On April 5, Indiana and Idaho became the latest of 10 US states to pass laws against gender-affirming care for transgender adolescents in the past three months.

The bill, signed into law by Indiana governor Eric Holcomb, bans medication and surgeries that aid youth in transitioning, stating that "permanent gender-changing surgeries with lifelong impacts and medically prescribed preparation for such a transition should occur as an adult, not as a minor". Further, a bill from Idaho governor Brad Little prohibits any gender-affirming care being offered to transgender youth, in an effort to protect minors from “surgeries or treatments that can irreversibly damage their healthy bodies”.

Gender-affirming care includes psychological, behavioral, social, and medical interventions targeted at supporting an individual’s gender identity. The aim of such treatment is to create a safe environment for the individual to overcome their feelings of gender dysphoria, the chronic distress when feeling the lack of gender characteristics that one wants to have to reflect one’s gender identity. Some healthcare specialists consider it to be vital and life-saving. Katherine Imborerk, co-director of the UI Health Care’s LGBTQ+ Clinic in Iowa City, emphasized the importance of gender-affirming care by comparing it to how essential insulin is for someone with diabetes.

Major medical associations including American Academy of Pediatrics, the American Psychological Association, the Endocrine Society, the American Academy of Child and Adolescent Psychiatry, the American Medical Association, and the American Psychiatric Association endorse these treatments and care programs that have been available for more than a decade. A comprehensive review of 16 studies examining evidence for gender-affirming medical care shows that trans youth are positively mentally impacted by treatment. There is evidence that such care reduces the high risk of suicide amongst trans adolescents.

Despite the evidence backing up the benefits of transition treatments, critics argue that the legislative moves of Indiana and Idaho are part of a broader effort by the Republican party to restrict LGBTQ+ rights. In the past three years, on top of the restrictions made on puberty blockers, hormone therapies, and transition surgeries, at least 25 states have passed bills restricting the everyday lives of transgender individuals, from the use of pronouns and participation in sports teams to restrictions on genderfluid/ nonconforming drag shows. There have also been instances of hospitals being harassed for providing care to transgender or non-binary youth.

The 53,000 transgender adolescents in states that have severely restricted or banned gender-affirming care now face the challenge of crossing state borders to receive treatment. The lack of access to gender-affirming care for trans youth has been explicitly linked with higher suicidality, depression and self-harm. Citing such drastic health consequences, the American Academy of Pediatrics and the American Medical Association urge governors not to intrude on care provided to trans youth that is approved by parents and recommended by doctors.

Republican lawmakers in a dozen more states are evaluating similar bans on gender-affirming care for adolescent transgender individuals. Many of those states, however, have at least one chamber held by Democrats or have a Democratic governor, severely limiting the bills’ prospects.