Matt Goldenberg and Gina M. Sequeira: Standing up for TGD care: Doctors urge vigilance against future threats

By Matt Goldenberg, PsyD, and Gina M. Sequeira MD, MS

As mental health and medical providers caring for transgender and gender diverse youth in Idaho and Washington, we are often tasked with helping patients overcome barriers to accessing gender-affirming care.

On Wednesday, the Idaho Senate blocked a bill that, should it have become law, would have made providing recommended medical care for TGD youth a felony.

Our clinics, which are some of the few providing gender-affirming care to youth in Idaho, would have been forced to discontinue care for patients and turn away vulnerable, high-risk youth. This bill was based in misinformation and would have been a violation of federal civil rights law as it would have posed discriminatory restrictions on access to health care. We have dedicated our careers to supporting TGD youth and their families, and we laud those Senate leaders who halted the advancement of this bill. At the same time, we feel we must explain why this bill would have been profoundly harmful for Idaho youth – and why we urge vigilance against any similar efforts in the future.

We stand alongside six major medical organizations, which represent nearly 600,000 physicians and medical students, in clear opposition to legislation criminalizing the provision of gender-affirming care for adolescents. All patients deserve to have decisions about their medical care made in partnership with their parents and doctors. Legislators should have no place in these decisions.

We provide quality, evidence-based medical care grounded in existing research and current guidelines. There are at least 16 studies in the medical literature demonstrating the positive impact of gender-affirming medical care for adolescents. The most recent study was conducted at the Seattle Children’s Gender Clinic and showed that adolescents who received gender-affirming medications like puberty blockers and gender-affirming hormones had 60% lower odds of moderate or severe depression and 73% lower odds of suicidality. Gender-affirming care improves mental health for TGD adolescents. This care saves lives.

The decision to initiate puberty blocking medications or hormones is one that is thoughtfully considered in our clinics. Initial conversations are lengthy and followed by ongoing discussions about the current guidelines of care. Parents should be encouraged to seek this care, not forced to put themselves at risk of imprisonment by doing what they feel is right for their child. As the providers who are having these conversations with TGD youth and their families in the region covering Washington, Wyoming, Alaska, Montana and Idaho, we need all Idahoans to hear this:

Gender-affirming care is NOT experimental, nor does it lack medical evidence.

On the contrary, gender-affirming care is both in line with recommendations from every major medical organization including the American Academy of Pediatrics and the existing medical evidence.

While Idaho’s Senate has shown wisdom not evidenced in the House, which overwhelmingly passed its version of the bill, we urge everyone to consider the impact of any future legislation of this nature. In addition to going against national and local medical experts, such measures would send a chilling message to TGD youth and their families. It would tell them that Idaho is not a place they can expect to be seen or be safe. Parents would be told their only option to help their child would be to flee and live elsewhere, erasing their and their children’s potential contributions to the culture, economy and legacy of Idaho. Many would not have the ability to flee and would face severe mental health consequences, including increasing suicidality as a result.

Ensuring TGD adolescents in Idaho, with the support of their parents, can access quality, evidence-based medical care is both a legal and moral obligation. We ask all parents and youth allies to join with us in thanking those legislators who halted the advancement of this horrible bill – and demanding better of those legislators who supported it.

Matt Goldenberg is a psychologist at Seattle Children’s Hospital. Gina M. Sequeira is an adolescent medicine physician at Seattle Children’s Hospital. Eileen A. Baez, MD, a pediatric endocrinologist at St. Luke’s Children’s Hospital, Boise; Juanita Hodax, MD, a pediatric endocrinologist at Seattle Children’s Hospital; and Katie Sumerwell, ARNP, an adolescent medicine nurse practitioner, Seattle Children’s Hospital, also contributed to the piece.