Rachel Kessler-Weinstein: Access to treatment for gender dysphoria can be a matter of life and death

Utah Legislature would be wrong to ban hormone therapy and other needed treatments.

A few months ago, my friend Miles was supposed to have his first appointment with a gender clinic after school. He’d waited for years, ever since he realized he’s transgender. (Miles was born female and identifies as a boy.)

Visiting the clinic meant requesting the hormone testosterone, and Miles radiated excitement.

“This is too big for my heart to handle.”

But things didn’t go as planned.

Miles’s appointment was canceled because of scheduling conflicts. Now he’d have to wait months for another chance to start testosterone. When he found out, Miles hugged me harder than he ever had before and sobbed for 10 full minutes. He’s still grieving that loss.

Many people might question why a 17-year-old wants to visit a gender clinic so badly. That’s why I’d like to talk about the whole deal with transgender teens and hormones. Why are they important, and why, especially now, must we defend the rights of transgender youth to get them?

In almost every case, transgender people seek out hormones for one main reason: gender dysphoria.

For Miles, like many trans people, his gender dysphoria intensified during puberty.

“I remember feeling incredibly uncomfortable with my body for reasons I couldn’t pinpoint. I thought I had issues with weight or self-esteem, but I didn’t then and I don’t now. Sometimes I would say something in a particularly high-pitched voice and it would echo over and over in my head. This only happened more often as I got older.”

Dysphoria is a daily battle Miles must fight, which impairs his ability to do activities he loves and manage in school.

“Many times after choir practice, I’ve had to go mute, because I can’t stand the way I sound after singing high parts. That once made me unable to do an oral presentation for French class. I couldn’t even explain why. I had to just sit there and shake my head.”

Since then, Miles had to quit choir. He loves singing, but it’s too painful to do so with a voice that isn’t his.

Gender dysphoria takes a toll on mental health for youth like Miles. Anxiety and depression rates are about 10 times higher in transgender people than non-transgender people. Often, this can be deadly. In 2019, 54% of trans youth seriously considered suicide, and 29% made a suicide attempt.

Fortunately, gender dysphoria has a treatment. According to the DSM-5 and the American Psychological Association, that treatment is transition.

“Transition” can mean a name change, different clothes, taking hormone suppressants to delay puberty, starting hormone replacement therapy as a teen or adult, or, for some trans adults, gender affirming surgeries.

Many people ask, what if a minor starts hormones and later regrets it? That’s a valid concern, but the regret rate isn’t as high as people think. Only ~3% of people [who medically transition] experience some form of regret. So if a young person says they need gender affirming care, there’s a 97% chance they’re right.

Many trans youth can’t access medical transition until adulthood, but they see more mental health benefits when they transition as youths.

Research from the Stanford University School of Medicine concludes that, “Odds of previous-year suicidal ideation are 135% lower in people who began hormones in early adolescence, 62% lower in those who began in late adolescence and 21% lower in those who began as adults, compared with the control group [who never started hormones despite wanting to].”

For transgender youth like Miles, access to hormones can be life-saving. But, in Utah, this might become impossible.

In our last legislative session, trans youth were under attack. HB127 threatened to deem it “unprofessional” for doctors to give “medically unnecessary” gender affirming care to trans patients under 18. This bill is invasive, counterfactual and dangerous.

Thankfully, it didn’t pass during the 2022 session, but it’s a frightening omen for next year.

Miles is still able to visit the gender clinic, for now, but the next legislative session could make it a thousand times harder for him to get the care he needs.

“I’m so tired of being denied my own autonomy and identity everywhere I turn,” he says. “I just want to see myself in the mirror.”

Let’s not deny transgender Utahns like Miles of the care they need.

Rachel Kessler-Weinstein

Last year, Rachel Kessler-Weinstein was the co-president of the Queer-Straight Alliance of Rowland Hall High School. She is currently an intern for Alliance for a Better Utah, and she is beginning her first year at Oberlin college in the fall.