Young people deserve to feel supported and loved. They deserve access to affirming and inclusive health care; to caring adults who fully support and honor their development; to schools that promote their growth and learning; and to communities and friends that respect and support them.
Unfortunately, despite knowing what young people need, policymakers in many states are doing the exact opposite, passing law after law targeting transgender, non-binary, and gender expansive young people. As of September 2024, the ACLU is tracking 530 anti-LGBTQ+ bills in state legislatures across the country.* Many of these laws target gender-affirming care; more than three-quarters of youth who identify as transgender live in one of the 40 states that have passed laws or have pending bills that limit access to gender-affirming care. These laws, which target children, youth, parents, teachers and health care providers, not only deny transgender, non-binary, and gender expansive young people basic health rights, but signal to young people that they are not safe, accepted, or supported. In doing so, they create an all-out assault on the health and well-being of young people across the country.
These bans only compound the challenges transgender, non-binary, and gender expansive young people already face, particularly youth of color, as they navigate health systems. In a 2022 survey of transgender and nonbinary young people, 32 percent of respondents, including 46 percent of young people of color, reported being refused medical care by a health care provider in the past year. Twenty-one percent of respondents, including 28 percent of young people of color, reported that a health care provider refused to provide reproductive or sexual health services due to their gender identity. And, research suggests that transgender participants are more likely to delay care and report negative effects of disclosure to their provider compared with cisgender participants.
States’ efforts to make accessing gender-affirming care nearly impossible are actively harming young people. These bans make it impossible for transgender, non-binary, and gender expansive young people to be themselves, and research shows that they exacerbate existing mental health concerns and create new ones. They have resulted in increased anxiety, depression, and suicide risk among young people.[1],[2],[3] A recent study published in Nature highlights the devastating impacts of anti-trans legislation in states, finding that these bans—a collection of laws that restrict rights including access to gender-affirming health care—lead to a 72 percent increase in suicide attempts among transgender individuals, compared to states without such legislation.
Gender-affirming care has been available for decades and research shows it lowers the odds of depression and suicide,[4] and is described as medically necessary by major medical organizations. Yet this care is no longer accessible for young people who live in one of 26 states that have passed bans on gender-affirming care, unless their family has the resources to seek help in another state. And for those in foster care, it may not be an option if they live in one of several states that has recently moved to implement or consider actions aimed at limiting access to gender-affirming health care in Medicaid, particularly for youth.
These bans are hurting young people. They signal a broader rejection of their identities and bodies, communicating that they are neither valid nor deserving of protection. We need to eliminate policies—including bans on gender-affirming care—that marginalize or diminish any aspect of a young person’s identity, and in its place, we must establish policy that centers young people by recognizing and respecting their full identities. We owe young people protective policies that support and affirm their rights and promote their health and well-being.
* This data reflects estimates as of August 2024 and includes youth ages 13-17. It includes 2,300 youth living in Arkansas and Montana where bans are currently on hold or blocked from enforcement through court orders.
[1] The Trevor Project. 2023 U.S. National Survey on the Mental Health of LGBTQ Young People. Available at: https://www.thetrevorproject.org/survey-2023/
[2] Novotney, A. (June 29, 2023). ‘The young people feel it’: A look at the mental health impact of antitrans legislation. Available at : https://www.apa.org/topics/lgbtq/mental-health-anti-transgender-legislation
[3] https://www.nature.com/articles/s41562-024-01979-5.epdf?sharing_token=EbX7LsH7-AF5n99850vpnNRgN0jAjWel9jnR3ZoTv0PNveFlXHsicuqelg3jvg1Wcsju1CXHxspC9onbX6frEcU1-J5M25Ml5piLTNjBr959LGK7ejPr20VtTVSb18ArMlJnGNGgZYyU9CJQoJuUjN01H4VVGluDqO_epnWIg_A=
[4] Tordoff, D.M., Wanta, J.W., Collin, A., Stepney, C., Inwards-Breland, D.J., Ahrens, K. (2022). Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Netw Open, 5(2):e220978. doi:10.1001/jamanetworkopen.2022.0978. Available at: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423