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June 20, 2022

Transgender Youth and Access to Healthcare

By Elaine Yap

Despite recent evidence showing that debates regarding the restriction of transgender persons’ rights have negatively impacted LGBTQ+ youth mental health[1] and that physicians generally oppose legislation that interferes in or criminalizes patient care,[2] state legislatures across the United States have introduced and, in some cases, even passed bills that deny transgender youth access to best-practice medical care by criminalizing physicians for providing gender-affirming care. While not all of the proposed bills have passed[3], these anti-transgender politicians have continued their assault on the rights of transgender persons.[4]

As of April 7, 2022, Gov. Kay Ivey of Alabama signed SB184 and HB322, which makes it a felony to provide gender-affirming medical treatment to transgender youth under the age of nine, a crime punishable by up to 10 years in prison.[5] This bill adds to the anti-transgender laws already enacted by Arkansas and Tennessee. On April 8, 2021, Tennessee’s General Assembly adopted and passed Senate Bill 126, which “prohibits a healthcare prescriber from prescribing a course of treatment that involves hormone treatment for gender dysphoric or gender incongruent prepubertal minors. . . .”[6] As of Feb. 2, 2022, Tennessee Representative John Ragan introduced HB 2835, which seeks to ban gender-affirming surgeries for minors and would impose penalties on any medical provider who provided this type of medical care.[7] Also in February, Texas Gov. Greg Abbott ordered the Texas Department of Family and Protective Services “to investigate child abuse claims filed against parents who might be providing their transgender children with gender-affirming medical care.”[8] On March 23, 2020, the Arkansas Senate passed a bill that bans access to gender-affirming care for transgender minors, including puberty blockers and hormones, which impacted about 1,450 young people above the age of 13.[9]

Although proponents of anti-transgender laws have been unrelenting, the Alabama, Arkansas, and Texas laws have faced pushback from the federal court system based on the argument that these laws violate the equal protection clause of the U.S. Constitution’s Fourteenth Amendment.[10] Additionally, lawmakers from states like California, New York, and Minnesota have coordinated a response to protect transgender youth’s access to gender-affirming medical care.[11] While federal courts and LGBTQ+ supportive states have assisted in protecting the rights of transgender persons, the crusade against transgender rights have led many to call for federal legislation, such as the Equality Act, which would prohibit discrimination based on individuals’ sexual orientation or gender identity.[12] 


[1] “The Trevor Project reported that between January and August 2021, crisis contacts from LGBTQ youth in Texas seeking support increased 150% compared with the same time period in 2020. Many transgender and nonbinary youth stated they were feeling stressed, using self-harm, and considering suicide due to anti-LGBTQ laws being debated in their state.” https://www.americanprogress.org/article/the-2022-legislative-landscape-for-lgbtqi-rights/?msclkid=dea078a0cfb311ec83766f88b303a63a

[2] https://www.psychiatry.org/newsroom/news-releases/frontline-physicians-oppose-legislation-that-interferes-in-or-criminalizes-patient-care

[3] On March 9, 2021, a bill to amend the South Carolina code of laws was submitted to “prohibit the performance of a medical procedure or the prescription or issuance of medication, upon or to a minor, that is intended to alter the appearance of the minor’s gender or delay puberty, with exceptions; to create criminal penalties.” As of May 9, 2022, this bill is still in committee in the South Carolina House of Representatives. https://www.scstatehouse.gov/billsearch.php?billnumbers=4047&session=124&summary=B. On Aug. 9, 2021, a bill was submitted to the Texas Legislature that would prohibit liability coverage to a physician who conducted gender-reaffirming surgery. https://capitol.texas.gov/BillLookup/Text.aspx?LegSess=872&Bill=HB133.

[4]For example, a number of states have introduced laws that would prohibit transgender women and girls from competing on teams that align with their gender identity, often including intramural and club teams. See https://legislature.idaho.gov/wp-content/uploads/sessioninfo/2020/legislation/H0500.pdf, https://trackbill.com/bill/tennessee-house-bill-3-local-education-agencies-as-enacted-requires-that-a-students-gender-for-purposes-of-participation-in-a-public-middle-school-or-high-school-interscholastic-athletic-activity-or-event-be-determined-by-the-students-sex-at-the-time-of-the-students-birth-as-indicated-on-the-students-original-birth-certificate-amends-tca-title-49/1952530/; https://www.flsenate.gov/Session/Bill/2021/1475/?Tab=BillHistory

[6] https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=HB1027&ga=112

[9] https://www.nbcnews.com/feature/nbc-out/arkansas-passes-bill-ban-gender-affirming-care-trans-youth-n1262412?msclkid=1696407ccfb811ec8683ab7245d96b16

[11] https://www.msn.com/en-us/news/us/u-s-lawmakers-in-16-states-to-introduce-laws-to-protect-transgender-youth/ar-AAWSUbL?ocid=BingNewsSearch

[12] https://transequality.org/blog/the-equality-act-what-transgender-people-need-to-know?msclkid=667c1e92cfc111ec84ffeb53e8d9a822