To protect Idaho’s youth, we should provide health care options — not take them away
Passing a ban on gender-affirming care will make a desperate situation for understaffed clinics and hospitals more dire, writes guest columnist Rachel Chisausky.
Passing a ban on gender-affirming health care will make a desperate situation for understaffed clinics and hospitals even more dire, writes guest columnist Rachel Chisausky. (Getty Images)
As a doctor, I have seen a lot of people in their most vulnerable moments. But some visits with patients stick to your soul and never leave.
I’ll never forget one of my most heartbreaking visits, when a transgender patient looked at me with pleading eyes and asked, “Am I safe here?”
My patient was referring to the state of Idaho, not my clinic.
And I could not ethically tell them yes.
This year, the Legislature has propelled Idaho into the top tier of states that are slamming their constituents with anti-transgender legislation. Perhaps chief among them for medical professionals is the bill to ban access to gender-affirming health care.
If you take a look at comments on social media, you will see deeply held anti-transgender hatred vaguely disguised as a desire to “protect children” from accessing care — from people who blatantly ignore the stories of trans youth and their parents, faith leaders, and employers, who have testified over and over again about their humanity, saying this care saved their lives.
I need my fellow Idahoans to truly understand what the implications are of taking health care away from some individuals – necessary health care for people who already must face discrimination, social stigma, scarce resources, and, too often, outright hatred in order to access it, from both in and out of the health care system.
And now, Idaho’s lawmakers have decided we doctors shouldn’t provide medically safe health care for reasons not based on medical reasoning or mainstream best practices.
As doctors, we take an oath to put the wellbeing of our patients first. We are trained to be competent medical providers. We’ve spent many years, countless never-ending late nights learning medicine and training to make nuanced diagnoses based on peer-reviewed research on modern medicine and understanding of the workings of the human body. We practice discussing intimate and individualized health care plans for each patient, and do not simply hand out medication and treatment without knowing it is the best course of action for our patients. We believe in parental rights, and work with parents and families to come with a unique plan for each patient. Idaho’s lawmakers do not and can not know better than the overwhelming majority of doctors and our patients about what each transgender person’s medical needs are.
The American Medical Association, along with 30 other prestigious medical groups such as the American Academy of Pediatrics, the American Psychiatric Association, and even the World Health Organization have stood firmly in support of gender-affirming health care for youth. These national and international associations that represent more than 300 state and specialty medical societies, have published, many times, in no unclear terms, that trans youth must be able to access gender-affirming health care, because if not, they will suffer harmful health consequences.
Idaho’s Legislature has already made some terrible, sweeping medical practice bans over the protests of the medical community. Our backwards, discriminatory laws have driven out many doctors already. Currently, there is a 98% primary care physician shortage in Idaho. Criminalizing physicians for offering the health care we swore an oath to provide will drive doctors out, limiting access to rural primary care and specialty care. Passing House Bill 71 will make a desperate situation for both understaffed clinics and hospitals even more dire. It will bring incredible harm to the transgender community and will have a negative ripple effect on everyone who receives health care in our state, transgender or not.
Although being transgender is a normal part of the human experience, gender diverse youth face stigma and prejudice on a regular basis, leading to significantly higher risks for depression and suicidal thoughts and attempts compared to cisgender youth. Bills like this, that strip away basic rights, do not help. What does help is access to the spectrum of gender affirming care; A Journal of American Medical Institute study published in 2022 showed 60% lower odds of depression and 73% lower odds of suicidal thoughts for transgender youth receiving gender-affirming care and support. This is lifesaving medical care.
Lawmakers need to stick to the facts and listen to parents, patients and doctors. Young children are not undergoing surgery to have body parts removed. With the consent of parents, we are ethically treating minors who are experiencing crushing gender dysphoria. We are helping them and their families through a fully vetted, lengthy process that involves medical and psychological teams working with the patient and their legal guardian to make the best medical decisions for their mind and body.
If HB 71 becomes law, I will tell my trans patients I don’t know if they are not safe in Idaho. I will tell my families that they will now need to travel for the care they need and deserve, whether that means relocating or the time and cost of regular out-of-state doctor’s visit. I may also join my colleagues in a state where doctors are the ones providing medical care, one where I can tell my trans patients, yes you are safe, and I will give you the care you need.
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