Kaydee was 22 years old and contemplating suicide when she started hormone therapy in April 2021. The gender-affirming care has been “lifesaving,” she says, but now the Minnesota native spends her days panicking that this access will be taken away. (Like other trans youth interviewed for this article, Kaydee’s full name has been withheld to maintain her privacy.) “Mentally, it’s a huge drain to see new anti-trans bills being proposed every week,” she says. “It’s a reminder that people would rather we didn’t exist.”
This year alone, hundreds of anti-LGBTQ bills have been proposed in state legislatures according to the ACLU’s ongoing legislation tracker; by the end of the year, the figure is predicted to be record-breaking. These proposals are often brutal and take aim at specific aspects of trans life, including banning gender-affirming health care for minors, removing insurance provisions for trans people, and banning trans athletes from competing in sports.
Concurrent with this onslaught of anti-trans bills is a sharp rise in mental health crises among trans youth, highlighting the often unexplored link between discriminatory legislation and mental health. According to a January poll by the Trevor Project, an LGBTQ+ mental health advocacy organization, a staggering 85% of trans and non-binary youth, as well as 66% of all LGBTQ+ youth, said their mental health was negatively impacted by anti-trans state laws. The research showed what should be obvious: when politicians endlessly debate your right to exist, it can take a serious mental toll.
“Systemic transphobia often impacts me more heavily than individualized, person-based transphobia,” says Rex. Rex describes a sense of powerlessness, and says “it adds a weight over the rest of my life. Loved ones don’t understand the nuances of it; they don’t understand the background noise it creates.” No matter how much Rex tunes out of the headlines, the awareness of this rising transphobia is impossible to ignore.
Maggi A. Price, an assistant professor in Boston College’s School of Social Work, recently co-authored pioneering research that corroborated the link between structural transphobia — which Price’s study defines as discriminatory laws and prejudicial attitudes in one’s state or region — and poor mental health. “It is a very new and emerging field,” she tells me. “Most of the work that has been done so far in this area is very well done. It clearly and consistently indicates that structural stigma is associated with a range of mental health problems and barriers to care.”
Yet there is still little to no research specifically examining how structural transphobia affects trans youth, a lack that Price attributes to transphobia itself. “Since the inception of research with human subjects, people with marginalized identities — and young people – have been underrepresented in research,” she says, “due to bias of all kinds.”
Despite a lack of research, statistics and surveys do highlight the high costs of cultural and institutional transphobia for both trans youth and adults. According to a recent CDC health survey, there are more young trans people in the U.S. than ever before, a statistic that correlates with a rise in trans visibility and representation over the last few years in particular. More Americans now personally know someone who’s transgender, yet trans communities still face a sizable wage and employment gap. Rising visibility has made trans people more visible targets for both physical violence and targeted legislation, like the aforementioned anti-trans bills. Transphobia is rising in other corners of society, too; among Evangelicals, Republicans, right wing pundits, and other groups, rhetoric that seeks to associate trans people with “grooming” and anti-trans legislation that claims to want to “Save Adolescents From Experimentation” is on the rise.
Rebecca Minor, a social worker who specializes in gender, sees trans children suffering from poor mental health due to this rhetoric on a weekly basis. “Kids are an easy target for adults to say ‘they’re too young to know,’” she explains. “Most people don’t have the privilege I do of sitting with trans teens for 30 hours a week, and seeing the depth of awareness and sense of self that many adults fail to demonstrate.”
Tennessee, Arkansas, and Alabama have all recently passed legislation severely restricting healthcare access for trans youth; Alabama almost made it a felony, but a judge blocked this part of the bill. The sponsors of these bills aim to strip trans youth of their autonomy by describing their healthcare as “experimental,” a term that frames trans healthcare as villainous and implies kids should be barred from accessing it, whether they want to or not. “There are few better vehicles for moral panic than the supposed indoctrination and abuse of children,” says Minor.
The trans people I talk to describe mutual aid and online community networks as their lifelines. “I was lucky enough to have access to social media, namely Discord,” says Mio, an 18-year-old who came out to their parents as trans during the pandemic. “I found supportive groups online and made some friends, plus my sister is bisexual, so she helped me come out to my parents. From there I got a therapist and eventually started hormone therapy.” Anecdotally, some trans people gather excess hormones and pass them between each other for those who need them; others gather in forums like Reddit’s r/transhealth, using their lived experience to fill gaps in trans healthcare education. Databases like Lighthouse and the National Queer and Trans Therapists of Color Network are also cropping up and enabling more young trans people to find like-minded professionals, who often offer services on a sliding scale.
Research overwhelmingly shows that access to trans healthcare helps alleviate poor mental health, despite the arguments of some religious, right-wing groups. “I was luckily able to afford a major procedure that's heavily improved my life,” says 21-year-old EV. “It feels so hollow whenever I run into other trans people who doubt they’ll be able to afford parts of their research further down the line.”
Yet the benefits that mental healthcare can bring to vulnerable trans youth are contingent on their ability to access it in the first place, and in many places where they’re most at risk, they may find a lack of therapists trained to understand their specific needs. A recently released study, also co-authored by Maggi Price of Boston College, found that states with more restrictive, anti-trans laws and policies had a substantially lower number of trans-specific youth mental health providers.
Mio, an 18-year-old who came out as trans last year, is one of the fortunate number of trans youth who say they’ve been able to access mental healthcare and hormone therapy. “I’ve had access to a therapist who specializes in LGBTQ+ issues,” he tells me. “Still, I’ve lost all my friends since the pandemic and I just feel like I’m spiraling. I’m scared to transition due to anti-trans bills, and I can’t imagine what it would be like for someone in states where these bills have passed. I know a lot of kids in more rural, conservative places don’t have the option of therapy, and these anti-trans bills will make finding LGBT therapists even harder. That’s a scary thought.”
Mutual aid and grassroots organizations will continue to offer lifelines for trans folks in need, but the fear that the worst is yet to come is battering the mental health of trans people nationwide. When it comes to her transition, “I’m scrambling to get as much done as I possibly can right now,” says Kaydee. She says she feels forced to rush her transition in case Republicans use the courts to label gender-affirming healthcare as cosmetic or elective rather than essential and life-saving. “It terrifies me to think of a future where the care that saved me from suicide is made inaccessible,” she concludes.
Get the best of what’s queer. Sign up for Them’s weekly newsletter here.