Gender-affirming care debate underlines health care challenges in LGBTQ+ community

Risks like suicide are not due to the identity of being transgender itself, but it is due to the external factors around them, according to Public Health – Dayton and Montgomery County: factors such as social acceptance.

For LGBTQ+ youth who feel accepted by a parent/caregiver, they are around 40% lower odds of attempting suicide, according to the Trevor Project, a national organization with the goal to end suicide among LGBTQ+ young people.

“That’s one accepting adult,” said Richelle Frabotta, LGTBQ+ health initiatives project manager at Public Health.

In 2022, nearly half of the respondents to the U.S. Transgender Survey ― 48% of more than 92,000 people ― reported having at least one negative experience with a health care provider because they were transgender.

Examples of medical discrimination could include being refused health care, being misgendered, having a provider use harsh or abusive language when treating them, and/or having a provider be physically rough or abusive when treating them, according to the U.S. Transgender Survey, the largest survey of transgender people across the U.S.

By removing access to care, local parents, allies and members of the LGBTQ+ community are worried about these outcomes.

Iris Patton, of Hamilton, who works with students both high school and college-aged at Miami University Regionals, says college is a peak time where transgender youth transition. But they have seen where even just getting an initial appointment to start accessing gender-affirming care can take upwards of six months.

“There’s already an immense amount of time and effort that people have to go through in order to get even the consideration that this is something that they need,” Patton said.

Patton has also had about four or five friends hospitalized for their mental health, such as for attempting suicide, but then they were able to transition once they reached college.

“It enabled them to go on and live the rest of their lives,” Patton said.

Ohio has already been one of the top 10 states from which transgender people moved. This is due to state laws targeting transgender people for unequal treatment, according to the U.S. Transgender Survey.

Gender-affirming medical care, such as hormone therapy, is associated with positive mental health outcomes, including showing promise for reducing suicide risk, as published in a 2021 study in the Journal of Adolescent Health.

Those researchers found gender-affirming hormone therapy is significantly related to lower rates of depression, suicidal thoughts and suicide attempts among transgender and nonbinary young people.

Life satisfaction post-transition

Doctors have seen firsthand how transgender patients react to gender-affirming care.

“Patients also often come in and say after their follow up visits, after they started hormones, that they feel a lot of relief, and they’re finally able to feel comfortable and feel like their true selves, and sometimes they say for the first time ever in their lives,” Liner said.

Treating gender dysphoria with hormones is also much more effective than treating the condition with antidepressants, many of which are known as SSRIs or selective serotonin reuptake inhibitors.

“All in all, they have pretty good efficacy. They work pretty well for depression, but they are nowhere near the level of how well hormone care is beneficial for folks,” said Dr. Teagan Vaughn, director of gender-affirming care at Equitas Health.

Almost all (94%) of the transgender people in the 2022 U.S. Transgender Survey said they felt their life was generally better since transitioning.

There are high-profile examples of people who regret receiving gender-affirming care, referred to as “detransitioners.”

Morgan Keller was the only detransitioner from Ohio who testified in opposition to House Bill 68. She didn’t respond to interview requests from the Dayton Daily News, but told state lawmakers: “I can say with one hundred percent certainty that this medicalization only gave me new health problems and mental distress.”

The survey found 2% of respondents said they were “a lot less satisfied” after transitioning.

With 92,329 respondents, the survey found 79% of those people reported they were “a lot more satisfied” and another 15% saying they were “a little more satisfied” with their life since transitioning.

Of the remaining 6%, there were 3% who reported feeling neutral, 1% were “a little less satisfied,” and 2% were “a lot less satisfied” with their life.