For 2023, the American Civil Liberties Union of Tennessee (ACLU-TN) and Tennessee Equality Project (TEP) expect bans on hormones and surgeries for minors, forced outing and mandatory reporting, gender affirming care being defined as child abuse, religious exemptions for counselors, and doctors being criminalized for professional misconduct.
The ACLU-TN and TEP made this prediction during a presentation titled “The Reality of Trans Healthcare in Tennessee: A Conversation With Trans Advocates,” on Friday, October 21, 2022.
Advocates joined together to not only give an overview of the state of trans healthcare in Tennessee, but to inform attendees on the process of receiving care for youth, potential obstacles, and different forms of care.
This session comes after it was announced that Vanderbilt University Medical Center, which Dulce Torres Guzman of Tennessee Lookout said was a “leader in transgender healthcare,” would be temporarily stopping gender affirming surgeries for minors.
According to the ACLU-TN and TEP, Tennessee law currently allows for families to access gender-affirming healthcare for youth. It is also legal for medical providers to provide this care to youth. The ACLU-TN said that if lawmakers try to pass legislation that violates the rights of trans people, their plan of attack is to “fight it in the legislature.”
“As the ACLU-TN of Tennessee and as the Tennessee Equality Project we are sworn and heavily dedicated to access to gender affirming care for youth,” said Henry Seaton, ACLU-TN’s first-ever trans justice advocate.
In 2022 SB 657/HB 578 was withdrawn, which according to the ACLU-TN “prohibited any sort of intervention for gender identity, or any gender affirming care for prepubescent minors and minors in general. It also would have punished violations as “child abuse.”
SB 2360/HB 2451 failed, which required parents to have access to information in their child’s school such as teacher names, book titles in the library, and curriculum. It also would have prohibited healthcare providers to give treatment to minors without parental consent.
The ACLU-TN also said that SB2696/HB 2835 was placed in a general subcommittee and encompasses a number of policies that touch on gender affirming care, the usage of state funds to “prepare a minor for treatment, the ability of school staff to “out” a student to their parents, and more.
According to advocates from the ACLU-TN and TEP, the process for minors to receive care is extensive, and is “influenced largely by access to education, care, and safe support systems.” Advocates said that there is a lot that needs to be done before a child can receive care due to a number of obstacles.
Some of these obstacles include families not having the education that they need or not having a safe support system.
The TEP said that the most common form of care is social assistance, which involves educating parents so that the child can start socially transitioning at school, home, and with their friends. After this, a child may start Hormone Replacement Therapy (HRT) after the “appropriate stages of development, but never before puberty.”
If gender dysphoria still poses a threat to the “biopsychosocial safety of the youth,” then surgery will be allowed. The American Psychiatric Association (APA) defines gender dysphoria as “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.”
Surgery is only considered after a series of mental and physical health evaluations, and familial counseling. TEP also said that genital surgery does not occur before the age of 18.
There are a lot of factors that contribute to the reasons why healthcare providers opt to not delay care to minors. TEP said that there are increased risks in suicide, self-harm, and mental illness. TEP also said that kids who were able to transition as youth contributed to a 73% decrease in suicidal behavior and ideation in the first six months.