Gender-Affirming Care Is Healthcare Not Child Abuse

Chicago, IL --   Ann & Robert H. Lurie Children’s Hospital of Chicago applauds the American Academy of Pediatrics (AAP) the Texas Pediatric Society (TPS), and the Texas chapter of the AAP for their strong statement opposing the actions taken in Texas that directly threaten the health and well-being of transgender youth and their medical providers who care for them. 

On February 22, Texas Governor Greg Abbott directed the Texas Department of Family and Protective Services and other state agencies to investigate certain gender-affirming services as child abuse, based on following a legal opinion that was issued by the Texas attorney general on February 18.

Since its inception, the Lurie Children's Gender Development Program has proudly provided clinical care and clinical support services to over 2,000 transgender and gender diverse children, adolescents and their families.  

The overwhelming predominance of scientific research confirms that being transgender is not a phase, nor is it an affectation; rather it is a natural expression of the human condition. Gender affirming medical treatments are not experimental. Rather, they are well-studied and well-supported by scores of scientific research conducted across the globe. This makes the premise that evidence-based, gender-affirming care equates to child abuse, inconsistent with the definition of child abuse. Inappropriately involving a state child protection agency and subjecting transgender patients and their families to investigations that can result in civil or criminal penalties is damaging and will result in negative consequences.  

Lurie Children’s Hospital has long supported gender-affirming care for transgender youth, which includes the use of puberty-suppressing treatments when appropriate, as outlined in the AAP policy statement, urging that youth who identify as transgender have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space in close consultation with parents or legal guardians.   

Lurie Children’s embraces the sentiments expressed by the AAP. Transgender children and adolescents need and deserve care that is grounded in compassion, science and principles of public health and human rights. These patients and their families are harmed by misinformation, pseudoscience and state-sanctioned hostility. They must not be denied lifesaving gender-affirming support and clinical care. Transgender youth and adolescents are already vulnerable to negative health outcomes. According to the Trevor Project’s 2022 report, “Issues Impacting LGBTQ Youth,” 85 percent of trans and nonbinary youth say that their mental health has suffered due to recent state-level attacks on trans rights. Gender-affirming care can reduce emotional distress, improve their sense of well-being and reduce the risk of suicide. 

We anticipate that legislative efforts that are created to reduce access to lifesaving care will have negative consequences for transgender youth, their families, and their communities. 

The state-sanctioned discrimination of transgender youth that is happening in states like Texas is cruel, damaging and contradictory to standards of care for these patients. 

Gov. Abbott’s directive to block gender-affirming services is the first such use of executive powers, but we have been alarmed to see a growing number of state legislatures pursue similar prohibitions in recent years. So far in 2022 alone, 18 states have taken action on 29 bills. More than 30 bills in 19 states across the U.S. have considered, introduced, and now in the case of Texas, have enacted laws prohibiting medical providers from delivering gender-affirming healthcare. 

These bills threaten the health and well-being of children and families in Texas, Arkansas and beyond; they are fundamentally anti-science, anti-public health and perpetuate discrimination against transgender people. 

Our country is in the midst of a mental health crisis for youth and adolescents. These harmful policies will exacerbate, rather than abate, this crisis.  As pediatricians and healthcare providers, we stand in solidarity with our colleagues doing this work in hostile environments, and we will do whatever we can to support and affirm you.  

To the families who support and love their transgender children, we will continue to fight for you and for your families. Most importantly, to the transgender children and youth who are being targeted and bullied by these policymakers, you are seen, you are loved, you are heroes. You matter and we stand with you. 

We are proud to be healthcare providers in Illinois and at  Ann & Robert H. Lurie Children's Hospital of Chicago, where this work and these children and adolescents matter. Lurie Children’s is committed to fighting for the rights and dignity of families and their children. 

  
Robert Garofalo MD, MPH, Director Lurie Children's Gender Program and Division Head of Potocsnak Family Division of Adolescent and Young Adult Medicine 

Aron Janssen, MD, Vice Chair of Clinical Affairs, The Pritzker Department of Psychiatry and Behavioral Health, Lurie Children’s 

Norell Rosado, MD, Interim Division Head, Child Abuse Pediatrics, Lurie Children’s