In considering legislation that affects people’s health, especially children’s health, the most important guideline comes from the Hippocratic Oath, “First do no harm.” In choosing what to support in proposed laws, each of us needs to apply that same guideline.
Legislation has been introduced in Utah claiming to be for the protection of our transgender and gender-diverse young people. The proposed changes run counter to the standards of care established by major medical organizations. These include organizations such as the American Medical Association, American Academy of Pediatrics, American Psychiatric Association, Association of American Medical Colleges, Endocrine Society, Pediatric Endocrine Society, American Academy of Child and Adolescent Psychiatry and the American College of Physicians.
We all want to get behind measures that protect children from harm. We want our youth to have the best chance of living happy productive lives. But given the large body of peer-reviewed science and medical backing, it appears that these proposed laws are based on fear and discomfort with different gender identities.
Gender dysphoria is a complex health issue where each person and case is unique. Each case requires many specialists who weigh several factors that put the patient’s mental and physical health at the center of their efforts. Doctors, parents and patients are in the best position to gather all the facts for each individual. Government should not intervene and prevent care that is evidence-based, meets clinical guidelines and looks at individual circumstances.
Gender dysphoria that is untreated can cause severe mental health issues, including suicidal behavior. Research shows that not having gender-affirming health care available in childhood and adolescence can be harmful to a transgender person’s mental health over the rest of their life. Even seemingly small affirmations such as using their preferred names and pronouns or having their preferred name and/or gender marker on legal documents will significantly decrease suicidal ideation.
In 2022, Stanford Medicine News Center reported that “transgender people who began hormone treatment in adolescence had fewer thoughts of suicide, were less likely to experience major mental health disorders, and had fewer problems with substance abuse than those who started hormones in adulthood.”
This study was analyzed by looking at when participants began hormone therapy. Severe psychological distress and suicidal ideation had the greatest reduction in those who began hormone therapy in early adolescence when compared to the control group. Additionally, those who began hormones in adolescence had reduced lifetime use of illegal drugs.
Each year when these types of bills come up, I see an increase in discrimination and cruel comments directed at transgender people. This is true even when the law doesn’t pass. When similar laws were proposed in Texas between 2020 and 2021, the Trevor Project had 150% increase to their LGBTQ+ crisis line.
About 85% of transgender/non-binary youth report their mental health has been negatively affected due to recent debates about restricting their rights. Hate crimes in Utah against LGTBQ+ people have increased, especially against transgender and gender-diverse people.
While proposed legislation would block medically sound gender-affirming care for teens, legislators have carefully created language that will still allow physicians to do what amounts to largely cosmetic surgery on newborn babies with disorders of sexual development (DSD), or ambiguous genitalia, with the sole purpose of forcibly making them fit into their false assumption of binary sexes. These surgeries have well-documented long-term problems and dissatisfaction. They are no longer medically recommended and no longer conform to modern legal or ethical standards of care. The United Nations has declared this type of surgery a human rights violation.
Harvard Law Review published an article about state legislatures trying to pass laws outlawing gender-affirming health care for minors – just as these bills propose. The Harvard Law Review states that these kinds of laws are unconstitutional. Blocking parents from medically necessary treatment for their children is intrusive government. Parental due process rights were made to guard against this.
One of the most important steps to becoming a doctor is taking the Hippocratic Oath. Here is where doctors promise to “first, do no harm.” I ask all lawmakers to please apply this guideline. Our transgender kids should not be paying a steep price because people decide to use these vulnerable youth as their political boogeymen.
Debra Oaks Coe
Debra Oaks Coe, Lehi, works as a volunteer on suicide prevention and is the founder of Of-Worth.com.