Political Forces and Pressure Impinge Stress on Transgender Teens’ Mental Health

It had been suggested to Charlie Apple that he was just a confused kid or even a moral aberration. As a transgender teen, he was aware that discrimination, violence, and verbal abuse would be part of his future. In spite of the risk, he said he felt peace after he transitioned physically.

However, Apple found it especially painful last year when Texas lawmakers made the same dehumanizing remarks he heard on the playground while debating whether to prevent trans kids from participating in sports and receiving gender-affirming medical care.

“Seeing these people who are supposed to protect you, who are supposed to make laws to protect children, say all these horrible things and make it clear that you are not worth fighting for?” said Apple, 18, whose parents testified against several anti-trans legislation bills.

“That’s a whole different thing.”

Across the country, legislators introduced a record number of bills related to transgender youth in 2021. There were 50 such bills proposed by Texas lawmakers, including an unsuccessful bill that threatened to jail parents and place their children in foster care if they embraced gender-affirming treatments. Seven states alone introduced transgender and nonbinary youth legislation in the first week of 2022. Transgender girls and college-age women will no longer be able to play on female teams starting in February Since South Dakota Gov. Kristi Noem signed the bill. The state becomes the 10th to ban such activities.

According to USNews, Dr. Aron Janssen, vice-chair of Lurie Children’s Hospital’s psychiatry and behavioral health department in Chicago, said that the larger debate outside of medicine resulted from the legislative efforts to restrict access care is having a negative impact on transgender youth.

“These are kids who are already quite vulnerable. We know that suicide rates among transgender youth are incredibly high,” Janssen stated.

“We would anticipate that legislative efforts that are created to reduce access to lifesaving care are going to have negative consequences.”

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In a survey from the Trevor Project, 85% of transgender and nonbinary youth reported negative effects on their mental health as a result of debates about anti-trans bills. In a survey conducted in 2020, a nonprofit focused on crisis intervention found that 42% of LGBTQ youth seriously considered suicide in the past year, with over half of those being transgender and non-binary.

“What I am concerned about is that something that is doing significant and documented harm to the health and well-being of LGBTQ youth is being seen as a highly effective political tactic and means of fundraising,” said Casey Pick, the Trevor Project’s senior fellow for advocacy and government affairs.

“It scares me that LGBTQ youth are being sacrificed to a political process.”

In the past year, Pick said, the Trevor Project’s lifeline and digital crisis services had more than 200,000 calls, emails, and texts from across the country.

Mary Elizabeth Castle, a senior policy adviser at Texas Values, an advocacy group that has pushed forward legislation banning gender-affirming care, said moreqq legislation is coming.

“Our position at Texas Values, and with our research, is that kids should not have access to any puberty blockers, cross-sex hormones, or any gender transition surgeries,” she stated.

“A lot of these kids claiming they are going through gender dysphoria are dealing with the normal problems preteens face, just realizing themselves and finding their identity.”

As a result of the increased political heat, repercussions have been felt. An LGBT youth resources page, which included information about suicide prevention and the Trevor Project hotline, was removed by the Texas Department of Family and Protective Services from its websites after criticism from a conservative gubernatorial candidate. Texas school districts have also blocked access to LGBTQ+ resources, such as the Trevor Project, but have reinstated some after protests.

Those pullbacks are particularly troubling, said Pick, because LGBTQ+ kids are overrepresented in child protective services and have less access to mental health care and medical treatment, as well as internet access, outside of schools or child welfare agencies. As compared to their peers, LGBTQ youth in foster care are more likely to report attempts to commit suicide.

“Regardless of what they think about trans youth, and whether it’s real or not, you’d think they would want to prevent suicides,” said Laura Edwards-Leeper, an Oregon clinical psychologist stated.

“If they really cared about young people, they would be putting their energy into allocating more resources to areas that are lacking in the field.”

Edwards-Leeper advocates for improved training for therapists and for greater diligence in considering mental health concerns beyond gender identity before initiating medical treatments like puberty blockers and transgender hormones. Nevertheless, she said, some youth might benefit from medical intervention.

“My feeling is that these things, especially the treatment of these kids, should not be left up to the courts or lawmakers,” Edwards-Leeper explained.

“It should really be in the hands of mental health and medical providers who are trained to do that work.”

In a 2018 American Academy of Pediatrics policy statement on supporting transgender children, pediatrician and psychologist Jason Rafferty said the current political rhetoric and legislation lack scientific support. He pointed out that transgender medical protocols are not new, and that politicizing the delivery of health care to transgender youth is both wrong and destructive.

“By taking away books or banning websites, you can’t erase people’s experiences,” he said.

“Kids are still feeling what they are feeling; they’re now just feeling more isolated and alone and won’t have those references to help normalize their feelings as part of the human experience. That’s scary when we’re talking about emotional and psychological health and development.”

As the American-born daughter of Mexican immigrants, Lizette Trujillo is well versed in overcoming societal barriers as the parent of a 14-year-old transgender son. Nevertheless, she and her husband were concerned that their son would face more marginalization when he came out as transgender.

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Trujillo knows where to find safe businesses and neighborhoods for her son. At school, he has been subjected to anti-trans slurs. It has become increasingly difficult, she said.

“There is this exhaustion and this disappointment that we are still having these same conversations and these same fights over and over,” Trujillo added.

In the end, the legislation and surrounding discussion are aimed at children, said Dr. Terrance Weeden, a pediatric fellow at Chicago’s Lurie Children’s Hospital.

“This is just who these children, these youth, are,” Weeden expressed.

“They did not wake up one morning and decide ‘Hey, I want to be part of this community that’s ostracized, looked down upon, made fun of, that’s isolated.’”

While Apple remains hopeful that things can improve despite concerns about future legislation and its rhetoric, Apple is concerned about its impact on LGBTQ+ youth.

“I am a human being and I am also trans,” he explained to KHN.

“I am a mosaic of experiences and identities, with joy and sorrow and happiness and love, just as you are. Seeing us as the multifaceted human beings that we are is the first step in fighting this.”

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