Politicians should follow the science on gender-affirmation treatments

Transgender children and teens are being targeted, as Arkansas became the first state to ban doctors from offering gender-affirming medical treatments, while other states are considering similar measures.

Although the sponsors of these bans on medical treatments for transgender young people claim that such actions are intended to protect them, the fact is these efforts are likely to harm children in distress and those who are seeking medical care that affirms their identity.

Research suggests that policies that systemically discriminate against transgender youth create “minority stress,” which is linked to a host of negative academic, educational and health outcomes. Meanwhile, a recent study found that states that implemented health insurance non-discrimination policies saw a significant reduction in suicidality among transgender and gender diverse individuals.

The peer-reviewed research suggests that transgender children and youth who are treated with affirmation and receive evidence-based treatments tend to see improvements in their psychological wellbeing.

Between 2000 and 2008, researchers followed 70 adolescents who had felt conflicted about the sex they were assigned at birth. Adolescents who needed and received gender-affirming medical treatment before reaching puberty demonstrated a decrease in depressive symptoms and behavioral and emotional problems alongside significant improvements in their general functioning.

In another study, published in 2014, Dutch scientists followed the same group of gender diverse teens into their early 20s. After they received gender-affirming medical care in early adulthood, the participants demonstrated improved psychological functioning and their sense of wellbeing was similar to or better than that of their peers in the general population, the researchers found. 

Similar studies have been conducted in the U.S., including a longitudinal analysis published in 2019 of transgender youth in the Midwest receiving gender affirming hormone treatment. The research showed that after treatment, the participants demonstrated both an increase in general wellbeing and a decrease in suicidal thoughts.   

Some lawmakers have expressed concern about transgender children and teens changing their minds as they grow older and regretting their decision to transition. These concerns should be addressed by ensuring that these youth have access to treatment providers who follow best practices of gender-affirming care, which includes providing the information needed for the youth and their parents to make the decision they determine to be in the best interests of the youth. From this approach, medical providers can empower families through information and evidence-based care.  

As work in this area of study continues, we may see contradictory findings. This is common in science. That’s why researchers who study transgender issues, like scientists in every field, look at the evidence, replicate studies and continue a robust scholarly debate.

The American Psychological Association (APA), where I serve as president, calls on the sponsors of these anti-transgender bills to review the existing body of psychological research in this area and refrain from introducing legislation that has been shown to harm their young constituents. My organization and other major mental health and medical organizations are prepared to meet with legislators and share the science on the issue. 

Rather than trying to control the lives of transgender kids through legislation, state lawmakers should introduce bills banning discrimination against transgender people. Currently, only 20 states and the District of Columbia have laws banning discrimination based on sexual orientation and gender identity. 

We also need Congress to act. This year, the U.S. House of Representatives passed the Equality Act, which prohibits discrimination based on characteristics including gender identity. APA calls on the U.S. Senate to pass this legislation and send it to President Biden for his signature. 

We all want to help our youth grow into strong, happy and resilient adults. That’s why we should base our policies on good science while also listening to the young people, and their families, who are affected by these decisions. 

Jennifer F. Kelly, PhD, ABPP, is president of the American Psychological Association.