The Texas order to investigate gender-affirming care as a form of child abuse goes against guidance from all relevant medical organizations and will cause serious damage ‘by the mere fact of the utterance,’ say Northwestern experts. Three professors explain how viewing gender-affirming treatments as child abuse could worsen depression among transgender youth, and why investigating LGBTQ families follows a similar vein heard across history.
Brian Mustanski is the director of the Institute for Sexual and Gender Minority Health and Wellbeing and a professor of medical social sciences and psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine.
Dr. Sumanas Jordan is the director of the Gender Pathways Program at Northwestern Medicine, which gathers providers to coordinate care for trans and non-binary patients, and an assistant professor of plastic surgery at Feinberg.
Marquis Bey is assistant professor of African American studies and English at Northwestern and author of the forthcoming book, “Cistem Failure” (Duke University Press), on the antagonistic relationship between blackness and cisgender.
‘Gender-affirming care saves lives’
“Gov. Abbott’s order has the potential to cause serious distress and harm to trans and non-binary young people in Texas,” Mustanski said. “Contrary to what Gov. Abbott claims, gender-affirming care for transgender people saves lives.
“Research tells us that gender-affirming health care reduces depression and thoughts of suicide among transgender people. Trans and non-binary young people under the age of 18 who receive gender-affirming hormone therapy, for example, report fewer suicide attempts than those who want but are not receiving hormone therapy.
“We also know that when LGBTQ young people have supportive adults in their lives, they are more likely to thrive. By calling on state agencies to investigate parents and medical professionals who provide gender-affirming care to their trans kids and patients, Abbott also threatens to remove critical familial and social supports.”
Health care decision-making at the state’s mercy
“It's not good for these young patients and their families, but it's also retraumatizing the entire transgender community as adults think back to when they came out,” Jordan said.
“The directive also takes health care decision-making away from families and doctors and places it in the hands of the state,” Mustanski said.
“These efforts are inconsistent with guidance from all relevant major health organizations — including the American Medical Association, the American Academy of Pediatrics and the American Psychological Association, which say that gender-affirming care is medically necessary for transgender youth,” Mustanski said.
Following a familiar rhetoric
“Many LGBTQ Americans will find the rhetoric in Gov. Abbott’s order familiar,” Mustanski said. “It is simply the latest entry in the particularly ugly history of falsely associating queerness and child abuse. Whereas gay men and lesbians were once cruelly equated to child abusers, today we see Texas leadership accuse adults who ensure transgender young people receive life-saving care of child abuse.”
What can we do?
“If this sentiment were to proliferate — in policy or law, or in others’ interactions — we could see a slew of additional laws as well as an increase in violence for trans youth,” Bey said. “Not only this, but we will also see more agitation to affirm, more forcefully, trans affirmative care. So, not only is there this anti-trans ethos, but there is also always a fight against it that should give us hope, make us not complacent, and demand more justice.
“Continue sharing information about the monumental benefits of trans affirmative care, especially for trans youth who are particularly vulnerable. Organize in the ways that we can; teach and educate as much as we can, in a number of different places; we need to proliferate the overwhelming good that trans affirmation has not just on trans youth and adults, but also those who care for and love trans people.”