NC experts: Gender affirming care saves lives. These bills won’t. | Opinion

Drs. Leigh Spivey-Rita , Dane Whicker, Sarah Wilson, Moira Rynn
·3 min read
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Editor’s note: The presidents of the N.C. Psychological Association, N.C. Psychiatric Association, and N.C. Council of Child & Adolescent Psychiatry also signed on to this op-ed.

Several bills proposed by the N.C. General Assembly threaten youth in our state and take away the rights of parents to keep their transgender and nonbinary children safe from harm.

If these bills pass, parents would no longer be allowed to follow the expert guidance of highly trained teams of healthcare providers.

These bills also reflect the flood of inaccurate information spreading across the U.S. about gender affirming care. In actuality, the process of providing gender affirming care for transgender and nonbinary youth is evidence-based, rigorous, cautious, safe and beneficial — even life-saving — when done by healthcare providers with expertise in such care.

With the very small number of trained gender care specialists in North Carolina, young transgender and nonbinary people and their parents/guardians wait months to see a specialized team of providers. After careful evaluation by the team, followed by multiple mental health and medical appointments, an evidence-based care plan is developed with the family. Expert healthcare teams do not rush something as serious as social and/or medical gender transition.

Care may include psychotherapy appointments, FDA-approved medications to temporarily delay puberty, fertility preservation, FDA-approved hormone therapy, and, in rare cases, surgical interventions for older adolescents. Studies show that access to gender affirming care saves lives.

For many transgender and nonbinary youth, it is difficult and painful to live in a world where they constantly feel stigmatized. They know there is serious risk of rejection by parents, peers and communities. But many of these children and teens feel they cannot continue enduring the pain of living in the wrong body and being treated as the wrong gender. This pain often leads to hopelessness, depression and self-harm. Gender affirming care can help relieve this suffering.

Senate Bill 639 and House Bill 808 ban this life-saving care and take away parents’ rights to decide what healthcare options are best for their children. Forcing transgender and nonbinary youth to proceed with a puberty that is inconsistent with who they are is not a “neutral” option, as it results in irreversible changes to their body. These bills contradict the unified stance of the most well-respected medical and healthcare organizations in the U.S. — more than 1.3 million doctors.

Senate Bill 560 would prevent parents from making healthcare decisions in the best interests of their children. The requirements it proposes create so many barriers to accessing gender affirming care that it is functionally a ban on that care.

For example, the bill requires monthly in-person visits with a “child psychiatrist.” Our state has an extreme shortage of pediatric psychiatrists, and more than half of its counties have no pediatric psychiatrists. According to our calculations, each pediatric psychiatrist in the state would be responsible for serving the needs of 117 transgender youth under this bill. It is not feasible for the current pediatric psychiatrist workforce to comply with the proposals in SB 560.

We hope North Carolinians who want to protect our state’s most marginalized children will heed this alarm and call for action. Legislation like this has been shown to increase depression and risk for suicide among LGBTQ+ individuals. These bills and other anti-LGBTQ+ bills filed in North Carolina, do not keep youth safe — they cause serious harm.

We are asking the General Assembly to vote no on this harmful legislation. We’re asking North Carolinians who want to protect transgender and non-binary youth to speak up for what is right.

And, to the transgender and non-binary youth of North Carolina: We see and hear you. We will never stop listening to you and advocating for you.

The writers are affiliated with Duke University School of Medicine: Moira Rynn chairs the Department of Psychiatry and Behavioral Sciences, Leigh Spivey-Rita is a medical instructor, Dane Whicker directs Gender and Sexual Diversity Initiatives, and Sarah Wilson is an assistant professor. The views expressed are their own.