The American Civil Liberties Union is currently tracking nearly 500 anti-LGBTQ bills in the United States. This is already more than twice the number of such bills introduced during 2022, and 12 times the number introduced in 2018. In the first half of 2023 alone, 17 states have enacted bans or Significant new restrictions on gender-affirming care for minors, most ending the use of cross-sex hormones and puberty blockers. Supporters say the bans protect children from medical treatments they view as harmful and unproven. But this position challenges much of the medical establishment, which views care as medically necessary and beneficial for some children with gender dysphoria.
Recent surveys indicate that this increase in anti-LGBTQ discourse and legislative concerns is having far-reaching consequences. About 41% of LGBTQ youth have seriously considered attempting suicide in the past year, including half of transgender and nonbinary youth and nearly three in 10 cisgender LGBTQ+ youth, according to a 2023 report from the Trevor Project. The report surveyed more than 28,000 LGBTQ+ youth aged 13 to 24 in the United States. The same study found that nearly two in three LGBTQ+ young people said that hearing about possible state or local laws prohibiting people from discussing LGBTQ+ people in school worsened their mental health.
Mental health experts confirm these results. “Trans youth today experience a tremendous amount of anxiety,” said APA President Thema Bryant, PhD. “We feel like we don’t feel safe. This heightened sense of animosity toward this already vulnerable population affects even those who live in states where anti-transgender legislation is not even on the table.”
(Related: Best Practices for Mental Health Facilities Working with LGBTQ Clients)
While the direct adverse health consequences of not having access to gender-affirming care are well documented, Dhanani and Totton’s 2023 study in Sexuality research and social policy examined the indirect, or holistic, harm of the mere existence of this type of legislation. She found that perceived support for the legislation was associated with greater rumination, depressive symptoms, physical health symptoms, and fear of revealing one’s identity. Notably, many respondents linked access to gender-affirming care to suicidality, stating that access to gender-affirming care “saved my life” or that if they had not lack of access to gender-affirming care, they would have suicidal thoughts.
“Our results show that it is not enough to say ‘under these bills, if they were passed, X number of trans people would not have access to gender-affirming care,'” Dhanani said. “What we’re really seeing is that everyone who is a member of the trans community is at risk of being harmed, simply because these bills exist, simply because people are spending time and engaging in a stigmatizing rhetoric around the trans community, because they” I point out that these people do not have the same rights as others.
The study included a national sample of 113 trans youth and young adults, and it noted that where a participant lived did not matter when it came to mental health issues.
Sarah Burgamy, a Colorado private practitioner, PsyD, who works with transgender and non-binary children and adults, has seen this play out in her state, where she sees mixed reactions from her clients: a relief to live there where they live, but also a growing awareness that where they live does not, in fact, guarantee their “safety”.
Her young clients have been hit hardest because they are not yet equipped with the ability to protect themselves from some of what they see and hear, as many adults might be, she said.
“Young people feel it deeply: they think that people hate who they are and everything about them, and they listen to people tell them that they don’t have the right to be themselves,” she declared. “I’ve seen self-harm skyrocket and suicidal thoughts are on the rise. This goes beyond rhetoric – steps taken to almost erase the existence of many of these young people who are just coming to terms with their identities for the first time in their lives. It’s sinister.
