Health care for transgender people and youth is mainstream care, supported by widespread consensus in the medical and scientific communities and every major medical association.
Judges in six states have issued rulings blocking the states’ restrictions on this essential care, while also dismissing testimony from state witnesses for lacking qualifications and credibility. In addition, lawmakers in at least 13 states have passed laws protecting access to transgender health care.
A review of the facts:
- At least 30 professional organizations have written statements in support of transgender health care that includes the viewpoints of mental and physical health professionals across multiple specialties and disciplines, and across the patient lifespan.
- “Gender affirming” care is widely prescribed to non-LGBTQ people and youth, to zero opposition and concern, including puberty blockers, hormone treatments, and procedures.
- Health care for trans people amd youth begins with social transition and non-invasive steps such as affirming names, pronouns, titles, hair and dress. It does not automatically include, or always lead to, medication or surgical intervention.
- 19 states have proposed restrictions and other policies limiting essential health care, at odds with medical expertise and the lived experience of the vast majority of transgender people, youth and their families, and are being successfully blocked in court in state after state.
- 13 states have passed protections for transgender people to access health care, including many states that have also passed protections for access to reproductive care. “These fights are linked by a really simple belief that each of us are the rightful authors of our own life stories,” said Arli Christian, a campaign strategist focused on LGBTQ rights at the American Civil Liberties Union (ACLU) told The 19th News. “Each of us has the freedom to determine our path in life, each of us has the right to make decisions about our medical care and our bodies without government interference.”
Judges have ruled to block bans on transgender health care in 7 states: Alabama, Arkansas, Florida, Indiana, Kentucky, Tennessee. Oklahoma has agreed to not enforce its ban while a temporary court order blocking it is being pursued. Missouri’s emergency rule restricting access was also blocked by a county judge, before being withdrawn completely.
Arkansas: “Rather than protecting children or safeguarding medical ethics,” U.S. District Judge James Moody, Jr. wrote, “the evidence showed that the prohibited medical care improves the mental health and well-being of patients and that, by prohibiting it, the state undermined the interests it claims to be protecting.” Judge Moody wrote that the state of Arkansas failed to provide evidence of its assertions, and that its witnesses (who have also testified in other state hearings on the subject) lacked credentials and qualifications:
- “The Court does not credit the testimony of Professor [Mark] Regnerus and gives it no weight because the Court finds that he lacks the qualifications to offer his opinions and failed to support them.”
- “Dr. [Patrick] Lappert does not meet the requirements under Daubert to give opinions relevant to this case.”
- “Dr. [Paul] Hruz has never treated a patient for gender dysphoria.”
Florida: U.S. District Judge Robert Hinkle granted a preliminary injunction against Florida Surgeon General Joseph Ladapo, the Florida Board of Medicine, the Florida Board of Osteopathic Medicine and other state leaders, and will allow the parents who challenged the state to access medical care for their transgender children as the ban’s constitutionality is debated in court. Hinkle stated the denial of treatment would cause “needless suffering for a substantial number of patients and will increase anxiety, depression, and the risk of suicide… There is no rational basis for a state to categorically ban these treatments.”
In a separate ruling, Judge Hinkle ruled that the ban on Medicaid paying for hormone therapy and puberty blockers was an equal protection violation, violated federal Medicaid law as well as the Affordable Care Act. He called the restrictions “purposeful” discrimination against transgender people and not a “legitimate state interest.”
[Florida’s new ban on drag performance was also struck down in June, with U.S. District Judge Gregory Presnell noting the measure violated a state law guaranteeing the rights of parents to make decisions in the best interests of their children, and likely violated constitutionally protected free speech while being too vague to enforce.]
Kentucky: U.S. District Judge David Hale: “the Court finds that the treatments barred by SB 150 are medically appropriate and necessary for some transgender children under the evidence-based standard of care accepted by all major medical organizations in the United States.” The ACLU of Kentucky, along with the National Center for Lesbian Rights and law firm Morgan, Lewis & Bockius, noted SB 150 singles out trans kids by blocking access to medical care that cisgender kids can receive. They also say it unjustly limits a parent’s rights to make medical decisions for their children.
Tennessee: U.S. District Judge Eli Richardson issued an order blocking the state from enforcing a ban on gender-affirming medications such as puberty blockers and hormone therapies. Tennessee can enforce its ban on gender transition surgical procedures, which states have failed to show are happening. Judge Richardson’s opinion indicated Tennessee officials have failed to make a convincing case on the constitutionality of the law.
On July 8th, two of three judges on the Sixth U.S. Circuit Court of Appeals in Cincinnati granted an emergency appeal from Tennessee to allow the state’s ban to go into effect. Dissenting Judge Helene White: “I fail to see how the state can justify denying access to hormone therapies for treatment of minor Plaintiffs’ gender dysphoria while permitting access to others, especially in light of the district court’s robust factual findings on the benefits of these treatments for transgender youth.”
“We recognize that other courts and judges have taken different approaches to these issues,” Chief Judge Jeffrey Sutton wrote. “We may be wrong. It may be that the one week we have had to resolve this motion does not suffice to see our own mistakes.”
[Tennessee’s recent ban on drag performance was also struck down in early June, ruled “unconstitutionally vague and substantially overbroad.”]
Missouri: A judge blocked the attorney general’s emergency rule requiring extensive documentation of a need for care, noting patients are at “high risk” of having their medical care interrupted indefinitely and losing care through their current providers if the rule takes effect. The attorney general withdrew the rule; Missouri lawmakers passed a ban in May.
GLAAD’s Fact Sheet on Transgender Health Care includes best practice guidelines for reporters:
- Seek expertise over opinion and include facts from experts in transgender healthcare.
- Seek quotes and background from transgender people in any story about transgender people or youth. Their lived experience is valuable to help readers and viewers understand trans people exist, live full and healthy lives, and receive healthcare that is safe and lifesaving.
- Accurately report the widely-held consensus about the safety and efficacy of transgender healthcare.
- Avoid elevating singular voices or rare cases and concerns in equal weight to the consensus and preponderance of evidence – doing so is inaccurate storytelling.
- Challenge people making negative claims about transgender healthcare to provide facts and evidence for claims. Include fact checks of quotes and claims in your reporting.
- Check for and include critics’ history of advocating against LGBTQ people. The GLAAD Accountability Project has profiles of public figures and groups and their records of targeting LGBTQ people. Evidence-based healthcare is the latest target, as are youth who do not have a voice or desire to be public about their private healthcare.
- Avoid “both sides” reporting. Efforts to restrict or remove evidence-based healthcare are not a “debate” or a “culture war,” they are baseless attacks against transgender people and their private health care, attacks not made against non-LGBTQ people and their care, and not supported by medical professionals who research and treat transgender people. Recognize trans people and youth are people, not a “side,” and like all human beings, want to be themselves and be safe.
- Include the benefits of evidence-based healthcare to the health and wellbeing of trans youth. For example, research shows access to puberty blockers during a transgender person’s adolescence is associated with a significant decrease in suicidal ideation. Doctors have also used these medications safely for decades for cisgender children who experience precocious puberty. The Journal of Adolescent Health found that gender-affirming hormone therapy resulted in lower rates of depression, suicidal thoughts, and suicide attempts among older transgender and nonbinary teens. Using a trans youth’s authentic name and pronouns improves mental health.
- Include research on harms to vulnerable youth from efforts to take away their healthcare. 85% of transgender and nonbinary youth — and 66% of all LGBTQ youth — say recent debates about state laws restricting the rights of transgender people have negatively impacted their mental health.
- Safety and Security Considerations. Confirm if the storyteller is comfortable using their full name, only their first name, or a pseudonym, and sharing their physical identity. Do not expose their location, rather, record in a way that does not reveal addresses, street signs, or clear landmarks.
- Informed Consent. Be clear to transgender storytellers with the specifics of your outlet and audience. Obtain their consent to continue the interview once that information is provided. Ask what areas of their story are off limits. Give them the opportunity to decide what is on record and off record.
Include transgender voices and their families in any discussion about trans people.
GLAAD can connect you to ensure their voices are centered in conversations about their private health care.