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Expand chart
Data: UCLA/Williams Institute; Chart: Sara Wise/Axios

Medical experts and pediatricians are worried about a new rash of mental health crises among transgender kids, due to the dozens of bills states have introduced to criminalize gender-affirming health care.

Why it matters: Tens of thousands of trans youth are at risk of losing health care from the proposed bills, the Williams Institute estimates.

The big picture: 20 states this year have introduced bills to criminalize gender-affirming healthcare for transgender kids, in some cases making it a felony offense for doctors and parents to provide puberty blockers or surgery. 

  • The bills — including the high-profile measure that's now the law in Arkansas — often rely on inaccurate medical claims about puberty blockers and the risks of gender transition procedures.
  • 6 bills focused on health care across five states have failed, per ACLU data.

What's happening: Some doctors in these states fear the bills will leave in limbo patients who are undergoing gender-affirming treatment.

  • "If I have patients who are doing very, very well with a course of therapy I’ve started, I will not stop that therapy without a medical reason to do so," said Morissa Ladinsky, a pediatrics physician and co-leader of the gender health team at the University of Alabama at Birmingham.
  • Since the bill was approved in Arkansas, several young people who were receiving hormone treatment at the Arkansas Children’s Hospital program have attempted suicide, according to Michele Hutchison, a pediatric endocrinologist who runs the clinic.
  • The Trevor Project, a crisis hotline for LGBTQ youth, tells Axios its counselors have been getting calls from trans youth and families concerned about their ability to continue receiving care, uncertainty about when the bans are set to go into effect and whether there are ways to get around the legislation.

Doctors at Children’s of Alabama, who treat transgender youth from all over the state, fear similar influxes in their emergency rooms from LGBTQ youth who were already at risk from suicide ideation, depression and anxiety.

  • "I see multiple patients daily that are suffering with depression and suicide ideation and suicide attempt and anxiety, and my fear is that if we deny them this evidence-based treatment, we’re only going to see massive more patients come to the emergency room," Jesse Martinez Jr., a doctor of psychiatry at Children’s of Alabama, said.

The state of play: Studies have shown that doctors who give children the ability to socially transition, access puberty blockers and gender-affirming hormones encounter lower rates of suicide and mental illness.

What they're saying: "For those that suggest that transgender kids should not receive the services or the care that they need, those folks should also realize that not allowing transgender adolescents and teens to access care is also an irreversible choice that will lead to costly and painful medical interventions in the future," Human Rights Campaign president Alphonso David told Axios.

The bottom line: Even if the bills are not passed, patients will be exposed to stigma and harm to their physical and mental health long-term, doctors say.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: dial 711 then 1-800-273-8255) or the Crisis Text Line by texting HOME to 741741.

Go deeper

Kansas bill to ban trans athletes fails by one vote

Gov. Laura Kelly. Photo: Mark Reinstein/Corbis via Getty Images

A Kansas bill banning transgender girls from playing women's sports failed Monday after the state Senate failed to override a veto from Gov. Laura Kelly (D).

Why it matters: The 26-14 vote meant that the bill hinged on one Democrat — Sen. David Haley — voting in opposition and breaking the needed two-thirds majority, per AP.

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The Cleveland Clinic on Tuesday released a study showing that 99.75% of patients hospitalized with COVID-19 between Jan. 1 and April 13 were not fully vaccinated, according to data provided to Axios.

Why it matters: Real-world evidence continues to show coronavirus vaccines are effective at keeping people from dying and out of hospitals. The Pfizer-BioNTech and Moderna vaccines have been found to be 95% and 94% effective, respectively, at preventing symptomatic infections.

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The Biden administration has reached agreements with ride-sharing companies Uber and Lyft to offer free rides to coronavirus vaccination sites through July 4, the White House announced Tuesday.

Why it matters: The free rides, starting in the next two weeks, are part of the Biden administration's push to administer at least one vaccine dose to 70% of U.S. adults by Independence Day.