Dr. Britta Roach
- Dr. Britta Roach is a pediatrician, and currently a pediatric emergency medicine fellow at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, TN.
As I stepped into the patient’s room, I saw a teenager sitting on the hospital bed. I introduced myself as the physician and asked, “What is your preferred name?” The patient responded with a name different than the one in the medical record and preemptively shared his preferred pronouns: he, him, and his.
As we began talking, he disclosed that he had attempted suicide at home. His mother interrupted, “I found empty pill bottles in her bedroom.” As is typical of all psychiatric assessments, I asked the mother to leave the room so that I could speak to the patient alone.
He opened up more about his transgender identity — sharing that he had attempted suicide due to his unsupportive family and bullying at school. Unfortunately, as a pediatric ED physician, this is a common patient encounter for two reasons.
Suicide is the second leading cause of death among youth, and second, more than half of transgender youth considered suicide in 2021. Despite this disheartening data, legislators across the United States continue to introduce anti-trans bills.
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States across the country are introducing harmful laws
Texas introduced a directive that would re-classify medical treatment for trans youth as child abuse. The Florida Senate passed the “Don’t Say Gay” bill which bans classroom discussion about gender identity.
The Tennessee Senate has proposed the “Youth Health Protection Act,” which would prohibit and criminalize gender affirming medications and surgeries for transgender youth.
The American Academy of Pediatrics (AAP), a professional association of pediatricians, has firmly supported transgender medicine. A policy statement released in 2018, outlining the Gender-Affirmative Care Model whereby “pediatric providers [should] offer developmentally appropriate care that is oriented toward understanding and appreciating the youth’s gender experience.”
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Anti-trans bills negatively affect trans youth's mental health
This month, the Tennessee AAP chapter organized its annual "Day on the Hill," allowing pediatricians to advocate to legislators on behalf of children state-wide. After spending the day expressing our staunch opposition to the “Youth Health Protection Act,” my fellow pediatricians and I learned that this bill would likely not pass.
While this was reassuring, I remain outraged by the mere proposal of the bill and others like it. These bills send a clear, harmful message to trans youth that they are not welcome in society, further perpetuating feelings of isolation and rejection.
In addition to endangering trans youth, this bill also threatens physicians who provide gender affirming care. Physicians are ethically obligated to treat all patients, without regard to race, religion, gender identity and politics.
To prohibit gender affirming care would force physicians to make a choice. Either they break the law, or their oath to “first, do no harm”— since to deny gender affirming care would be to deny life saving treatment.
As a pediatrician and member of the LGBTQ community, I would choose to do no harm.
According to the 2021 Trevor Project National Survey, 94% of trans youth reported that recent politics had negatively impacted their mental health; whereas, the use of proper pronouns reduced rates of attempted suicide.
I wonder if the boy in the ED would have attempted suicide if he had felt supported by his mom, school, and politicians. To those proposing and supporting these bills, I urge you to set aside political plans and personal prejudices.
Let’s treat children as individual humans rather than policy statements.
Dr. Britta Roach grew up in White House, Tennessee. She is a pediatrician, and currently a pediatric emergency medicine fellow at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville. This piece reflects the opinion of the author; it does not reflect the opinion of her affiliated institutions.