Healthcare professionals and activists have issued stark warnings as the United States Congress prepares to vote on the first-ever national bills aimed at banning gender-affirming medical care for transgender youth. The proposed legislation, described as a dangerous escalation of anti-trans rhetoric, could criminalise providers and strip Medicaid coverage for critical treatments.
Two Bills, One Target: Restricting Care for Minors
This week, the US House of Representatives introduced two separate bills targeting healthcare for transgender children. The first, HR 498, was introduced by Republican Marjorie Taylor Greene as one of her final acts before retiring. It seeks to make providing gender-affirming care to anyone under 18 a federal felony, punishable by up to ten years in prison for medical practitioners.
The second bill, HR 3492, was put forward by Republican Dan Crenshaw. This legislation would prohibit Medicaid, the state-funded health insurance programme, from covering any gender-affirming care for minors. This would block access to puberty blockers, hormone therapy, and surgical care for transgender children on Medicaid, while cisgender children would retain access to equivalent treatments.
Activists and Clinicians Sound the Alarm
In response to the announcement, activists with the group Bulletproof Pride conducted a last-minute canvass of lawmakers' offices on Capitol Hill. Among them were Nicholas Mitchell, a psychiatrist, and Odile Saint-Flour, a nonbinary nurse who uses they/them pronouns.
"Trans people make up a very small percentage of the population, but they’re very over-represented in psychiatry because the suicide rate is incredibly high," Saint-Flour explained. They pointed to societal rejection as a primary driver of this mental health crisis. Mitchell, who left Texas after its restrictive abortion laws created a climate of fear for providers, drew a direct parallel. He warned of the "ripple effects" of such targeted legislation, where narrow laws end up blocking broad access to essential healthcare.
Recent data underscores their concerns. A 2024 survey by the Trevor Project found that nearly half (46%) of transgender and nonbinary young people in the US seriously considered suicide, with 12% of LGBTQ+ youth attempting suicide. In comparison, 2023 figures for all high school students showed 20.4% seriously considered suicide and 9.5% attempted it.
What is Gender-Affirming Care and Why Does it Matter?
Gender-affirming care is a broad term often misunderstood in political debates. For young people, it rarely involves surgery. Most care consists of social transition support, using correct pronouns, and, for some, reversible medications like puberty blockers. Medical interventions are only pursued following extensive assessment and with patient and family consent.
Mitchell stressed the proven efficacy of this care model. "We’ve seen repeatedly that good, open access to gender-affirming care has been extremely effective in lowering the rates of suicide amongst trans youth," he told congressional staffers. Research consistently shows that access to supportive healthcare significantly reduces rates of anxiety, depression, and suicidality among transgender youth.
"Bills like this are dangerous," Saint-Flour stated unequivocally. "They hurt people. They say that it’s to protect children, but they’re trying to prevent people from getting healthcare that actually lowers the rate of suicide for trans youth and trans people in general."
The final vote on the bills is scheduled for Wednesday, marking a pivotal moment in the national debate over transgender rights and healthcare access in the United States.
