Kristin M. Rager, M.D.

As a physician, one of my most important obligations is the promise I make to my patients that I will treat them to the best of my ability using sound science and the best medical practices available. This is essential to providing the excellent care that Tennesseans deserve, and it is being compromised by proposed legislation in our state.

The Tennessee Legislature is considering a bill that would substitute dangerous and unsound ideas about transgender youth into medical decisions best left to doctors and the people for whom they care.

House Bill 2576/Senate Bill 2215 threatens doctors and parents with criminal prosecution for providing necessary and medically appropriate health care to transgender youth. In fact, the health care that the bill criminalizes and otherwise burdens is health care that saves the lives of my patients.

Science and medical experts condemn the bill

Years of research and clinical experience tell us the best ways to treat and support transgender youth.

As an expert in adolescent health for almost 20 years, I know that when a young person is experiencing distress associated with the incongruence between their gender identity (the gender they know they are inside) and the gender assigned to them at birth, every medical and mental health standard advises to affirm the young person.

When we instead try to force a young person to live in ways typical of their assigned gender, we know that they face a number of negative outcomes, including increased risks of anxiety, depression, suicide and self-harm.

That’s why the American Academy of Child and Adolescent Psychiatry has taken a strong stance against bills like HB 2576/SB2215, saying that sweeping bans on care (such as currently proposed here in Tennessee) compromise the health and well-being of transgender youth.

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The American Academy of Pediatrics advocates for medical providers to offer “developmentally appropriate care that is oriented toward understanding and appreciating the youth’s gender experience,” and the Endocrine Society recommends best practices when it comes to gender-affirming health care for transgender youth.

Every one of these leading medical groups opposes efforts to force transgender youth to live in their gender assigned at birth.

Doctors, not politicians, know how to treat patients best

Transgender children, like all children, deserve communities that support them, safe environments in which to learn and the ability to access the medically necessary treatments that can help them to be healthy and happy. This care is truly life or death for my patients.

I recently had a visit with my patient, a young woman named Sarah (name changed for confidentiality) who is transgender and her mom.

During the visit, we discussed how Sarah is thriving as a freshman in college. She was proud to tell me how she had made the honor roll, was making new friends and enjoying life as a typical college student.

As we celebrated her successes, Sarah’s mom began to cry. She explained that “none of this would have been possible” if Sarah had not had access to medically appropriate health care as a teen.

She also wondered aloud what her life instead would have been like and if Sarah would even be alive today had a bill like HB 2576/SB2215 been law during her child’s adolescence.

Because HB 2576/SB2215 is written by politicians, and not by doctors, it misunderstands the types of treatments that most transgender youth receive. No young kids are being forced into treatment. Rather, health care teams are providing affirming care and later, evidence-based medical treatment, that saves the lives of transgender youth.

Legislation tells transgender youth they don't belong

For Tennesseans who don’t know a transgender person, it might be hard to imagine what it’s like to live in a body that doesn’t match the person you know yourself to be. In my practice, I work closely with families to help them understand what it means to be transgender, and we work together to develop an individualized treatment plan that puts the health and well-being of the young person first.

Health care teams have procedures in place to ensure that transgender kids get appropriate treatment and that parents and young people fully understand and consent to care.

Legislation like HB 2576/SB2215 does just the opposite. It blocks best practice health care for transgender youth and sends a message that Tennessee lawmakers think that there’s something wrong with them, making their lives harder and telling them that they don’t belong.

It has to stop.

We are hurting young people who deserve our love and support. As a community we must commit ourselves to creating a welcoming place where all children can grow into the people they are meant to be.

It is our job as physicians to implement best medical practices and to fulfill our Hippocratic Oath to do no harm.

Legislation like HB 2576/SB2215 threatens to send us to prison for following the Oath that we so proudly take.

That puts us in the impossible position of choosing between appropriately caring for our patients or staying out of jail. This not only compromises Tennessee’s reputation as a wonderful place to live and raise families, but also compromises the lives of our fellow Tennesseans.

Kristin M. Rager, M.D., MPH, FAAP, FSAHM is an adolescent medicine specialist in Nashville.