I write as the proud father of a courageous, kind and empathetic 24-year-old transgender daughter to provide some insight into our family’s experience with gender-affirming care and hopefully to correct some of the most egregious misinformation about it.

In the past year, there has been a tsunami of anti-transgender legislation in the United States, with bills targeting transgender people introduced in nearly every state. These bills and their sponsors are supported by a richly financed group of anti-LGBTQ+ groups such as the Alliance Defending Freedom, which received more than $96 million in contributions and grants in its 2022 fiscal year.

Most distressing is this network’s focus on banning gender-affirming care for adolescents, which has been passed into law in 25 states. We know from our own experience just how radical and cruel these laws are.

When our daughter came out to us as transgender just before her 16th birthday, we listened to her intently, trying to understand what she was going through and how we could best support her. And we questioned, like many parents of transgender children do initially, whether this was just a phase that she would outgrow. In hindsight, we didn’t really comprehend then what it would mean for her to be transgender, but we understood clearly that she was suffering.

One of the most common misconceptions about being transgender is that it reflects a choice, closely related to the false narrative of “social contagion” whereby children allegedly are influenced to identify as transgender by peer pressure, especially through social media.

However, when we consulted experts in transgender care, we came to understand what a federal court at the time found after hearing the evidence: “that being transgender is not a 'preference,' that being transgender has a medically-recognized biological basis, and that it is an innate and non-alterable status.” 

In response to questioning whether our daughter was going through a phase, her medical and mental health care team informed us that a transgender individual is someone who “consistently, persistently, and insistently” identifies as a different gender than their assignment at birth, in contrast to cisgender (i.e., nontransgender) people who may merely experiment with gender expression that does not conform to stereotypical notions of gender-appropriate appearances.

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We came to another important realization on our family’s transition journey: Inaction is not a neutral option, and for adolescents experiencing gender dysphoria, nonintervention increases the risk of adverse mental and physical health outcomes.

Gender dysphoria is a medically recognized condition suffered by many transgender individuals, characterized by debilitating distress and anxiety resulting from the incongruence between a person’s gender identity and sex assigned at birth. The onset of puberty and its associated development of secondary sex characteristics can trigger or exacerbate gender dysphoria.

Myths around gender-affirming care are designed to scare parents 

This was exactly the situation for our daughter, but in hindsight we failed her: In our desire to be deliberate and diligent about her care, we lacked the requisite sense of urgency reflective of her intense dysphoria-driven distress.

Critics of gender-affirming care for adolescents baselessly claim that children are rushed into such care, but the opposite is true: A recent study found that the median wait time for transgender adolescents is 10 months between contacting a clinic and receiving puberty blockers or cross-sex hormones.

This long wait reflects both the care and deliberation families invest in such decisions and the scarcity of qualified medical professionals providing such care.

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For adolescents approaching the onset of puberty, puberty-blocking medicines may be appropriate for delaying the development of secondary sex characteristics not matching their gender identity, an intervention that is fully reversible.

Subsequently, cross-sex hormone treatment may further treat gender dysphoria by bringing the body more into alignment with the individual’s gender identity. 

Our daughter achieved substantial relief from her depression and dysphoria once she started taking puberty blockers and then initiated hormone therapy. She has told us, and repeated publicly, that she may not have survived her teen years without this medically necessary care. Those who would deny teens this medically necessary care can offer no medically approved alternative therapy whatsoever.

The anti-LGBTQ+ groups that promote bans on gender-affirming care are the same groups pushing book bans in the name of “parental rights.” If parents have the right to direct what their children read, surely they must have the right to direct their adolescents’ medical care in consultation with their children’s doctors.

Interfering with safe medical care isn't a conservative value

I was a registered Republican for decades, and I know there is nothing conservative about interposing the state between a child and their parents and physicians who know best how to care for that child.

Politicians should stay out of families’ medical decisions, especially when those decisions are in accord with medical consensus.

Unlike the political arena, where unscrupulous ideologues can recklessly promote junk science, courts of law make decisions based on evidence presented under stringent rules. Nearly every U.S. trial court to consider the evidence in challenges to bans on gender-affirming care has concluded that such care is medically necessary, safe and effective, and supported by every major medical association in the country.

Last year, a trial court in Montana, no bastion of liberalism, barred enforcement of the state’s recently enacted ban on gender-affirming care, observing:

“The Court is forced to conclude that the purported purpose given for (the statute) is disingenuous. It seems more likely that the (statute)’s purpose is to ban an outcome deemed undesirable by the Montana Legislature veiled as protection for minors. The legislative record is replete with animus toward transgender persons, mischaracterizations of the treatments proscribed by (the statute), and statements from individual legislators suggesting personal, moral, or religious disapproval of gender transition.”

This description could apply to any of the other 25 state laws that ban gender-affirming care.

Politicians should stop trying to impose one-size-fits-all, statewide mandates and interfering in the private, individualized medical decisions of families with transgender children and their physicians.

Sean P. Madden, Esq, is a director of GRACE (Gender Research Advisory Council & Education), a nonpartisan communications and public affairs nonprofit that provides evidence-based education about transgender people and the health care they receive. He is a retired attorney, investor and transgender rights ally and advocate. He lives in Charlotte, North Carolina, with his wife.

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