As a growing swath of GOP-led states propose restrictions to transgender health care services – mostly for individuals under the age of 18 – a new report says at least a third of transgender teens nationwide are at risk of losing gender-affirming care. 

What You Need To Know

  • A new report from UCLA's School of Law Williams Institute says at least a third of transgender teens nationwide are at risk of losing gender-affirming care

  • At least 15 states have either enacted policies or are considering bills that would “deny gender-affirming medical care to transgender youth," the report says

  • Approximately 58,000 transgender individuals between the ages of 13 - 17 live in those 15 states, over a third of the 150,000 transgender youths across the country

  • The spate of legislation comes despite pushback from some of the nation’s largest medical groups, including the American Medical Association

According to data from UCLA’s School of Law Williams Institute, at least 15 states have either enacted policies or are considering bills that would “deny gender-affirming medical care to transgender youth.” By comparing the text of various statewide bills, proposals or other orders to a 2017 report from the ​​Behavioral Risk Factor Surveillance System that stratified transgender  Americans by age, the group was able to estimate approximately how many individuals will be impacted in each state.

Altogether, approximately 58,000 transgender individuals between the ages of 13 - 17 live in those 15 states proposing restrictions to gender-affirming care, a tally that equals over a third of the 150,000 transgender youths across the country, the report said in part. 

The 58,000 number is the middle-point estimate of how many transgender teens will be impacted by the policies; the UCLA study says as little as 34,250 to as many as 98,050 people might face restrictions to gender-affirming services. 

In Arkansas – which in 2021 became the first state to attempt to ban gender-affirming care for minors – anywhere between 850 to 2,500 transgender individuals will be impacted. 

The proposals differ in scope and intention across state lines. Last year, Arkansas Gov. Asa Hutchinson vetoed a bill banning all “gender transition procedures” for individuals under the age of 18, which was later overridden by the state’s General Assembly. The ban included all surgical procedures, as well as other medical services that could serve as gender-affirming care, including hormone therapy and puberty blockers; doctors who violate the law can be sued privately or sanctioned by the state.

A judge blocked Arkansas’ law, and the state is appealing.

In Texas, Republican Gov. Greg Abbott in February ordered the state’s child welfare agency to investigate reports of gender-confirming care for kids as abuse, which came a week after Republican Attorney General Ken Paxton released a non-binding legal opinion that labeled certain gender-confirming treatments as “child abuse.”

The opinion by Paxton was directed at treatments that include puberty blockers and hormone therapy. It came months after Texas Republican legislators — who filed more anti-LGBTQ proposals last year than in any other statehouse — proposed laws banning such treatments but failed to pass them.

Other states considering proposals to curb gender-affirming care for transgender individuals aged 13 - 17 include Arizona, Georgia, Idaho, Iowa, Kansas, Kentucky, Louisiana, Missouri, Ohio, South Carolina and Tennessee. 

Bills proposed in North Carolina and Oklahoma would apply to all transgender individuals under the age of 21, while a bill in Alabama includes individuals under the age of 19.

The spate of legislation comes despite pushback from some of the nation’s largest medical groups, including the American Medical Association, which have opposed Republican-backed restrictions filed in statehouses nationwide.

Numerous studies have shown that transgender individuals face more discrimination, including bullying and harassment, than their cisgender peers, which is in turn associated with higher rates of anxiety, depression and other mental health issues. Doctors at the Cleveland Clinic recommend transgender individuals find a supportive environment, whether or not they choose to pursue surgical or other medical options, to best protect their mental health. 

A 2021 study conducted by The Trevor Project and published in the Journal of Adolescent Health found that availability and use of hormone therapy treatments “significantly related to lower rates of depression, suicidal thoughts, and suicide attempts among transgender and nonbinary youth.” 

Over half of the 9,000 transgender or nonbinary respondents said they were not currently raking hormone replacement therapy, but would like to; individuals who received gender-affirming hormone therapy reported lower rates of depression and suicidal ideation than those who wanted the therapy, but could not get access.

The Associated Press contributed to this report.