Op-ed: 'Defending gender-affirming doctors is our moral imperative'

click to enlarge Alt: A transgender woman in a hospital gown being treated by a doctor, a transgender man. - Photo by Zackary Drucker / The Gender Spectrum Collection
Photo by Zackary Drucker / The Gender Spectrum Collection
Alt: A transgender woman in a hospital gown being treated by a doctor, a transgender man.

2021 was the deadliest year on record for transgender Americans. As of December, The Advocate has documented that 50 members of this population have died by violence, surpassing 2020's record of 44. Today trans people are not only victims of hate-crimes but they are also routinely attacked by elected leaders. More anti-trans bills were passed in 2021 than any year before, including legislation aiming to deprive transgender youth from participating in sports teams that align with their gender identity and restricting access to lifesaving gender-affirming medical care.

The latest maneuver by transphobic politicians to date is the legislation being proposed in 21 states which would criminalize doctors for providing medical care to trans minors. One such bill, HB 211, was introduced in Florida in September 2021 and seeks to impose criminal penalties for medical practitioners that perform gender-affirming treatment.

This draconian bill represents nothing short of political persecution targeting the people who provide essential care and save lives every day. To defend our healthcare providers, we hope pro-LGBTQ legislators vote to oppose HB 211. Condemning the proposed legislation is critical for transgender rights and is also our moral imperative as a free democratic society.

Ignorance breeds transphobia

As outlined in HB 211, health care practitioners who perform surgeries including a vasectomy, sterilization, mastectomy or vaginoplasty would face criminal penalties. Providing hormone blockers and hormone therapy that use testosterone or estrogen would also incur criminal liability for the practitioner.

Ironically, the ignorance inherent in the language of this bill becomes most apparent in the legislation’s only exclusion. If a patient was born intersex, the bill allows for parents to proceed with surgery that could change their child’s sex. What the authors of this bill fail to acknowledge, however, is that intersex individuals can also identify as transgender or nonbinary.

The hubris of anti-LGBTQ politicians picking and choosing which trans child has the right to medical care is an affront to all American families. Unfortunately, this willful ignorance is also reflective of the general population’s lack of education regarding the nuances of the gender spectrum and the complexities of gender-affirming treatment. And this lack of education is at the root of the anti-trans violence permeating American life today.

click to enlarge Op-ed: 'Defending gender-affirming doctors is our moral imperative'
Orlando Gonzalez

Gender-affirming care saves lives

One of the greatest misconceptions among America’s general population is that gender-affirming medical procedures are a cosmetic choice on part of the patient. Anti-LGBTQ politicians often reinforce this false notion while discussing anti-trans legislation, but transgender health experts and the medical community at large tell us differently.

The World Professional Association for Transgender Health, considered the governing body on this issue, has stated that “medical procedures attendant to gender affirming/confirming surgeries are not ‘cosmetic’ or ‘elective’ or ‘for the mere convenience of the patient.’” “In some cases, such surgery is the only effective treatment for the condition,” and for some people, genital surgery, in particular, is “essential and lifesaving.”

The American Medical Association (AMA) has been outspoken against anti-trans bills which it recognizes as “a legislative intrusion into the practice of medicine.” In letters to legislators, the AMA has emphasized that it is “imperative that transgender minors be given the opportunity to explore their gender identity under the safe and supportive care of a physician.”

Meanwhile, the American Academy of Child and Adolescent Psychiatry continues to strongly oppose any legal and legislative efforts to ban evidence-based care for transgender and gender-diverse youth. As the organization states, “blocking access to timely care has been shown to increase youths’ risk for suicidal ideation and other negative mental health outcomes.”

Indeed, medical research continues to demonstrate that gender-diverse youth who are supported in living the gender role consistent with their gender identity have better mental health outcomes than those who are not. They also have much better odds of staying alive.

We must remain ever vigilant in today’s anti-trans climate

Even as we fight clear and present threats to transgender lives, like HB 211, we must also continue to watch for new emerging dangers. As 2021 came to a close in December, Florida Governor Ron DeSantis escalated his vicious campaign against LGBTQ youth by taking down a Department of Education webpage that provided anti-bullying resources and suicide prevention support for students, parents, and educators.

This is just the latest example of DeSantis sacrificing the safety of children by fighting his political battles in our state schools and turning their campuses into hostile territory for LGBTQ students. These efforts also include inviting harassment and threats of violence towards LGBTQ students from anti-vax extremists at school board meetings and calls for banning LGBTQ-inclusive books. While DeSantis panders to his base with these spiteful political maneuvers, Florida’s LGBTQ students continue to face higher and higher rates of bullying, discrimination, violence, depression, and suicide.

Our LGBTQ community must hit the ground running in 2022 if we are to prevail in the fight against politicians who seemingly stop at nothing to strip our rights and threaten our lives. We hope you will join us in denouncing Florida House Bill 221 as the legislative session kicks off this week. To support our pro-equality mission, we are asking you to spread the word, educate others, and help us end ignorance and hate in our community.

Orlando Gonzales is the Executive Director of SAVE LGBT.
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