Lawmakers should follow medical guidance on gender rules
There are some experiences that are unique to being a pediatrician. Here is one of them.
A lifelong patient, now a teenager, sits down in your office. As their concerned parent looks on, the patient describes feelings of depression and anxiety. Lifestyle changes, counseling and medication have not helped.
After a long discussion, you realize this patient is expressing clear signs of gender dysphoria. You gently inquire — and the floodgates open as a weight is seemingly lifted off their shoulders. With the three of you working together, you develop a plan for the teen to begin discussing their identity with their counselor, friends and family. In the short time of that visit, that patient is instilled with better health, hope and an open path forward.
This is a true story. It is one that we, as pediatricians caring for families across Virginia, have seen play out many times.
This safe, evidence-based collaboration between pediatricians, mental health providers, patients, families and schools is being threatened. In Virginia, the Youngkin administration has proposed changes that would be dangerous to the health and well-being of transgender and gender non-conforming youth.
In accordance with Virginia Department of Education guidance, which calls for the deployment of evidence-based practices, the Virginia Chapter of the American Academy of Pediatrics recommends the VDOE work
with pediatricians, adolescent medicine physicians, mental health providers, and other medical specialists on the ground to craft policy around gender-affirming care of young Virginians. This should include transgender and gender-nonconforming people who have lived experience and are most affected by these policies — their voices need to be heard.
Studies show that socially transitioned transgender youth who are supported have developmentally normal levels of depression and only minimal elevations in anxiety. However, the new plan proposed by the governor interferes with collaborative, evidence-based model of care. The policy would necessitate outing a transgender or gender non-conforming student to their parents, who must officially change school records for them just to use a different name or pronoun in class. This violates our patients’ free choice for speech and expression and puts them in danger; many transgender and gender non-conforming children and adolescents live in homes where disclosing this makes them unsafe. Abusive homes can lead to mental health problems, youth running away, and increased risky behaviors such as alcohol and substance use. A 2017 study showed that LGBTQ+ youth have a 120% increased risk of experiencing homelessness.
Lastly, suggesting that transgender and gender non-conforming students be relegated to a single-user bathroom can lead to segregation and discrimination. We believe singling out transgender and gender non-conforming students in such a public manner would lead to alienation and bullying. We stand by the American Academy of Pediatrics policy that supports removing barriers for gender expression and affirming those who are transgender and non-conforming.
Pediatricians are not politicians. The politicization of the care we provide threatens our ability to provide evidence-based care. We implore our elected leaders to craft health guidance in consultation with established, mainstream medical institutions with expertise in this area. Pediatricians will continue to advocate on behalf of all our patients, including transgender and gender non-conforming youth.
Kristina Powell, M.D., of Williamsburg; Natasha Sriraman, M.D., of Norfolk; Percita Ellis, M.D., of Lexington; and Michael Martin, M.D., of Tysons Corner, serve on the executive board of the Virginia Chapter of the American Academy of Pediatrics and care for families across the state.