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Why a New Law Denying Health Care for Trans Youth Has Local Black Advocates Worried

Detractors say SB 140, signed by the governor, contradicts guidance from experts and could have dire consequences.

Critics say Georgia's SB 140 disregards guidance from the American Academy of Pediatrics and the U.S. Department of Health and Human Services Department on gender-affirming care for trans youth. (MediaNews Group/Getty Images)

Black LGBTQIA+ advocates are concerned about legislation in Georgia aimed at restricting medical care for transgender children.

On Thursday, Gov. Brian Kemp announced he signed Senate Bill 140, which will prohibit certain gender-affirming care for transgender minors. Doctors who offer the banned care will face serious consequences, including losing their medical license. 

SB 140 would block doctors from performing gender reassignment surgery for youth under age 18, and would prevent them from prescribing hormone replacement therapy — commonly known as HRT — to trans youth under age 18. 

“The bigotry is astounding,” said Sa’Real McRae, a lobbyist with the Georgia Youth Justice Coalition and a student at Georgia State University. “The refusal to acknowledge or to care that be these are life-saving treatments, that young people need these treatments, and without them, they are pushed to die by suicide or attempt to die by suicide — it’s disgraceful.”

SB 140 is part of a larger trend of state legislation targeting LGBTQIA+ youth, which has advocates concerned for queer and trans youths’ physical and mental health. 

State Sen. Carden Summers, the sponsor of the bill, argues that people under 18 are too young to make drastic, possibly irreversible changes to their bodies, and the government should intervene. In the text of the bill, lawmakers also argue that there’s been an “unexplained rise” in the diagnosis of gender dysphoria — the psychological distress resulting from an inconsistency between one’s assigned sex at birth and one’s gender identity or expression. 

In the bill, the senator also argues that taking a “wait-and-see” approach for gender-affirming care for those suffering from gender dysphoria will allow children time to “mature and develop his or her own identity.” 

“I’m simply saying that it has also been proven that children that have dysphoria issues, sort of outgrow them as they mature,” Summers said during a hearing in front of the Senate Public Health Committee on Tuesday. “So instead of having a surgery that’s devastating before the age of 18 years old, let’s put a pause there.” 

The bill is a new step in a trend of anti-transgender legislation passed in Georgia. Last year, the General Assembly introduced the “Save Girls’ Sports Act,” which would have prohibited transgender students from playing sports on teams for their preferred gender. The bill died — instead allowing for school districts to make the decision themselves. The Georgia High School Association eventually voted to ban trans students from playing on teams that match their gender identity.

Chanel Haley is the gender policy director for Georgia Equality, a policy advocacy organization that works to pass pro-LGBTQ legislation. Haley transitioned over two decades ago, and says she worries about what the effects of anti-trans legislation have on the mental health of young people. 

“Kids are not the ones making the decisions,” Haley said, countering language in the bill that suggests children being the sole decision makers about transitioning. “It’s actually the parents of the children and the medical team. They fail to realize that the treatment is starting first with social transitioning, then we get into medical transitioning. There’s a long process. So this isn’t something where a kid comes and says ‘I want to be the opposite sex’ and overnight, it happens.”

When Summers was questioned about the science behind his bill, he admitted that he hadn’t read guidance from the American Academy of Pediatrics on gender dysphoria treatments. Part of those recommendations includes “providing youth with access to comprehensive gender-affirming and developmentally appropriate health care.” 

Summers’ bill also contradicts the United States Health and Human Services Department’s recommendations for gender-affirming care for trans youth. That guidance, per the HHS, says providing care for trans youth leads to better mental health outcomes and overall quality of life.

It is well documented that trans youth already lack access to adequate mental health care. For Black queer and trans youth, it’s more dire. The Trevor Project, an LGBTQIA+ advocacy group, notes that more than 60% of LGBTQ youth said anti-trans legislation is negatively affecting their mental health. 

For Black trans youth, the Trevor Project also notes that because of Black trans youth living at the intersection of multiple marginalized social statuses (being Black and transgender), these youths can suffer disproportionately. A report by the organization found that 1 in 4 Black transgender and nonbinary young people reported a suicide attempt in the past year. That is more than double the rate for Black queer, cisgender youth.

The American Civil Liberties Union of Georgia has vowed to sue the state if Kemp signed the legislation. It’s unclear when the organization plans to file suit, but it has in the past sued the state over anti-abortion and anti-trans legislation. 

​​“We will use every legal means at our disposal to block this bill from hurting children and families. It’s disturbing how quickly the governor acts to sign bills that take away people’s rights,” said Andrea Young, executive director of the ACLU of Georgia.

This story has been updated.