A new poll finds that 54% of Floridians support access to gender-affirming healthcare for minors when it’s recommended by their doctors or supported by their parents. Coming after so many political attacks and caricatures of what gender-affirming care really is and who receives it, this is a welcome sign that science and human compassion still have real power to shape our lives for the better.
My travels over the past several months, from Texas to New Mexico to Florida, have given me the chance to hear what it’s like to be a young LGBTQI+ person growing up in America. The experiences I’ve heard about — college students volunteering to train people on inclusivity, middle-school students supporting trans peers when teachers misgender them in the classroom — have demonstrated genuine resilience and emotional generosity. They have been an inspiration to me.
Many of these conversations with youth and their families have included honest discussions about mental health, and what I’ve heard is concerning. If the experiences of teenagers I’ve met are any indication, the actions of some state leaders are hurting young Americans, likely with long-term consequences.
In almost every respect, LGBTQI+ kids are the same as other people their age. They listen to music, have friends, and want to grow up to live fulfilling lives. They just want the chance to have the same adolescence as everyone else their age.
Unfortunately, too often they’re being denied that opportunity. I recently met a trans girl in Florida who was told not to hold hands with boys as early as elementary school. I heard from a Florida trans woman in college who described repeated failures by counselors, staff, deans and other adults to protect students regardless of gender, ethnicity or socioeconomic class. Many trans youth describe struggles as simple as not knowing which counselors and psychiatrists will be friendly toward them and as complex as lacking access to job offers and affordable housing because of who they are.
The stories I’ve heard are borne out by data. According to the 2015 U.S. Transgender Survey, the largest survey of trans people in the United States to date, 82% of transgender individuals have seriously considered killing themselves at least once. Two in five have attempted suicide. A 2020 study found that these figures are highest among transgender youth, 56% of whom reported a previous suicide attempt and 86% of whom reported suicidal thoughts within the past six months.
These tragic statistics are, in part, reflect the fact that many politicians and their supporters continually describe the LGBTQI+ community as a blight on our culture. In one widely publicized case, a 16-year-old transgender boy in Texas attempted suicide soon after state officials announced they would investigate the families of transgender youth for child abuse simply for facilitating their gender-affirming medical care.
The American Psychiatric Association notes that transgender people are not inherently prone to negative mental-health outcomes. These conditions are brought on by harassment, bullying and discrimination and made worse when supportive medical care is unavailable.
The good news is that it doesn’t take much to save the life of a young trans person. In 2019, The Trevor Project published research showing that youth with at least one accepting adult in their lives were 40% less likely to report a suicide attempt. This person doesn’t even have to be a family member to significantly reduce the risk of youth LGBTQI+ suicide.
In a study published in May in the journal Pediatrics, 94% of binary transgender youth continued to identify that way five years after their initial social transition. Anyone looking to understand trans experiences will find many more stories of happiness after a successful transition than they will of second thoughts or ongoing regret. In a collection of 16 studies highlighted this year by the Stanford University School of Medicine, where I spoke on this issue in June, trans youth who received gender-affirming care reported lower depression, higher quality of mental health and fewer instances of suicide thoughts and attempts than peers without care.
The American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, the Academy of Child and Adolescent Psychiatry, the Endocrine Society, the Pediatric Endocrine Society, the Society for Adolescent Health and Medicine, and the World Professional Association for Transgender Health, among other professional groups, all agree that gender-affirming care is medically necessary, safe and effective for transgender and non-binary children and adolescents. The process is tailored to individuals with parental input.
These facts shouldn’t be lost in the political rhetoric, and it shouldn’t be hard to translate this knowledge into more compassionate policies that protect, rather than undermine, youth mental health. All of us, especially those in positions of governmental responsibility, should work against intolerance until everyone living in America can live their life openly and freely.
As the assistant secretary for health, I urge everyone — especially those who see trans people like the youth I’ve met as easy political targets — to base medical decisions and public pronouncements on real data and human compassion rather than slander and stigmatization. The mental health of a generation of young trans Americans depends on it.
Adm. Rachel L. Levine is assistant secretary for health for the U.S. Department of Health and Human Services.
This story was originally published July 12, 2022 5:21 PM.