Ban on gender-affirming care comes before N.H. lawmakers today. Health providers warn of 'catastrophic' impact on youth

As New Hampshire lawmakers prepare to consider bills aimed at banning gender-affirming care for transgender youth, local medical providers and mental health professionals are pushing back — saying the proposed legislation is not based in science and would be damaging to vulnerable young people.

New Hampshire-based providers said access to medical care that affirms their gender identity — and a supportive social environment — can make a huge difference in the mental health of trans youth, who struggle with higher rates of depression, anxiety and suicidal ideation.

Harvey Feldman, a New Hampshire-based therapist who works with LGBTQ youth, said the mere existence of these proposals can take a toll, even when they don’t pass.

“There's lots of questions coming up about, ‘What does this mean for me?’ ‘What if I can't get care?’ ‘What if the care that I am getting gets taken away from me?’” Feldman said. “You know, there's a lot of stress and anxiety and worry.”

This is not the first time, he added, “that we have to go to the state Legislature and essentially ask to be able to exist.”

Conservative state lawmakers across the U.S. have increasingly sought to restrict access to this kind of care in recent years, as part of a larger push to restrict the rights of trans youth.

The ban on gender-affirming care for minors in New Hampshire is included in a sweeping Republican-sponsored bill before New Hampshire lawmakers Tuesday, which would also prohibit trans students in K-12 schools from using the bathrooms that align with their gender identities, among other restrictions. Another Republican bill also scheduled for a public hearing Tuesday would define gender-affirming care as child abuse.

Democrats have put forward their own bill protecting access to gender-affirming care, which will also be heard Tuesday.

Gender-affirming care has the backing of major medical groups including the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association and the Endocrine Society.

For youth, this kind of care could involve counseling, drugs that delay the onset of puberty and hormone therapy later in adolescence.

Research has found that gender-affirming care is associated with better mental health outcomes, including decreases in depression and anxiety and fewer suicide attempts.

People “experience a tremendous amount of relief — and a reduction in symptoms of anxiety, distress, depression — when they can align who they are with their body,” Feldman said. Banning that care would have a “catastrophic” impact on the mental health of people who need it, he added.

“I think if we were talking about someone who had juvenile diabetes, and then was not allowed to access insulin, we could understand,” Feldman said.

In written testimony opposing one of the proposed bans in New Hampshire, Caroline Callery, a registered nurse at Dartmouth Hitchcock Medical Center’s pediatric endocrinology department, described similar impacts.

“Most of the patients I initially meet are hurting, they are depressed, anxious and sometimes suicidal,” Callery wrote. “After getting on these life-saving medications such as puberty blockers, to delay puberty and give them the time to decide what is right for their own bodies, I personally see these adolescents experience a metamorphosis.”

Dr. Jack Turco is an endocrinologist who co-directs Dartmouth Health’s transgender and gender-diverse health program. Withholding gender-affirming care, he said, would violate his ethical obligation as a doctor to do no harm.

“We have very good data to show that without being supported, these children and families have a lot of potential for negative outcomes,” he said.

Susan Stearns, the executive director of the New Hampshire chapter of the National Alliance on Mental Illness, echoed Feldman’s concerns about the impact of legislative debates over trans rights on youth.

She mentioned a 2021 poll commissioned by national LGBTQ advocacy group The Trevor Project, which found 85% of transgender and nonbinary youth surveyed said debates about such restrictions had been detrimental to their mental health.

“There's no question that our youth are listening, and our youth are well aware of these bills, here in New Hampshire, and across the country,” Stearns said.

Resources: You can reach the National Suicide Prevention Lifeline by dialing 988 and the Samaritans Statewide Hotline (call or text) at 1-877-870-HOPE (4673). Call2Talk can be accessed by calling Massachusetts 211 or 508-532-2255 (or text c2t to 741741).

This story is a production of the New England News Collaborative. It was originally published by New Hampshire Public Radio.