Peer-reviewed article

Anti-Transgender Legislation—A Public Health Concern for Transgender Youth

Harry Barbee, Cameron Deal, Gilbert Gonzales · 8 Nov 2021

Abstract

State legislatures are pursuing policies that deny rights and services to transgender youth.In 2021, 8 states have passed anti-transgender laws, while 29 others have attempted similar actions.Some policies, like those that deny transgender youth access to transition-related health services (eg, gender-affirming surgeries and hormone therapy), have explicit health implications.The health consequences of other policies, like those that ban transgender youth from athletics, are less obvious, though perhaps not absent.Drawing from transgender health research, we caution that anti-transgender legislation could exacerbate existing health disparities, facilitate risky health behaviors, and lead to preventable deaths.These potential outcomes warrant treatment as public health concerns. Transgender People Experience Health DisparitiesIn 2011, the Institute of Medicine recognized transgender people as a population with unique health disparities.1 Compared to cisgender people, transgender individuals in the US report poorer self-rated health, more chronic illness, and higher rates of disability.A leading explanation for these disparities is that transgender people experience ongoing exposure to prejudice, discrimination, and harassment, which causes chronic stress that wears down the body over time. 2 Importantly, transgender health disparities may be influenced by enduring systemic issues, like religious-based persecution, exclusion from institutions, and a lack of protections from discrimination in workplaces, schools, and other public accommodations.Systemic marginalization may have uniquely harmful effects on transgender youths' health.The Figure presents analyses by Johns and colleagues, 3 who studied health risk behaviors or experiences and health outcomes using the 2017 Youth Risk Behavior Survey.The researchers found that, compared to cisgender youth, transgender youth are more likely to