More than 144,000 transgender youth at risk of losing access to gender-affirming care

The Williams Institute on Thursday said an estimated 144,500 transgender youth ages 13 and older in the U.S. are at risk of being denied gender-affirming medical care due state bans and policies.

As of March 24, 2023, 32 states have restricted access to gender-affirming care or have considered laws that would do so.

An estimated 77,900 transgender youth live in 11 states that have enacted bans or taken executive actions to limit access to gender-affirming care. This includes 18,700 youth in Georgia, Iowa, Mississippi, South Dakota, Tennessee, and Utah, where bans have been signed into law this legislative session.

An estimated 66,600 youth in 19 states remain in jeopardy of losing access to care if pending legislation is enacted. This includes Kentucky, where the state legislature has sufficient votes to override the Governor’s recent veto of a ban, and West Virginia, where a ban was passed but has not yet been signed. Bans that would have impacted 12,000 transgender youth in two states—Virginia and Wyoming—failed this year.

The bills carry severe penalties for health care providers, and sometimes families, who provide or seek out gender-affirming care for minors. Many bills prohibit insurance companies from offering coverage or restrict the use of state funds for gender-affirming care.

“An unprecedented number of bills have been filed this year to restrict access to gender-affirming care for transgender youth,” said study author Elana Redfield, federal policy director at the Williams Institute. “States are exploring every avenue to prevent access to care, such as encouraging private lawsuits against providers, extending the time to bring them, and prohibiting anything that could be seen as ‘aiding or abetting’ access to these treatments.”

Gender-affirming medical care includes using hormones to delay puberty and promote physical development consistent with a child’s gender identity. It is considered safe, effective, and medically necessary by major professional health associations, including the American Medical Association, the American Academy of Pediatrics, and the Endocrine Society.

“Research shows that gender-affirming care improves mental health and overall well-being for transgender people, including youth,” said study author Kerith J. Conron, the Blachford-Cooper Distinguished Scholar and Research Director at the Williams Institute. “Bans on access to medically appropriate health care add to the existing burden of stress experienced by transgender youth and their families.”

Prior research from the Williams Institute found that the risk of past-year suicide attempts was lower among transgender people who wanted and received gender-affirming medical care.

You can read the full report here.

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