Access to this care is under threat in several states.


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For transgender people, gender-affirming hormone therapy is one of several medical interventions that can help align an individual's gender identity and physical characteristics. New research indicates that making this therapy available during adolescence, rather than waiting until adulthood, could result in better mental health outcomes.

Figure. Quinncy Park... - Click to enlarge in new windowFigure. Quinncy Parke, 17, testifies to the South Dakota House State Affairs Committee against a bill to make it illegal for physicians to give gender-change treatment to children under age 16. Photo by Stephen Groves / AP Photo.

In a study published in PLoS One in January, researchers analyzed data from 21,598 adult participants in the 2015 U.S. Transgender Survey who reported ever wanting gender-affirming hormone therapy. They found that, compared with individuals who started hormone therapy as adults, those who started between ages 14 and 17 had a lower likelihood of past-month suicidal ideation, past-month severe psychological distress, and past-month binge drinking, as well as a lower lifetime risk of illicit drug use.


The findings come amid efforts in several states to ban or restrict gender-affirming health care to transgender minors. Last year, 10 state legislatures were considering such legislation, according to the Williams Institute at the University of California, Los Angeles, School of Law. With some exceptions for intersex children, most of the proposed bills establish criminal or professional penalties for health care providers who deliver gender-affirming care, and several would penalize parents who seek it on their child's behalf. Only Arkansas's legislature has passed such a law, overriding the governor's veto. But the law, which bars minors' access to "gender transition procedures," was blocked from taking effect last summer by a federal court order, pending resolution of a lawsuit filed by the American Civil Liberties Union (ACLU) on behalf of four transgender teens and two physicians. In February, Texas governor Greg Abbott issued a directive to investigate and report gender-affirming care as child abuse.


Major medical organizations, including the American Medical Association, American Psychiatric Association, American Academy of Pediatrics, and American Academy of Child and Adolescent Psychiatry, have voiced opposition to legislation against gender-affirming care for transgender youth. In support of the ACLU's lawsuit in Arkansas, these organizations and several others-including the National Association of Pediatric Nurse Practitioners (NAPNAP)-jointly filed an amicus brief outlining the evidence on gender-affirming care for teens. In its announcement about the brief, NAPNAP stated that "providing evidence-based support to overturn the Arkansas law . . . is a critical step in preventing negative health outcomes for transgender youth and improving health disparities in Arkansas and across the country."-Diane Szulecki, editor