Soter: Trans Teens Need Gender-Affirming Healthcare


Gwen Christopherson

A pride flag hangs from a house in Salt Lake City, Utah on Sept. 21, 2020. This design of the pride flag includes Black, Brown and trans pride. (Photo by Gwen Christopherson | The Daily Utah Chronicle)

By Theadora Soter, Multimedia Managing Editor


Transgender patients all over the country are regularly discriminated against by their healthcare providers. In fact, 33% of respondents in the 2016 US Transgender Survey said they’d had a negative experience with their healthcare provider because of being transgender — and it seems reasonable to assume that percentage might be higher in conservative states like Utah. With that in mind, the University of Utah decided to help right the wrongs made by healthcare providers statewide and founded the University of Utah Transgender Health Program in 2017. The program provides a wide range of gender-affirming services which have all been remarkably successful, proving the state’s desperate need for the program. It also offers full services to transgender youth and teens, including puberty blockers, gender-affirming hormones and behavioral health. Unfortunately, though, the transformational and groundbreaking support the program has offered to young people statewide is under threat thanks to Rep. Rex Shipp’s heartless bill, H.B. 92.

Troy Williams, the executive director of Equality Utah, told me in an email interview that “the University’s Transgender Health Program is providing multi-disciplinary care for transgender youth. It’s all-encompassing — and exactly the care young people need to live happy, healthy lives. Denying access to such care would be grievously irresponsible of lawmakers.” But Shipp disagrees.

Shipp’s bill, deceptively titled “Medical Practice Amendments,” would prevent minors from getting access to the gender-affirming healthcare they deserve by making all forms of gender reassignment therapies illegal if provided to a minor. Under the bill, any healthcare professional who performs gender-affirming care would be stripped of their medical license, and any parent who signs off on such care could be accused of child abuse. As Williams wrote to me of the legislation, “It represents a fundamental lack of understanding about the healthcare needs of transgender youth. Denying youth access to medically necessary healthcare is blatant and cruel discrimination. And it could have serious consequences on the wellbeing of patients.”

The fact that H.B. 92 has even made it to a legislative committee is outright hypocritical in a year when the legislature has placed such an emphasis on youth-specific mental health bills. Body dysmorphia can have extremely damaging effects on a developing mind, but Shipp and the other Utah legislators who support this bill are clearly only concerned about mental health among children who identify as cis-gender. By prohibiting fundamental healthcare for transgender minors, H.B. 92 would only perpetuate Utah’s devastating trajectory when it comes to mental illness and suicide.

In an interview, one transitioned student at the University of Utah (who asked to remain anonymous for safety reasons) had a devastating response when I asked about his battle with mental illness as a transitioning minor. “I don’t think I would be here if I didn’t have testosterone when I had it,” he said. This is, sadly, a common experience for many transitioning minors. One study by the Human Rights Campaign found that more than 50% of transgender male minors and almost 30% of transgender female minors have attempted suicide.

Fortunately, these heartbreaking statistics have potential solutions. Trans individuals are more likely to have positive mental health outcomes when they get the care and support they need from their physicians and family. In 2018, doctors from the American Academy of Pediatrics formally recommended that children receive gender-affirming care as requested, as it has been proven that an affirmative and encouraging approach with transgender children will benefit them down the road. But Shipp’s bill would make the common-sense antidote of birthright healthcare impossible.

Perhaps one of the greatest challenges transitioning minors face is puberty. The transgender student I spoke with said, “When you’re going through your assigned-sex puberty as a trans person, it’s debilitating. It feels like such a horrible disconnect. It’s humiliating, yet you have to go through. It’s so incorrect.” Proponents of H.B. 92 are oblivious to this challenge. Instead, they are adamant about prohibiting minors from receiving puberty blockers because they believe the medications could lead minors to make irreversible decisions about their gender — but this is a massive misconception. In reality, puberty blockers do nothing but exactly what you’d think: pause puberty, leaving more time for the patient to feel secure in their choice to transition. Ironically, it is only without puberty blockers that patients have to face hard-to-reverse physical changes — apparently Republican lawmakers’ biggest fear.

As of now, Utah healthcare professionals are already supposed to provide minors with adequate and protective healthcare. Standard medical practice requires healthcare professionals to follow the World Professional Association for Transgender Health (WPATH) standards. But many transgender patients still experience discrimination at hospitals and doctor’s offices in our state, and Utah doesn’t currently have any laws that provide LGBTQ insurance protections. This means that even adults who wish to transition often can’t because the treatment is far too expensive.

Instead of passing laws that block transgender minors from the treatment they deserve, the Utah State Legislature should be focused on eliminating barriers. Legislation that protects the LGBTQ community’s fundamental right to health insurance would be a great start. As the U student eloquently put it, “It really just comes down to being empathetic towards human rights. I think that a lot of people don’t really pay attention to what happens to trans people because it only affects so few people. But, you know, we’re people too, and things like this really affect us.”


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