CARE IN TENNESSEE WILL STOP PROVIDING THIS CARE TO YOUTH ON JULY 1

care for youth, followed by Alabama in 2022. 2022 also saw several extremely concerning directives and guidelines regarding gender-affirming care for youth in Florida and Texas. Many will recall Texas’ directive effectively banning gender-affirming healthcare for transgender youth and defining such care as “child abuse”, which is still in effect.

Here in Tennessee, the first law targeting gender-affirming healthcare for youth was passed in 2021. This law banned hormone treatment for “prepubertal minors”, demonstrating both the Tennessee state legislature’s contempt for the transgender community and ignorance of gender-affirming care, as the type of hormone treatments banned by the law typically do not begin until the onset of puberty. In 2023, however, Tennessee passed a full gender-affirming care ban for youth under the age of 18, with extremely real and direct impacts on transgender youth and their families. As a result of this ban, most major providers of gender-affirming care in Tennessee will stop providing this care to youth on July 1 of this year, with a handful of providers continuing to see patients under the age of 18 until March of 2024. The ban directly impacts hundreds of trans youth in Tennessee who are currently accessing puberty blockers and hormone replacement therapy through in-state providers or telehealth. They will be forced to access HRT and puberty blockers out-of-state, and some even plan to move out of Tennessee. The ban does not impact Tennessee transgender youth’s ability to access mental healthcare instate, and those who support transgender youth in accessing gender-affirming care in other states where such care re- mains legal are not criminalized by the ban. Thankfully, the U.S. The Department of Justice recently announced that it is challenging Tennessee’s ban, stating that it violates the Fourteenth Amendment's Equal Protection clause by “denying necessary medical care to youth based solely on who they are.” The Department also asked the court to issue an immediate order preventing the ban from going into effect.

Whether or not gender-affirming healthcare becomes accessible for youth in Tennessee in the future, the impact this legislation has on vulnerable youth in Tennessee and the place it holds in a nationwide wave of anti-transgender hate remain extremely significant. Even before the passage of Tennessee’s gender-affirming care ban for youth, transgender people in Tennessee faced signif- icant health disparities. According to a 2021 survey conducted by the Campaign for Southern Equality and Campus Pride, 84% of transgender Tennesseans felt that access to gender-affirming care was important to their overall wellbeing when they were under the age of 18. Unfortunately, many transgender respondents described barriers to receiving such care, often citing a lack of gender-affirming providers in their communities. One respondent wrote:

“I’m extremely anxious about going to the doctor, and the only place around here that offers any kind of trans healthcare is in Nashville, meaning I have to travel hours to be seen and get minimal respect. Anti-trans laws make that anxiety worse because I always wonder what will happen if I or my partner need emergency care locally.” (LGBTQ Tennesseans: A Report of the 2021 Southern LGBTQ Experiences Survey)

This lack of access to healthcare was reflected in transgender Tennesseans self-rated health. 49% of trans or questioning Tennesseans rated their physical health as “fair” or “poor”, and 69% rated their mental health as such. Clearly, the health of transgender Tennessean’s was concerning prior to the gender-affirming care ban. The ban will likely exacerbate this. According to a brief from the UCLA William’s Institute of Law, the nationwide wave of gender-affirm- ing care bans could have a wide array of impacts, including the penalization of medical professionals and those who assist transgender youth in accessing healthcare, restrictions on funding for gender affirming-care, insurance-based limitations to accessing gender-affirming care, further non-consensual medical interventions for intersex youth, and increasing stress for transgender youth and their families.

Thankfully, the LGBTQIA community in Tennessee is banding together to support transgender youth and their families during this incredibly stressful time. Community organizations, trans community organizers, parents of trans youth, and so many others are coming together to show support for trans youth through mutual aid networks and by creating spaces to process what is happening; ultimately cultivating healing, resilience, and resistance. inclusion tennessee is part of a group of organizations across the South leading one such effort, the Southern Trans Youth Emergency Project (STYEP). Through this program, transgender youth who have lost access to gender-affirming care in their state can be connected with gender-affirming care providers in states where gender-affirming care remains legal. They can also access $250 grants to support things like travel costs, mental healthcare, or whatever they might need during this difficult time. To learn more about STYEP and get help in Tennessee, go to: https://southernequality.org/tnresources/