The Alabama Campaign for Adolescent Sexual Health joins the American Academy of Pediatrics (AAP) and the Society for Adolescent Health and Medicine (SAHM) in disavowing all policies that would prevent transgender and gender non-conforming adolescents from receiving gender-affirming support – including but not limited to hormone replacement therapy, mental health therapy, and pubertal blockers. As an organization that advocates for the sexual health and wellbeing of all young people in the state of Alabama, the Alabama Campaign believes that all medical decisions related to sexual and reproductive health are between an individual and their doctor. Legislation and policies that prevent healthcare professionals from providing this care is not founded upon scientific evidence and would cause harm to young people that are already disadvantaged and discriminated against.

Additionally, the Alabama Campaign denounces any policy that would require teachers to tell parents if their child discloses to them their gender nonconformity. These policies would force trans and gender non-conforming students to “come out” to their families, potentially exposing them to harmful and dangerous home life situations. It is essential that transgender and gender non-conforming students have safe spaces in their schools – confidential and free of discrimination. It is also essential and an evidence informed protective factor against risk-taking behavior for all young people to have trusted adults in their lives. Those trusted adults may be outside of the home structure, such as teachers. The Alabama Campaign for Adolescent Sexual Health encourages all Alabama decision makers to make themselves familiar with the statistics regarding the harms of outing transgender students and denying transgender adolescents medically necessary treatment.

Transgender and gender non-conforming youth experience an extreme amount of stress as a result of their bodies not matching their gender identity, also known as dysphoria. Statistically, transgender and gender non-conforming youth are approximately four times more likely to experience a mental health disorder, such as depression, anxiety, or suicide idealization, and are more likely to engage in substance misuse (Reisner et al, 2015). As a nonprofit organization that seeks to educate and help adolescents and young adults lead healthy lives, we do not condone policies that reinforce the continued stigmatization of trans and gender non-conforming people who are seeking health care. In addition, we condemn any legislation that seeks to disproportionately deny trans and gender non-conforming youth access to quality medical care and treatment. Such laws add to the preexisting stigmatization that these groups face and create or exacerbate undue health disparities across groups (Grant et al, 2011).

Medical organizations such as the American Academy of Pediatrics and the World Professional Association for Transgender Youth have affirmed that the best way to improve health care and medical treatment for trans and gender non-conforming youth is to provide social support and to assert their gender identity in the form of social support and/or mental health therapy. Current evidence shows that providing trans youth with the social support and medical infrastructure that they need improves patient outcomes and reduces mental health and substance misuse disparities. Trans youth who receive cross-sex hormones have a 75% reduced risk of suicidality, in addition to a 14% improvement in overall well-being (Allen et al, 2019). There is no evidence justifying the adoption of policies that disallow medical treatment and social support to trans and gender non-conforming youth.

References

Allen, L. R., Watson, L. B., Egan, A. M., & Moser, C. N. (2019). Well-being and suicidality among transgender youth after gender-affirming hormones. Clinical Practice in Pediatric Psychology, 7(3), 302–311. https://doi.org/10.1037/cpp0000288

Grant JM, Mottet, Lisa A., Tanis, Justin, Herman, Jody L., and Keisling, Mara. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force; 2011.

Reisner, S. L., Vetters, R., Leclerc, M., Zaslow, S., Wolfrum, S., Shumer, D., & Mimiaga, M. J. (2015). Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study. J Adolesc Health, 56(3), 274-279. doi:10.1016/j.jadohealth.2014.10.264