The Urgent Need to Preserve Gender-Affirming Care for Our Youth
- Dr. Louis V. Haynes
- Apr 23
- 5 min read
Updated: May 1
by Dr. Louis V. Haynes and Anthony Guerrero Short, MPH MS
As a community-based mental health organization serving youth and families across Illinois, we urge you to uphold and protect access to gender-affirming care, and enforce existing laws protecting youth in Illinois in accessing life-saving care. The stakes are high: the mental health, agency, and lives of young people are on the line.
Gender-affirming care is not controversial in the field of mental health—it is best practice.
It is rooted in decades of scientific research and clinical experience. The American Psychological Association (APA) affirms that its stance on gender identity and care is "grounded in the best available science" (APA, 2024). Similarly, the American Academy of Pediatrics (2023) describes gender-affirming care as a broad and developmentally appropriate spectrum of services, including social transition, mental health support, and medical interventions like puberty blockers and hormone therapy when clinically indicated (Le, 2023; AAP, 2018).
Protecting access and delivery of gender-affirming services is crucial to the lives of young Trans people in Illinois. Recent attempts to remove or deny the legitimacy of gender identity in federal policy have already created ethical and professional dilemmas for psychologists, barriers to care for transgender and nonbinary individuals, and restrictions on critical research and training (APA, 2024). These policy shifts directly contradict established science, penalize and threaten institutions when delivering this care, and ultimately increase mental health risks to transgender and gender-diverse populations.
The Science is Clear
Sex is not strictly binary. Approximately 1.7% of the global population is born with differences in sex development (DSD) or variations in sex characteristics (Esteban et al., 2023; AMA, 2021).
Gender is a nonbinary, deeply felt identity. It has been studied across cultures and centuries (Gill-Peterson, 2018; Institute of Medicine, 2011).
The brain supports identity. Neuroimaging has shown that the cortical structure of transgender individuals often aligns more with their gender identity than their assigned sex at birth (Mueller et al., 2021; Nguyen et al., 2019).
Affirmation improves health. Gender-affirming care decreases psychological distress and increases well-being, resilience, and quality of life (Mezza et al., 2024; Witten, 2003).
Conversely, discrimination and denial of care are the most significant risk factors for poor mental health outcomes among transgender individuals (Bradford et al., 2013).
The Reality in Illinois
According to the Illinois Department of Public Health, LGBTQ+ youth are three times more likely to attempt suicide compared to their cisgender peers (IDPH, 2024). These disparities emerge early—as young as 3 years old, children can experience gender dysphoria and psychological distress (Stewart et al., 2023).
Approximately 20% of Illinois youth identify as LGBTQ+, and an estimated 1–2% of youth identify as transgender or gender nonconforming (Herman, Flores, & O’Neill, 2022). These are not niche numbers—these are tens of thousands of children across our state.
Following anti-trans legislation and rhetoric in other states after the 2024 election, calls to The Trevor Project’s crisis services spiked by over 125%, directly correlating with the trauma these young people experience when their identities are politicized and their care threatened (Trevor Project, 2024).
A study in Nature found that in states with anti-transgender legislation, youth suicide attempts were 72% higher than in states with affirming policies (Human Rights Campaign, 2023).
The Role of Providers—and the Harm of Denial
Healthcare providers have the power to affirm or alienate. Yet in 2022, one in three transgender or gender nonconforming youth reported being denied care by a provider (Center for the Study of Social Policy, 2024). These rates are even higher for youth of color (Johns Hopkins Bloomberg School of Public Health, 2024).
When care is delayed or denied, identity development and mental health are harmed—sometimes irreparably. The damage compounds across the lifespan. As providers and as advocates we must do better, and not relent to demands which go against our existing state laws and policies, against validated scientific evidence, and against our ethical obligations to the care of residents in Illinois.
You have a choice: to protect the well-being and dignity of Illinois youth or to subject them to fear, stigma, and preventable harm.
We urge you to:
Protect access to gender-affirming care in Illinois, specifically for youth and families navigating early social and medical decisions.
Shield providers, institutions, and families from legal penalties, so they can act in accordance with clinical ethics and science.
Fight for residents in Illinois seeking gender-affirming care by enforcing existing laws that protect Trans youth and fighting for laws which enshrine their protection further.
Support continued efforts for funding ensuring that the next generation of providers is equipped to meet the needs of all Illinoisans.
This isn’t about ideology—it’s about public health, safety, and dignity. We urge you to keep your existing commitments to keep Illinois as an oasis for anyone seeking care, and to fight back against federal demands which attempt to gut protections for our youth and actively penalize institutions and providers for the provision of these services.
These young people deserve access to care that affirms who they are. They deserve professionals who can practice without fear. They deserve legislation that protects—not punishes—them for being themselves.
Gender-affirming care is essential care. It is time to preserve it.
References
American Academy of Pediatrics. (2018). Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics, 142(4): e20182162. https://doi.org/10.1542/peds.2018-2162
American Academy of Pediatrics. (2023). AAP reaffirms gender-affirming care policy. https://publications.aap.org/aapnews/news/25340
American Medical Association. (2021). AMA reinforces opposition to restrictions on transgender medical care. https://www.ama-assn.org/press-center/press-releases/ama-reinforces-opposition-restrictions-transgender-medical-care
American Psychological Association. (2024). APA adopts groundbreaking policy supporting transgender, gender diverse, nonbinary individuals. https://www.apa.org/news/press/releases/2024/02/policy-supporting-transgender-nonbinary
Bradford, J., Reisner, S. L., Honnold, J. A., & Xavier, J. (2013). Experiences of transgender-related discrimination and implications for health. AJPH, 103, 1820–1829. http://dx.doi.org/10.2105/AJPH.2012.300796
Center for the Study of Social Policy. (2024). Attacks on Gender-Affirming Care are Harming Young People. https://cssp.org/attacks-on-gender-affirming-care-are-harming-young-people/
Esteban, C., et al. (2023). Quality of life and psychosocial well-being among intersex-identifying individuals in Puerto Rico. IJERPH, 20(4), 2899. https://doi.org/10.3390/ijerph20042899
Gill-Peterson, J. (2018). Histories of the Transgender Child. University of Minnesota Press.
Herman, J., Flores, A., & O’Neill, K. (2022). How Many Adults and Youth Identify as Transgender in the United States? https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Pop-Update-Jun-2022.pdf
Human Rights Campaign. (2023). Get the facts on gender-affirming care. https://www.hrc.org/resources/get-the-facts-on-gender-affirming-care
Institute of Medicine. (2011). The Health of LGBT People: Building a Foundation for Better Understanding. National Academies Press.
Johns Hopkins Bloomberg School of Public Health. (2024). Study Reveals Significant Barriers for TGNC Adults. https://publichealth.jhu.edu/2024/study-reveals-significant-barriers-for-tgnc-adults-accessing-healthcare-in-the-us
Le, H. (2023). Further Defining Gender-Affirming Care. AAP. https://publications.aap.org/journal-blogs/blog/27752
Mezza, F., et al. (2024). Minority stress and mental health in European transgender and gender diverse people. Clinical Psychology Review, 107, 102358. https://doi.org/10.1016/j.cpr.2023.102358
Mueller, S. C., et al. (2021). The neuroanatomy of transgender identity. Journal of Sexual
Medicine, 18(6), 1122–1129. https://doi.org/10.1016/j.jsxm.2021.03.079
Nguyen, H. B., et al. (2019). The role of hormones in the transgender brain. Neuropsychopharmacology, 44(1), 22–37. https://doi.org/10.1038/s41386-018-0140-7
Stewart, S. L., Van Dyke, J. N., & Poss, J. W. (2023). Mental Health Presentations of TGNC Youth. Child Psychiatry & Human Development, 54(3), 826–836. https://doi.org/10.1007/s10578-021-01289-1
Trevor Project. (2024). Post-Election Day Crisis Contact Volume Data. https://www.thetrevorproject.org/blog/the-trevor-project-shares-post-election-day-crisis-contact-volume-data/
Witten, T. M. (2003). Middle Adulthood Issues in the Transgender and Intersex Community. Journal of Human Behavior in the Social Environment, 8(2–3), 189–224. https://doi.org/10.1300/J137v08n02_12
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