Make protection for gender care permanent

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Minnesota is now a little safer for transgender and gender-diverse kids and teens seeking gender-affirming care. The executive order issued Wednesday by Gov. Tim Walz protecting access to gender-affirming care comes at a critical time as legislatures in numerous states, including some bordering Minnesota, aim to ban this lifesaving care. I applaud Gov. Tim Walz and Lt. Gov. Peggy Flanagan for taking this important step to protect transgender and gender-diverse youth, their families and the clinical teams who care for them. I also urge Minnesota lawmakers to follow suit and pass the Trans Refuge Bill (HF 146/SF 63).

In my role as medical director of the Gender Health Program at Children's Minnesota, I have the privilege to see the significant positive impacts that providing gender-affirming care gives to transgender and gender-diverse kids and their families. In our clinic, our multidisciplinary team provides compassionate, age appropriate and evidence-based care for youth who identify as transgender and gender diverse. We provide a safe and supportive environment for children and families to ask questions of health care professionals who specialize in the care of transgender and gender-diverse youth. We help parents and caregivers understand their child who may be exploring their gender expression and/or gender identity and offer ways to support them on their journey.

This year, over 380 anti-LGTBQ bills have been introduced in state legislatures, with many bills targeting access to gender-affirming care. This is despite the fact that gender-affirming care for youth is endorsed by the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics. In our Gender Health clinic, we follow guidelines outlined by the World Professional Association for Transgender Health and the Pediatric Endocrine Society and address both the mental health and medical needs of our patients. Improving access to care is paramount to address the health inequities that exist in this country. And yet, there are dozens of bills in state legislations that will outright deny access to lifesaving gender-affirming care.

LGBTQ kids with diverse sexual and gender identities are already at higher risk for low self-esteem, bullying, depression, social anxiety, substance abuse and suicidality. Based on the 2022 Minnesota Student Survey data, reports of serious suicidal thoughts by 11th grade students have increased in the last nine years. The numbers are even more concerning for LGBTQ students. They are about three times more likely as heterosexual students to report seriously considering suicide, and four times as likely to attempt suicide as heterosexual students. Transgender students in the 11th grade report the highest rates of suicide attempts; they are more than four times more likely to attempt suicide than their cisgender 11th grade peers.

Our youth are already in the midst of a mental health crisis. By solidifying our state as a safe haven for gender-affirming care, Minnesota legislators will send the strong message to transgender and gender-diverse youth that they belong here in Minnesota and that they, just like all other kids, deserve access to the specialized health care to help them grow up happy, healthy, safe and strong.

Minnesota has made great progress on advancing LGBTQ rights and protections, Gov. Walz's executive order is one example of that. I urge our Minnesota lawmakers to make the protections to gender-affirming care access permanent and give our LGBTQ kids the protections they deserve to live and thrive as their true selves.

Angela Kade Goepferd, MD, is chief education officer and medical director of the gender health program at Children's Minnesota.