Utah has a growing demand for gender-affirming care, as lawmakers consider anti-LGBTQ bills

Diagnoses of gender dysphoria have increased nationwide, according to a new report — although its authors have since removed it from the internet.

(Rick Egan | The Salt Lake Tribune) A group named Armed Queers chant during a demonstration inside the Capitol in opposition to HB257, on Tuesday, Jan. 23, 2024.

Update • The report referenced in this article, originally published Jan. 4, has since been removed by Definitive Healthcare. Other outlets have cited errors with the data as the reason for removal. The Salt Lake Tribune reached out to Definitive Healthcare for comment, including whether any errors applied to Utah’s data, but has not yet received a response.

More Utahns are seeking health care to help embrace their gender identity, even as the state lawmakers have limited access to services and continue to target transgender people.

Every state but South Dakota had more people diagnosed with gender dysphoria in 2022 than in 2018, according to a Definitive Healthcare report.

“Our medical claims data shows that gender dysphoria diagnoses are on the rise, and patients with these diagnoses are seeking mental health services in greater numbers than ever,” the report reads.

A gender dysphoria diagnosis does not necessarily mean someone is transgender, and not all people who identify as transgender have gender dysphoria. But the diagnosis does often precede a transition.

The report claimed more Utahns sought gender-affirming care in the years leading up to the state banning that care for youth last year, pending a study of impacts, and more bills this legislative session that target transgender people.

Diagnoses on the rise in Utah, across the country

About 1.3 million Americans identified as transgender in June 2022, according to the Williams Institute at the UCLA School of Law.

That number includes an estimated 2,100 Utahns between the ages of 13 and 17, and an estimated 13,700 Utah adults.

“Transgender” is a broad term for people whose gender identity or expression differs from the sex they were assigned at birth.

Before transitioning, many transgender people experience gender dysphoria, a type of psychological distress arising from the perceived disconnect between their assigned sex and gender identity.

While gender dysphoria and identifying as transgender are not synonymous, a diagnosis is often the first step when seeking gender-related mental health care or gender-affirming care to access treatment and activate insurance coverage.

Definitive Healthcare said it spent three months analyzing medical procedure and diagnosis claims data from several sources, including the company’s own products, the NPI registry and proprietary research. The analysis showed that “more people than ever are seeking gender-affirming care, even while access to that care is being intentionally and systemically limited.”

The report doesn’t explicitly state why increases are happening but does note that conversations around gender identity and expression more broadly are becoming “more accepted by society.”

The report also notes year-to-year changes in some states as “shifting social and political climates” push patients to seek diagnoses in nearby states.

Utah among states to ban gender-affirming care for youth

Transgender patients’ access to care has received heightened national attention in recent years as the LGBTQ community’s work to promote visibility and equality has been met with legislative efforts to limit or ban trans-specific care services in nearly half of U.S. states.

As of December, 22 states had banned gender-affirming care for youth in some way. Utah is one of them.

That’s in addition to other barriers.

For example, a recent KFF survey of state Medicaid programs found that only two of the survey’s 41 respondents cover all gender-affirming health care services, from hormone therapy and surgery to mental health counseling.

That study found that as of July 1, 2021, Utah’s Medicaid program covered gender-affirming surgery, gender-affirming hormone therapy and behavioral health — but not voice and communication therapy or fertility services.

Utah, other states considering further restrictions

Though more people than ever have sought gender-affirming care in recent years, states — including Utah — continue to consider bills targeting transgender residents.

As of last week, the American Civil Liberties Union was tracking close to 300 bills targeting LGBTQ rights nationwide, including three in Utah.

One receiving a particular amount of criticism would change the legal definitions of “female” and “male” to exclude transgender people.

The bill, sponsored by Rep. Kera Birkeland, R-Morgan, and titled “Sex-based Designations for Privacy, Anti-bullying and Women’s Opportunities,” or HB257, also would bar transgender people from entering sex-specific spaces, such as public bathrooms. The bill passed the House last week, and was passed out of the Senate Business and Labor Committee on Monday.

The other bills the ACLU is tracking in Utah are HB253 and HB303.

HB253 would prohibit transgender people from using restrooms, locker rooms and changing rooms in Utah’s K-12 schools and higher education institutions that align with their gender identity. HB303 would prohibit school officials and employees from discussing political beliefs, including viewpoints on sexual orientation and gender identity.

Megan Banta is The Salt Lake Tribune’s data enterprise reporter, a philanthropically supported position. The Tribune retains control over all editorial decisions.