Georgia legislators should trust doctors on health care for children

Transgender and non-binary youth with access to medical care are less likely to experience severe depression and suicidality.
The Georgia House of Representatives on March 26. (Arvin Temkar / arvin.temkar@ajc.com)

Credit: Arvin Temkar/AJC

Credit: Arvin Temkar/AJC

The Georgia House of Representatives on March 26. (Arvin Temkar / arvin.temkar@ajc.com)

This week, the Georgia Senate Health and Human Services Committee passed a bill that would prohibit medical providers, including us, from providing medical care to transgender and gender-expansive youth in our state. In an orchestrated effort to prevent public testimony, the chairman of the committee added language to an unrelated bill, HB 1170, that would ban puberty-delaying medications and hormone therapy, even for patients who are currently receiving these treatments. This motion was undertaken without prior notice to the public or medical community, thus preventing any opposing testimony from qualified, board-certified endocrinologists, pediatric and adolescent gynecologists, adolescent medicine specialists, psychiatrists, psychologists, and other medical providers who treat patients with gender dysphoria.

As medical professionals, we are disheartened to see our legislators prioritize political tactics and exhibit such disregard for the standards of medical care for transgender and gender-expansive youth. Gender-affirming health care is supported by every leading medical and mental health association in the United States, including the American Medical Association, the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, the Society for Adolescent Health and Medicine, the North American Society for Pediatric and Adolescent Gynecology, and the American Psychological Association, to name a few.

For transgender adolescents, we know that puberty can be a time of significant distress as their bodies begin to develop in ways that are inconsistent with their gender identity. Puberty suppression helps to pause this process, giving young people more time to mature and understand their gender. Puberty-delaying medications are an important tool for managing gender dysphoria. As a medical community, we know from decades of experience in using these medications to treat kids with early-onset puberty that when these medications are stopped, puberty will resume and fertility will not be adversely affected.

Last year, when the Georgia Legislature passed SB 140 and limited access to hormone therapy for transgender minors, the sponsors of the bill repeatedly acknowledged their support for maintaining access to puberty-delaying medication for transgender youth. Now, those same senators who pushed through that harmful legislation are working to remove access to all medical care for the treatment of gender dysphoria.

Gender-affirming care for transgender youth, including the use of puberty-delaying medications and hormone therapy, is the standard of care for the treatment of gender dysphoria. Treatment guidelines for the management of gender dysphoria have been developed based on clinical research data that clearly shows improved outcomes for these patients. Transgender and non-binary youth with access to medical care have improved psychological function and well-being and are less likely to experience severe depression and suicidality. We have witnessed firsthand how access to quality medical care significantly improves the health and well-being of our transgender patients.

In a state already grappling with shortages of health care providers, this type of legislation further exacerbates the problem. Many medical trainees and providers have concerns about living and working in a state where health equity is not a priority. When surveyed, pediatric endocrinologists from all across the United States voiced concerns about their personal safety and the potential impact on their ability to care for patients amid a divisive political climate. It is unfathomable that lawmakers in Georgia would risk worsening the medical workforce shortage simply for political gain.

HB 1170 not only bans medical care for transgender youth, but it also explicitly threatens to penalize medical providers who follow the treatment guidelines provided by their medical societies. Under SB 140, medical professionals were placed in a highly precarious situation where offering evidence-based medical care to transgender youth could result in losing our ability to practice medicine. HB 1170 further intensifies the consequences that we may face by allowing civil or criminal liability simply for honoring our professional commitment to act in the best interest of our patients and to minimize suffering whenever possible. This sets a dangerous precedent and devalues the hard work and commitment of medical and mental health providers to offer safe, effective, and compassionate care to our patients of all gender identities.

Like SB 140, this current legislation is a clear form of government overreach that violates the rights of parents and medical providers to discuss health care options and make decisions that will be in the best interest of transgender and non-binary youth. Regardless of political affiliation, Georgians value the rights of parents and caregivers to make important medical decisions for their children. Our government should be identifying ways to improve access to care for children and adolescents across the state, not inserting themselves into the medical decision-making process and making it harder for some to acquire the care that they need.

We are urging lawmakers to vote no on HB 1170 and to stop all efforts to politicize medical care for children and adolescents in this state. Please trust us, as trained medical experts, to provide quality, individualized medical care that meets the needs of our transgender and non-binary patients and their families.

Jason S. Schneider is an internal medicine doctor in Atlanta. Pranav Gupta is a pediatric endocrinologist in Atlanta. Cassie Grimsley Ackerley is an infectious diseases doctor in Atlanta. They write on behalf of more than 275 health care providers around the state who signed this letter. The list of signers is available here.