October 24, 2018 at 1:59 pm PDT | by Dr. Johanna Olson-Kennedy
Trans youth facing public health and human rights crises in America

Dr. Johanna Olson-Kennedy is the medical director of The Center for Transyouth Health and Development at Children’s Hospital Los Angeles.

Despite the increasing visibility of transgender individuals in media and society, many people still don’t understand what it means when someone is transgender. For many, the only way to comprehend the struggles and resiliency of transgender individuals is if we ourselves have a transgender loved one. How best can we grasp another’s personal battle than to hear it from them firsthand?

As the medical director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles (CHLA), I have the privilege of caring for transgender children, teens and young adults, and I bear witness every day to the challenges they face. I’ve been an attending physician at CHLA for 12 years, working almost exclusively with gender non-conforming and transgender youth. I am deeply committed to ensuring the safety and well-being of my patients and helping them live full lives true to who they are.

This weekend we learned of a leaked memo from the White House that aims to invalidate the experiences of transgender people. This memo diametrically opposes the American Academy of Pediatrics’ recent statement encouraging pediatricians to extend affirmative care to transgender youth. The perspectives and policies provided by medical providers and scientists should take precedence when the lives of vulnerable populations are threatened.

There seems a great divide between the perspective of us doing the work, so to speak, and those who merely talk about it, or extend their own ideology around gender essentialism to deny rights to transgender individuals. My colleagues and I sit in rooms day after day having thousands of conversations with youth and families, hearing firsthand about the traumatic impact of having one’s authentic gender invalidated, belittled, disparaged and overtly discriminated against, and how deeply those wounds carry into every aspect of life. My own experience as a pediatrician has definitively demonstrated that supporting young people and affirming their authentic gender is imperative for them to live happy, fulfilling lives. 

Some of my patients know from a very young age that their gender is different from the one their body might dictate. These patients are insistent and persistent that their true gender differs from how their parents (and often, society at large) are raising them – and even as children they find ways to communicate this. Others are not as able to articulate how they feel but know that who they are doesn’t align with how the world sees them. Research suggests that even at an early age, brain activity patterns and structure in transgender youth more closely match those found in their desired gender than their assigned one.

Many of my patients struggle with gender dysphoria – the clinically significant and severe distress one feels if their body and gender do not align. This can lead to overwhelming levels of anxiety and depression. Studies have shown that affirmation and acceptance is critical to their physical and emotional well-being. Support for transgender young people can include the use of pronouns that match the child’s gender identity, using the name of their choosing and, often, allowing them to change their hairstyle and clothing to reflect their authentic identity. Taking these steps is known as “social transition,” which is reversible and does not involve the use of medication or surgery.

At its core, understanding transgender people is two things: First, it is a human rights issue. Compounding my patients’ anxiety and depression is the discrimination they often meet in their schools, communities and even within their own family. Many patients have been victims of bullying, as well as emotional, physical and sexual violence. Laws that protect transgender people from harm, ensuring they can go about their daily lives without fear, are fundamental to their survival. For example, nondiscrimination laws offering explicit protections for transgender people to receive medical care in doctor’s offices and hospitals, as well as the right to access public spaces, is directly correlated to their mental health, not to mention their physical and emotional safety. 

Secondly, we are facing nothing short of a public health crisis. Nearly half of all transgender youth will attempt suicide at least once before their 20th birthday. We must do everything in our power to stem the rate of suicide within this community. No child should have to think about, let alone attempt, ending their own life simply for being who they are, and because others have opinions about their truths.

Our center has cared for transgender young people since the 1990s and is one of the largest such programs in the country. In my years here, I have learned this truth about my patients: Transgender youth are not damaged, deceived or confused about who they are. The dreams and aspirations of my transgender patients are no different than the dreams of other children. They want to be nurses, firefighters, soldiers, attorneys, physicians, police officers and teachers. Many want to get married and have a family. And they want to participate in their communities.

We cannot allow discrimination and uninformed opinions to alter their paths and prevent them from being the productive, successful, and happy members of society that they dream, and are capable, of becoming. All people, including transgender people, have the right to feel safe and secure in the communities they call home.  

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