Scores of bills in US states aim to block medical treatments for trans youth. But research shows that these bans could have dire consequences.
But despite the governor’s veto attempt, the Utah bill passed, as have a few across the country that ban gender-affirming medical care for kids and teens. Many other such bills are currently in the works. These treatments—principally drugs that delay the onset of puberty, and hormone treatments such as testosterone and estrogen—help trans people achieve the bodies and appearances that feel right to them. Experts worry that the bans will have catastrophic effects.
Because such treatments for adolescents are relatively new, and access to them is limited, the pool of studies about their mental health effects is both small and recent. But WIRED spoke with half a dozen academics who have published studies on transition and suicidality in peer-reviewed journals, and they all agree—gender-affirming medical care seems to lower that risk among trans youth. There’s no single study that proves it once and for all, no clincher that can summarily end every argument.
Research in this area can be tricky because it deals with small numbers: Trans people are a minority of the population, and those who receive gender-affirming treatment as minors are an even tinier subset. Some of those minors may receive puberty blockers, others only get hormones, and some get both. Gathering enough participants to obtain statistically significant results takes a lot of time and money.
Studies limited to people who have attempted suicide would be smaller still. So researchers often focus on suicidality, a term that captures a wide range of behaviors, including thinking about ending one’s life. Critics have contended that this research doesn’t show evidence of a crisis—after all, thoughts are not actions. But ideation is a strong predictor of attempted suicide, and a “marker of really severe psychological distress,” Turban says.
To do that, researchers have two primary tools at their disposal. The first is the longitudinal study, which tracks individuals over a period of time to evaluate the efficacy of a medical intervention. In the trans health care context, these studies typically start in the clinic: Patients who want to pursue a particular intervention will get recruited for the study, and then researchers will follow them over the course of their treatment.
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