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Social science research on trans and gender diverse youth highlights importance of inclusive policies

Trans and gender-diverse youth (TGDY) face unique challenges that impact their mental health, well-being, and access to essential resources. Research underscores the critical role of gender affirmation in improving outcomes for TGDY, showing that supportive family environments and access to gender-affirming care significantly reduce risks of suicide, becoming homeless, and the incidence of substance abuse disorders. This growing body of research highlights the importance of fostering inclusive policies and practices to ensure that these young people can thrive.

Currently, the US Supreme Court is hearing US v. Skrmetti, a case that challenges the constitutionality of the state of Tennessee to ban gender-affirming care, such as restricting hormone therapy. SCOTUS's ruling in this case will impact other state-level care for transgender youth and affect parental control over medical decisions.

To provide the public and policymakers with a better understanding of the barriers confronting trans and gender diverse youth, the American Sociological Association (ASA) has published "Public Policy and the Well-Being of Transgender and Gender Diverse Youth in the United States: A Sociological Resource for Public Understanding" by Harry Barbee and Kathleen E. Hull, with the ASA Committee on the Status of LGBTQ People in Sociology.

Key points from the report include:

• Approximately 1.4% (300,000) youth identify as trans or gender diverse. This means that these youth do not identify with the sex they were assigned at birth; some are nonbinary, and others identify as girls or boys.

• Gender affirmation refers to accepting and validating the gender identities and expressions of youth.

• TGDY experience a variety of health issues, including mental health problems, self-harm, suicidality, alcohol use, and victimization experiences. Youth assigned female at birth are more likely to report mental health issues and self-harm. Black, Latine, Indigenous, and Multiracial trans youth are more likely to consider or attempt suicide.

• TGDY whose parents affirm and support their gender identities benefit. For example, TGDY whose household members do not respect their pronouns are twice as likely to attempt suicide and are more likely to experience homelessness. TGDY whose families are supportive have higher levels of self-esteem and are less likely to leave home.

• Trans and gender-diverse youth who can change their names and gender markers on legal documents are less likely to attempt suicide.

• Gender-affirming care improves outcomes for TGDY. For example, hormone therapy is associated with lower levels of depression, thoughts of suicide, and suicide attempts.

• Historically, health care providers have not been trained well and have treated gender-diverse youth ineffectively. Yet, currently, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the Endocrine Society, the American Medical Association, the American Psychological Association, and the American Psychiatric Association support gender-affirming care. Health care providers now use evidence-based guidelines, based on substantial research, to determine how to treat trans and gender-diverse youth.

• Despite the strong social science and medical evidence for gender affirmative care, there has been an explosion in legislation aimed at blocking TGDY from receiving health care, legal recognition, education and the right to exist. These efforts increase stigma and bullying, as well as decreasing access to appropriate support, and have led to a public health crisis for TGDY.