SC bill poses major risk to the mental health of transgender youths
I am a pediatrician in Columbia, South Carolina. I am writing to voice strong opposition to H4047, the SC Minor Child Compassion and Protection Act, introduced March 9, 2021. This legislation would prohibit gender affirming medical care for transgender youth and would compel school staff to notify parents if a youth discloses that they are transgender. This bill poses a major risk to the health and safety of transgender youth in South Carolina.
I have a very diverse patient population including youth who identify as transgender. I see these patients for routine well visits and acute sick visits. I also see them for mental health problems at a rate far greater than their peers. These problems include anxiety, depression, thoughts of suicide and actual suicide attempts. No child “becomes” transgender on a whim. I have cared for patients who have identified as transgender since they were preschool age, although they had no idea what the term meant at the time. These children struggle throughout childhood and adolescence due to lack of acceptance and outright bullying and abuse.
According to The Trevor Project, over 50% of transgender youth have had suicidal thoughts in the past year and approximately 35% have attempted suicide. My experience with my own patients would definitely support those rates. Those who experienced discrimination based upon their gender identity have more than double the risk of attempting suicide in the past year. This risk decreases by 25%, however, if the youth has a gender affirming space such as school. The risk also decreases if the youth receives supportive, gender affirming medical care. This is the model supported by the American Academy of Pediatrics policy, “Encouraging Comprehensive Care and Support for Transgender and Gender Diverse Children and Adolescents.”
Bill H4047 would eliminate both gender affirming care and that supportive space that is so important to these youth. This legislation would criminalize the use of puberty blockers, the effects of which are completely reversible when the medication is stopped. These medications do not cause permanent physical change in the child. Conversely, they delay the permanent physical changes of puberty which are frequently extremely distressing to a transgender child and can trigger a mental health crisis. Puberty blocking medications allow the child additional time to mature, receive counseling and make educated decisions about their future. The puberty blocking medications can be stopped at any time, allowing the physical changes of puberty to occur.
This legislation would also force teachers and school staff to “out” a transgender youth to their parents if the youth discloses their gender identity. This essentially eliminates the possibility of the school serving as the safe space that is so crucial for the mental health of transgender youth.
The S.C. Minor Child Compassion and Protection Act H4047 provides neither compassion nor protection for transgender youth in South Carolina. On behalf of my patients and all transgender youth in South Carolina, I stand in strong opposition to this legislation.