Opinion: Lifesaving Gender-Affirming Care Is in Danger. How Can We Save It?

Dozens of bills threaten to hinder gender-affirming care access. Here are at least three actionable steps to preserve it.

hand with gavel coming down on a lit rainbow candle
To save gender-affirming care, two researchers recommend expanding virtual care, providing financial support, and putting trans rights on the ballot. Cage Rivera/Rewire News Group illustration

The mounting attacks on gender-affirming care have hindered transgender and nonbinary youth from accessing medical and social services. As of May 22, 25 states—home to 39 percent of U.S. transgender youth—have enacted laws and policies that make it harder for trans youth to access life-saving gender-affirming care, according to KFF.

Research has shown a connection between access to gender-affirming care, including non-surgical options like puberty blockers and hormones, and lower odds of depression and suicidality among trans youth, who are also more vulnerable to experiencing poor mental health compared to their cisgender peers. This connection is important to note, especially for young people, because access to care earlier on in adolescence was found to be associated with lower odds of suicidal ideation in the previous year.

Simply put, restricting gender-affirming care not only prevents trans and nonbinary youth from being themselves, but it can also be downright harmful for their long-term health and safety.

We’re from Florida and Arkansas, two states that have tried to institute gender-affirming care bans—though fortunately it’s been blocked temporarily in part and permanently, respectively. We have seen firsthand the harmful effects of politicizing gender-affirming care in our own backyards: Lawmakers across the country are still considering dozens of bills that could put many communities at risk of losing access to gender-affirming care.

We must advocate to keep lawmakers away from a doctor’s office and let all people, including trans youth, make personal health-care decisions with their families and medical providers Transphobia is pervasive in many sectors of society, not just health care, so may this call-to-action lead to inclusion for gender-diverse youth everywhere.

Meeting patients where they are virtually

Young people who identify as trans or gender-diverse already experience higher rates of depression, anxiety, eating disorders, self-harm, and suicide. Gender-affirming care—defined as “medical, surgical, mental health, and non-medical services for transgender and nonbinary people”—supports an individual’s gender identity as a vital component of their holistic health profile. Even social and legal interventions, such as legal name changes and using pronouns that align with their gender identity, can have a positive effect on someone’s psychological well-being.

Health systems are uniquely positioned to provide support for trans and gender-diverse patients, even in states facing legal limitations. Digital mental health and wellness resources can provide a safe space for trans youth, especially as they navigate challenges seeking health care. While the restrictions on gender-affirming care impact medical treatments, mental health care provides a real opportunity to bridge the gap with virtual resources. This is especially vital to people who live in rural communities and may feel socially and emotionally isolated without close access to gender-affirming care providers, even in states that allow it.

For example, Q Chat Space, a project of CenterLink in partnership with PFLAG and Planned Parenthood, is a virtual community whose stated goal is to “help LGBTQ+ and questioning teens find community and connect with peers in a supportive environment.” The chats are moderated by trained facilitators, who make up the staff and volunteer team at LGBTQ+ center youth programs across the country.

Virtual resources like this are cost-effective and can be a stepping stone to get young people connected to even more resources that may be more uniquely tailored to their mental health needs. Institutions—including colleges and universities—have adopted a similar model by having LGBTQ+ centers on campus, but because of recent anti-DEI legislation, some centers are being forced to shut down, further highlighting the growing importance and urgency of fostering community for LGBTQ+ adolescents in the face of dissent.

Providing financial support to patients who need to travel for care

We can’t overstate the stakes of providing gender-affirming care in a timely manner. Without puberty blockers, the onset of puberty—with its slew of irreversible physical changes—can exacerbate feelings of gender dysphoria and the mental health challenges that come with it for trans youth. In states with restrictions and gender-affirming care bans, families are forced to travel to other states for the care and resources they need. This barrier disproportionately impacts low-income trans patients and their families who cannot front the travel costs associated with seeking care.

In the wake of these bans, grassroots mutual aid efforts have been instrumental in providing monetary support for patients to travel to states that offer the full spectrum of gender-affirming care. Nonetheless, financial need persists. Benefactors and family insurance plans could adopt a similar model where they reimburse eligible families for costs related to travel for gender-affirming care across state lines if their state of residence does not provide that care.

Financial assistance for travel-related health costs is not a new concept, as some employer-sponsored health-care plans already provide this coverage for specific procedures, and now increasingly abortion as well in the post-Dobbs era.

Putting trans rights on the ballot in November

This election season, the rights and freedoms of trans and nonbinary people are on the ballot. Electing representatives whose agendas acknowledge the existence and needs of trans youth as opposed to erasing them de-facto with invasive gender-affirming care bans is the bare minimum.

Trans youth live in fear that they will lose access to the care that allows them some peace of mind in a world that directs vitriol toward them. Gender-affirming care gives them the opportunity to feel like themselves so that they can spend more time doing what they love instead of being embroiled in politics. Even in “blue states” like California, conservative activists and Republican lawmakers are pushing anti-trans initiatives that specifically target young people.

Clinicians, donors, institutions, and advocates can all work together to push for policies and laws that make the country a safer place for transgender and nonbinary youth. Gender-affirming care is health care. It saves lives, and it is here to stay.