In the first 3 months of the 2023 legislative session, 430 anti-LGBTQ bills have been proposed in the United States. The majority of these bills are anti-transgender and specifically target free speech, education, civil rights and especially health care. In just the past 7 weeks, 19 of these bills have been signed into law in 10 states, stripping away the rights of parents, children, and their medical providers. Hundreds of additional laws, in nearly all 50 states, are under consideration. These laws (both proposed and passed) outlaw gender-affirming care, ignoring the clinical recommendations of every major medical organization, including the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the Endocrine Society, the American Medical Association, the American Psychological Association and the American Psychiatric Association.
I am a midwesterner, where we are supposed to politely avoid talking about politics, religion or money. I am a startup co-founder, where we are supposed to avoid alienating customers that may have different political beliefs. But at my core, I am a parent and a clinical psychologist who is saddened, angered, and deeply worried about how these new laws, driven by misinformation, fear-mongering, and transphobia, will hurt my patients, my colleagues, and my loved ones.
At Equip, we are honored to have already served over 150 children and adolescents that are transgender or non-binary. Transgender individuals experience eating disorders at rates significantly higher than cisgender individuals. (For those of you new to learning about gender identity, cisgender describes people whose gender corresponds to their sex designation at birth.) Recent studies have shown that 10-30% of transgender individuals will develop an eating disorder, compared to 2-5% of their cisgender peers.
Additionally, over 40% of transgender people report having attempted suicide at some point in their lives, a rate exponentially greater than the rest of the population. As a clinical psychologist, it is easy to see how thoughts of suicide, common in over 80% of transgender people, have been tied to the rampant discrimination and mistreatment they experience in education, housing, and employment; the rejection many experience from families and communities; the elevated levels of violence perpetuated against them; and the lack of access they have to healthcare.
These new laws codify the same discrimination and mistreatment of transgender people that make their lives feel unlivable. These laws tell them that they can’t wear what they want to wear. These laws tell them they can’t receive the evidence-based medical and behavioral health care that they seek, their parents desire, and their doctors advise. These laws tell them that they can’t learn about other people like them in school. And many of these laws permit and encourage housing, employment, and commercial discrimination against them. As a clinical psychologist and a human being, it is terrifying to watch our state governments make laws that we know will harm people's physical and psychological well being, while having absolutely no benefit for our society.
As both a clinician and a parent, I’m terrified by politicians' intrusion in our personal healthcare decisions and their blatant disregard of experts and clinicians. For weeks, I have not been able to stop thinking about Pastor Martin Niemoller’s poem, First They Came.
First they came for the Communists
And I did not speak out
Because I was not a Communist
Then they came for the Socialists
And I did not speak out
Because I was not a Socialist
Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist
Then they came for the Jews
And I did not speak out
Because I was not a Jew
Then they came for me
And there was no one left
To speak out for me
These laws take away the rights of parents. These laws say that politicians know more than physicians, researchers, and medical experts. Do you see the slippery slope? It takes only a one-minute Google search to find misinformation about ADHD medication. There are already politicians that think stimulants, like Ritalin and Adderall, are “harmful to children”, “equivalent to meth”, and “a gateway to drug abuse and addiction.” Thankfully, there is not (yet?) a politician sitting with me, my husband, and our child in our doctor’s office discussing the medication that we all agree has drastically improved his social and educational experience. The same negative rhetoric and debate exists around prescribing children antidepressants and antianxiety medications. There are current lawmakers who have been vocal about their opposition of these medications for minors-and I’m glad that they too weren’t in the room with our medical team when we all decided that our other son needed Zoloft in 2nd grade when his anxiety was robbing him of enjoying life.
But for both of our sons, while there are currently politicians that would object to their doctor’s evidence-based recommendations, they would not reject my children as humans. These laws targeting the human rights of transgender people not only rob them of evidence-based healthcare and the autonomy to make medical decisions for their family, but they also rob transgender people of their humanity.
And so while I am sad as a clinician and worried as a parent, I am mostly outraged–as a friend, a colleague, and a loved one to the many transgender and nonbinary people in my life. They are kind and brilliant and funny and deserving and HUMAN. I hope that we can all unite in our shared humanity to stop the dehumanization of our peers, and replace the fear mongering with our shared belief that we all deserve the same human rights.
To combat this legislation, there are a few actionable steps you can take in your communities and beyond:
1. For my peers in healthcare: hire transgender people, train providers in gender-affirming care, support your transgender patients, and create explicit gender affirming care protocols to enable providers to put their training into practice. Over the past three years, Equip has learned from, consulted with, and hired people from some of the organizations below. Please reach out if we can be helpful and/or if you have suggestions on other organizations.
2. To support transgender people in accessing healthcare during these unprecedented times or simply to learn more, here are a few resources:
- FEDUP Collective, a transgender and intersex run group providing direct support, case management, and advocacy to impacted communities.
- Trans Health Legal Fund, a legal defense fund for those criminalized for accessing gender-affirming healthcare.
- Trans Week of Visibility and Action (TWVA), a website with specific action for Mar 25-31, the third annual TWVA
- Project HEAL, an eating disorder non-profit providing earmarked funds specifically for transgender and intersex people to access care.
- American Civil Liberties Union, a nonprofit organization founded in 1920 to defend and preserve civil rights and liberties.
- Erin in the Morning’s substack, a great resource for accurate up-to-date information.
- Queer Legislation Alerts, real-time updates as bills either move or are defeated.
3. You can reach out to your state representatives to make your voice heard. You can look up your state legislators here. Click on their name to get their contact information and call or email your representatives. We have drafted emails here.
4. Importantly, check on your friends and colleagues who are transgender, or who have transgender kids and loved ones, to see how they would best feel supported during these times. They may need you to listen and process fears, and they may need you to participate with them in joyful resistance.