I sit across the exam room from a happy, healthy 16-year old boy. His voice cracks just a little as he tells me about the part-time job he just started. His mom and I laugh at his joke about needing stronger deodorant if he’s going to have to work so hard.
It’s hard to believe that this is the same dejected kid who, when I first met him, wouldn’t make eye contact or speak in sentences of more than three or four words. A few months of gender-affirming hormone therapy have placed this family firmly in the light at the end of the tunnel. And now I sit here, across the exam room, preparing to tell them that Indiana legislators are about to take it all away.
I live and work in Indiana, where our governor, Eric Holcomb, just signed SB 480. This bill bans all gender-affirming care for patients under the age of 18. Indiana’s SB 480, and similar bills in states like Kansas, Kentucky and Tennessee, are based on misconceptions about what this care entails.
For most transgender youth, gender-affirming care starts with therapy and simple changes to things like clothing and hairstyle. Once these children reach adolescence, care might include reversible puberty-blocking medications. These medications, often used in cisgender children who start puberty early, put a pause on puberty. This allows trans youth and their families time to explore gender identity, have conversations with their providers and chart a course for their care. This course may eventually include hormone therapy that would allow the child to enter the puberty of their affirmed gender.
I head home from work, the concerned words of my patient’s mother ringing in my head. Not only will SB 480 take away this child’s potentially lifesaving care, it will prohibit providers like me from referring these patients out of state for care. This bill will hamstring providers in our state. Physicians and advanced practice providers will be forced to ignore evidence-based care. They will be forced to act as if there is no safe and effective option for these patients. The mental health counselors who see these patients will be equally restricted in their care.
Some states face even more chilling effects on transgender youth. In Kansas, an anti-trans bill may allow sports officials to require a child to undergo a genital exam before playing youth sports. For those of us who took oaths of service, this definitely seems like causing harm.
In Indiana, 75% of LGBTQ youth report symptoms of anxiety. More than 80%…
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