Transformative Solutions for Transgendered Problems

In 2012, the National Transgender Discrimination Survey published their findings, discovering that a staggering 41% of transgender individuals have attempted suicide at least once in their lifetime. In some ways, progress has been made, such as the American Psychological Association announcing its unabashed support for transgender healthcare in 2024 (APA Council of Representatives), or Sarah McBride being elected as the first transgender United States congresswoman in 2025. In many others however, trans people, and transgender youth specifically, are fighting for their right to simply exist. Anti-trans legislation, from bathroom bans to denial of gender-affirming care, has “increased over 800% since 2018” (Stewart 11:30). Transgender youth are also more likely to be victims of bullying and be denied treatment by healthcare professionals (Singh, et al. 15). The barriers that trans youth face are systemic, and lowering these barriers could not only improve their mental health outlooks on such issues as anxiety and depression, but also genuinely save their lives.

The most common barrier transgender/gender non-conforming (TGNC) youth face is social. This would be day-to-day interactions with society at large. In a survey conducted in 2018 up to 60% of lesbian, gay, bisexual, transgender, queer (LGBTQ) youth feel unsafe in school, with 70% facing verbal harassment and 57% facing sexual harassment (Hobaica et al.). Such a statistic is heavily contrasted by general rates of bullying, which affects only 19.2% of middle and high school students overall (“Facts About Bullying”). TGNC youth are also well-documented to be more at-risk for mental illnesses such as depression and anxiety. While in school, a high likelihood exists for those exhibiting gender non-conforming behavior to be ignored and not be referred to any medical provider at all, furthering adolescent confusion. Overall, the social environment for transgender youth is that of hostility. It is not uncommon for trans youth to encounter trouble convincing their parents of their gender identity, so finding ways to make social environments more welcoming is important.

In creating a safer environment for transgender students, the environment becomes safer for all. More comprehensive sexual education courses, courses inclusive of LGBTQ identities, “link participation in the… program to more progressive attitudes towards girls and women, and less agreement with hegemonic masculinity” (Grose, et al. 1). This was measured by asking students particular questions/statements both before and after their sexual education course, such as “it is all right for a girl to ask out a boy”, or “men should not show their feelings”; the students answered on a scale of 1 to 4 from strongly disagree to strongly agree. After the course concluded, score averages on the questions went down, indicating more progressive attitudes. Fostering a better understanding between students is the primary objective, so trans and gender non-conforming figures, real or fictional, can also be incorporated into the curriculum. It has been found that short-term attitudinal training can foster feelings of homonegativity, or a general dislike of LGBT behaviors, so it’s important to provide “continuous opportunities for knowledge and discussion” (Singh 10).

Social barriers, however, are only the tip of the iceberg for problems that TGNC youth face; with social being the most common, medical barriers are the most frustrating. Oftentimes, trans youth are not believed when they outwardly express their gender identity, yet what happens when their parents do believe them, and their social environment welcomes them? The next step would most commonly be seeking professional guidance. Unfortunately, “[f]ew transgender youth eligible for gender-affirming treatments actually receive them”, writes Samantha J Gridley, a doctor specializing in pediatrics and LGBTQ health (1). In her study, “Youth and Caregiver Perspectives on Barriers to Gender-Affirming Health Care for Transgender Youth”, Gridley found that many transgender youth have trouble finding a provider that is close, takes their insurance, and is transgender friendly. TGNC youth and their families also cite a lack of general knowledge of transgender health among doctors, finding “forty two percent [of doctors surveyed] did not receive any education about transgender healthcare during medical training” (Yip et al. 1). With a lack of resources and a lack of knowledge on the part of the medical community, trans youth struggle greatly to receive the treatment they need.

A way to remedy this could be providing doctors and healthcare workers more specialized training in relation to transgender health. Doctors and primary care providers were very willing to receive extra education and training in relation to gender-affirming hormone therapy (also known as GAHT), which is one of the primary forms of medical intervention for transgender youth (Yip et al. 1). GAHT is known most predominantly for helping transgender people develop the secondary sex characteristics that they desire; however, GAHT has another major benefit: alleviating depression. “[A]ll cross-sectional and longitudinal studies over the last 5 years assessing depression… reported lower depressive symptoms in both [male-to-female] and [female-to-male] transgender individuals receiving GAHT” (Nguyen et al. 3). While GAHT is not considered an outright ‘cure’ for depression, doctors and mental health professionals do agree it can help lessen depressive symptoms, leading to a higher quality of life. GAHT allows for this by assisting transgender individuals in developing greater body satisfaction, developing the secondary sex characteristics they desire; this in turn also increases self-esteem (Nguyen et al. 4). If a family or healthcare professional is unsure how to proceed, The Worldwide Professional Association of Transgender Health also has a Standards of Care guideline (the SoC) that outlines an evidence-based, multidisciplinary approach to treating TGNC patients, which is backed by decades of research, starting in the early 1990’s (Warwick and Shumer). The SoC guidelines emphasize the individuality of each trans person and is founded on the ideas of restraint and informed consent. The first step is always psychological counseling and receiving a diagnosis before prescribing a child puberty-blocking medication, which itself is reversible. GAHT is delayed until early teenage years, most commonly after multiple years of counseling and puberty blockers to ensure their desired gender. Unlike therapy, puberty blockers, and GAHT, gender-affirming surgery on transgender minors is almost never an option; excepting very rare circumstances, it is put off until the minor has become an adult. Many of these facts and concerns seem to not be understood or are unaddressed in the medical community at large, and standardizing training on transgender health can lead to more desirable outcomes for those patients.

The final barrier to be explored is the most discussed amongst the general public: legal. In 2024 alone, 617 anti-trans bills were proposed in just the United States, which would be “the fifth consecutive record-breaking year for bills targeting trans rights” (Riedel). This indicates a governing body specifically going out of its way to target a particular minority group. Never in the history of the United States have so many bills been proposed to target a specific group in such a short period of time. This includes a bill, Oklahoma’s House Bill 2885, which would have made “contributing to social transition” a legal offense, and forced anybody found guilty to be put on the sex offender registry. These bills also often target treatment for TGNC youth specifically, such as Florida’s Senate Bill 254, which has made it illegal not only for Florida residents under 18 to receive gender-affirming care, such as reversible puberty blockers, but also prevents children/family visiting the state from the same.

The legal barrier is unique in its effects in that they ripple through the other barriers as well. The previously mentioned HB 2885 from Oklahoma affects social barriers, and Florida’s SB 254 affects medical; however, anti-trans legislation also has unforeseen effects on other aspects of the medical barrier. In a 2024 study, Nathan Hollinsaid found that when compared to provider availability for Attention Deficit Hyperactivity Disorder (ADHD) or Oppositional Defiant Disorder (ODD), states with even one anti-transgender law have less transgender-specialized therapists by a factor of 35%. In essence, anti-transgender laws also make it harder for transgender youth to receive even mental health treatment for their gender dysphoria, as well as any other mental illnesses they may be suffering from.

Solutions for the legal barrier are much more difficult to place, as many of these laws are proposed by democratically elected leaders in the American government. These leaders are often far-right and tend to take the stance of protecting children, or attempt to argue how it goes against their religion. However, as has been illustrated throughout this paper, the children are not being protected; they are being targeted. Conservative lawmakers have also been found to use doctors unassociated with any known medical organizations in order to further their agenda (Stewart 37:59). This is because major medical institutions, such as the World Health Organization do indeed recognize gender incongruence as a real condition related to sexual health that necessitates at the very least, psychological treatment.

Ultimately, an increase in education surrounding trans people and their experiences is imperative in order to allow our society to move forward, past the gender malaise of the 2010’s and 2020’s. In exploring the barriers surrounding TGNC youth specifically, this paper aims to give readers the tools to recognize that despite their demonization in the media, trans people are people too and together, we can work on solutions that don’t just increase quality of life, but also save their lives.  

Works Cited

. APA Policy Statement on Affirming Evidence-Based Inclusive Care for Transgender, Gender Diverse, and Nonbinary Individuals, Addressing Misinformation, and the Role of Psychological Practice and Science. American Psychological Association Council of Representatives, February 2024 https://www.apa.org/about/policy/transgender-nonbinary-inclusive-care

“Facts About Bullying.” StopBullying.gov, edited by StopBullying.gov Editorial Board https://www.stopbullying.gov/resources/facts

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Riedel, Samantha. “With 617 Bills Nationwide, 2024 Is a Record-Breaking Year for Anti-Trans Legislation.” Them, Condé Nast, 27 June 2024, www.them.us/story/anti-trans-legislation-record-breaking-year-2024.

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