I realize that while everything is the same, it is also brand new. For the first time in my life, I am competing as just myself–without the baggage of who everybody told me to be, who everybody said I was, who I thought I was supposed to be. Today, I am just who I am. I am Schuyler.

Schuyler Bailar (he/him) is a former transgender athlete, author, and activist who raises awareness by sharing his story about transitioning and the impact of gender-affirming care on young transgender and gender nonconforming (TGNC) individuals. Schuyler is an activist who advocates for access to lifesaving gender-affirming care, including hormonal treatment and social support, such as recognizing one’s name and pronouns, for TGNC individuals. Unfortunately, activists like Schuyler must advocate for these basic rights for TGNC individuals, especially children, due to an increasing number of states enacting legislation restricting lifesaving, gender-affirming care. Access to this care is becoming increasingly more difficult to obtain for TGNC children due to state restrictions which have a chilling effect that discourages parents and physicians from providing access to care to TGNC children. Gender-affirming care is lifesaving for TGNC individuals and these restrictions often exacerbate mental health issues such as anxiety, depression, and suicide.

            This paper will discuss the implications of restricting gender-affirming care for TGNC children and how this decreases essential parental support. Section I evaluates the differences in sex characteristics and gender variances that underlie the diagnosis of gender dysphoria, persistent distress in functioning due to differences between one’s assigned sex at birth and gender identity. Section II discusses how a diagnosis of gender dysphoria enables access to gender-affirming care, including lifesaving social and medical interventions that enhance TGNC individuals’ wellbeing. Section III identifies how access to gender-affirming care is essential and lifesaving. TGNC individuals in particular often experience severe gender dysphoria, which causes issues with their self-image and contribute to mental health issues such as anxiety, depression, and suicide. Section IV further discusses the significant benefits of receiving gender-affirming care, the limited and preventable negative outcomes, and the broader consequences of restricting access to care. Section V demonstrates how, increasingly, states such as Oklahoma, Idaho, and Texas have restricted TGNC children’s ability to access gender-affirming care, leading to more mental health issues. These restrictions conflict with the substantial scientific evidence demonstrating the benefits of gender-affirming care for TGNC individuals. Section VI provides examples of states like Colorado and Washington that currently provide successful, lifesaving, gender-affirming care for TGNC children. Section VII additionally discusses how restrictions on gender-affirming care can have implications on the child welfare system. States such as New York and Minnesota have protected parents’ rights to access gender-affirming care for their TGNC children, while states such as Florida and Ohio have removed these protections, with some classifying gender-affirming care as child abuse and advocating for the removal of children from parental custody for seeking gender-affirming care.  The paper’s conclusion provides recommendations for strengthening legal protections for gender-affirming care for TGNC children.