Disinformation about health care for transgender and gender-diverse people is harmful to the health outcomes of this community, and we are losing medical providers in Texas because of legislative attacks against best-practice medicine for transgender youth and adults. March 31, Transgender Day of Visibility, offered an opportunity for Texans to learn the facts on health care for trans people.
According to the Texas Medical Association, gender-affirming care is developmentally appropriate and meets all gender-diverse and transgender patients where they are in understanding their gender identity, or how a person perceives their own gender. An individual’s gender identity may or may not correlate with assumptions based on their sex assigned at birth.
When a person’s gender identity doesn’t align with the sex assigned to them at birth, it can cause a feeling of distress or unease called gender dysphoria. Particularly when exacerbated by a lack of social acceptance and support, this can lead to anxiety, depression and suicide. According to a 2019 study of more than 53 million electronic health records, approximately 58% of transgender patients had at least one mental illness compared with 13.6% of cisgender patients (patients whose gender identity matches their sex assigned at birth). Additionally, data from the Journal of Interpersonal Violence indicates that 82% of transgender individuals have considered killing themselves and 40% have attempted suicide, with the risk of suicide highest among transgender youth.
Best-practice, medically necessary services that affirm a patient’s gender or treat gender dysphoria can be lifesaving. These services include mental health counseling, non-medical social transition, hormone therapy and in some cases gender-affirming surgeries.
At Texas Health Action, we provide health care to transgender Texans through Kind Clinic locations in Austin, Dallas and San Antonio; Waterloo Counseling Center in Austin; and virtually to any Texas resident through TeleKind. We have seen firsthand an increase in fear and anxiety among our patients as politicians attack the existence of LGBTQIA+ people. In Texas and across the nation, politicians are taking away access to best-practice medical care by spreading disinformation and proposing legislation that comes between providers and the patients they serve.
Anti-trans lobbyists have attempted to discredit gender-affirming care by saying it is a false substitute for other forms of mental health care, frequently going so far as to imply or state that people are transgender because of mental illness. These transphobic claims are contradicted by various studies that indicate gender affirmation, social acceptance and access to gender-affirming hormone therapy improve mental health and other social determinants of health.
Proponents of bans on gender-affirming care have cited decades-old data, referencing outdated criteria that doesn’t account for gender identity, falsely purporting that as much as 80% of trans people detransition. However, contemporary surveys indicate detransition is rare. An average of 8% of respondents to a U.S. survey of transgender people reported having de-transitioned at some point, but most did so temporarily. The reasons cited for detransition were primarily tied to lack of acceptance or barriers to receiving care, rather than regret.
Legislation banning gender-affirming care for all Texans, including youth and adults, would allow a parent to consent to the same elective surgeries, procedures and medications it calls “gender modification” if their child is born intersex (with a combination of biological traits that do not fit binary conceptions of male or female). These procedures often lead to adverse health outcomes for intersex people who may not even know a procedure was performed on them as an infant or youth.
The onslaught of anti-trans and anti-intersex bills is discouraging healthcare professionals from practicing in Texas, and we can’t afford to lose healthcare professionals. Policy makers should listen to healthcare providers and make decisions based on the most current research. Trust us when we say that gender-affirming care is safe and effective. Major medical associations including the American Medical Association, AmericanAcademy of Pediatrics and American Psychiatric Association have all released statements advocating for access to gender-affirming care for adults and youth.
This is the moment for Texans who value trans lives to show allyship. Good allyship begins with educating those who are close to you, such as friends and family. If every Texan who values trans lives can learn the facts and correct disinformation when they see it, we just might have a chance at making Texas a place where everyone feels safe and welcome.
Health care a human right, not a privilege. Let’s keep it that way.
Rainey Fraser is a program manager with Texas Health Action’s TeleKind and Christopher Hamilton is CEO of Texas Health Action, based in Austin.
