rates among transgender youth are incredibly high,” Janssen said. “We anticipate that legislative efforts created to reduce access to life-saving care will have negative consequences.”
In a survey of Project Trevor conducted last fall, 85% of LGBTQ+ youth said recent debates over anti-trans bills had negatively affected their mental health. In a survey conducted in 2020the nonprofit that serves LGBTQ+ youth and focuses on crisis intervention, found that 42% of LGBTQ+ youth said they had seriously considered suicide in the past year, including more than half of transgender and non-binary youth.
“What worries me is that something that significantly and documented harms the health and well-being of LGBTQ youth would be seen as a very effective political tactic and fundraiser,” said Casey Pick, Senior Researcher for Advocacy and Government Affairs at the Trevor Project. “It scares me that young LGBTQ people are being sacrificed to a political process.”
Over the past year, Pick said, Project Trevor’s digital lifeline and crisis services have received more than 200,000 calls, emails and texts from across the country, including about 14,500 from the Texas.
“Our position at Texas Values, and with our research, is that children should not have access to puberty blockers, cross-sex hormones, or gender transition surgeries,” she said. “A lot of these kids who claim to be experiencing gender dysphoria are dealing with the normal issues that tweens face, just realizing themselves and finding their identity.”
Many medical associations, including the American Academy of Pediatricsthe American Medical Associationthe Pediatric Endocrinology Societyand the American Psychiatric Association, have endorsed gender-affirming care.
The heightened political heat had repercussions. The Texas Department of Family and Protective Services removed from its website a resource page for LGBTQ+ youth that included information on suicide prevention and the Trevor Project hotline after criticism from a conservative Texas gubernatorial candidate. At least one Texas School District also reportedly blocked access to LGBTQ+ resources, such as the Trevor Project, but reinstated some after student protests.
These setbacks are particularly concerning, Pick said, because LGBTQ+ children are overrepresented in the child welfare system and are less likely than other children to have access to appropriate mental health and medical care or internet access outside of school or child protection agencies childhood. Compared to their peers, LGBTQ+ children who have been in foster care also are more likely to report having attempted suicideaccording to the Trevor project.
“No matter what they think of trans youth, and whether it’s real or not, you’d think they would want to prevent suicides,” said Laura Edwards-Leeper, a clinical psychologist from Oregon who helped found an American clinic offering medical assessments and interventions for transgender youth. “If they really cared about young people, they would put their energy into allocating more resources to areas that are lacking on the pitch.”
Edwards-Leeper advocated for better training of therapists and increased diligence in exploring mental health issues beyond gender identity before a patient begins medical interventions such as puberty blockers. and cross-sex hormones. But, she says, medical intervention is appropriate for some young people.
“My feeling is that these things, especially the treatment of these children, should not be left to the courts or to lawmakers,” Edwards-Leeper said. “It really should be in the hands of mental health and medical providers who are trained to do this job.”
dr. Jason Raffertya Rhode Island pediatrician and psychologist who wrote a 2018 American Academy of Pediatrics policy statement on supporting trans children, said current political rhetoric and legislation is not based on science. Medical protocols for transgender people are nothing new, he said, adding that politicizing the provision of medical care to transgender youth is both inappropriate and harmful.
“By taking away books or banning websites, you can’t erase people’s experiences,” he said. “Children still feel what they feel; they now feel more isolated and alone and will not have these references to help them normalize their feelings as part of the human experience. It’s scary when it comes to emotional and psychological health and development.
In Tucson, Arizona, Lizette Trujillo, who has a 14-year-old transgender son, said she was very good at overcoming social barriers as the American-born daughter of Mexican immigrants. But when her son came out as transgender, she and her husband feared their child would be further marginalized.
Trujillo learned how to locate safe businesses and neighborhoods for his son. Still, he dealt with anti-trans slurs at school. And, she says, it’s getting harder and harder.
“There’s this exhaustion and disappointment that we’re still having these same conversations and these same fights over and over again,” Trujillo said.
Ultimately, the legislation and surrounding discourse targets children, said Dr. Terrence Weedenresearcher in adolescent medicine at Lurie Children’s Hospital.
“It’s just who these kids are, these young people,” Weeden said. “They didn’t wake up one morning and decide, ‘Hey, I want to be part of this community that’s ostracized, looked down upon, mocked, that’s isolated.'”
Despite concerns about the impact of future legislation and surrounding rhetoric on LGBTQ+ youth, Apple remains hopeful that things can get better.
“I’m human and I’m also trans,” he told KHN. “I am a mosaic of experiences and identities, of joy and sorrow, of happiness and love, just like you. Seeing ourselves as the multifaceted human beings that we are is the first step in the fight against that.
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