Patients & Providers: “Transgender” Banned

CDC is Forbidden From Saying “Transgender” 

by Jack Turban

Dr Jack Turban, resident child and adolescent psychiatrist at Harvard Medical School, outlines the significance of how research has led us to better understand, and care for the transgender community. In turn, he explains why the Center for Disease Control’s recent announcement to ban research funding for budget proposals that include the word “transgender” is a step in the wrong direction.

Dr. Turban speaking out as a physician on behalf of transgender health, the importance of transgender research, and the right for trans people to exist in public spaces is a testament to the support that our community has from health care professionals regardless of policy proposals at play.

The Washington Post reported on Dec 15th that the Trump administration is banning the Center for Disease Control (CDC) from using several words in its upcoming budget documents. These words include: transgender, vulnerable, evidence-based, and science-based.

Recent studies have shown that 0.6% of the US population identifies as transgender, amounting to 1.4 million Americans. These individuals suffer disproportionately high rates of bad medical outcomes. Rates of depression (>50%) and suicide attempts (41%) are dramatically higher than the general population. Thanks to evidence-based research initiatives, we now know that these high rates of poor mental health outcomes are largely due to harassment, bullying, and discrimination.

Ford family (photo from NY Times “Raising a Transgender Child“)

Among transgender youth, for instance, the greatest known predictors of anxiety and depression are bullying and family rejection. Up to 80% of transgender youth experience bullying, and these damaging relationships with peers have been found to be one of the greatest predictors of mental health problems among these children. In contrast, transgender youth who are accepted by their families and allowed to live as their preferred gender, appear to have normal mental health.

Thanks to studies like these (cited below), we have made huge shifts in the way doctors treat transgender patients – both children and adults. Ten years ago, doctors were following manuals for “gender identity disorder in young boys.” These manuals recommended interventions that included banning “feminine” activities like gymnastics and “letting go” of the boy by the mother. The hope was that children would not grow up to be transgender. Transgender youth during that time suffered high rates of depression and anxiety. By young adulthood, nearly half had attempted suicide. This is a striking contrast to children who are allowed to explore their gender identity openly. Research so far shows that these children have developmentally normal mental health.

Without science-based research and healthcare initiatives like those cited in this article, we are at risk of taking major steps backwards in how we treat vulnerable transgender Americans – both within healthcare and as a society. With the Trump administration’s attempts to ban further work to help transgender Americans, we should be worried about what will happen next.

References

Flores, A.R., Gates, G.J., & Brown, T.N. (2016). How many adults identify as transgender in the United States. Los Angeles: Williams Institute. Nuttbrock, L., Hwahng, S., Bockting, W., Rosenblum, A., Mason, M., Macri, M., & Becker, J. (2010). Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. Journal of sex research, 47(1), 12-23.

Haas, A. P., Rodgers, P. L., & Herman, J. (2014). Suicide attempts among transgender and gender non-conforming adults: findings of the national transgender discrimination survey. American Foundation for Suicide Prevention.

McGuire, J.K., Anderson, C.R., Toomey, R.B., & Russell, S.T. (2010). School climate for transgender youth: A mixed method investigation of student experiences and school responses. Journal of Youth and Adolescence, 39, 1175– 1188.

Vries, A. L., Steensma, T. D., Cohen-Kettenis, P. T., VanderLaan, D. P., & Zucker, K. J. (2016). Poor peer relations predict parent-and self-reported behavioral and emotional problems of adolescents with gender dysphoria: a cross-national, cross-clinic comparative analysis. European child & adolescent psychiatry, 25(6), 579-588.

Durwood, L., McLaughlin, K.A., & Olson, K.R. (2017). Mental health and self-worth in socially transitioned transgender youth. Journal of the American Academy of Child and Adolescent Psychiatry, 56, 116–123. e2.

Olson, J., Durwood, L., DeMeules, M., & McLaughlin, K.A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137, 1–8.

Turban, J.L. (2017). Transgender youth: The building evidence base for early social transition. Journal of the American Academy of Child and Adolescent Psychiatry, 56, 101–102.

Meyer-Bahlburg, H. F. (2002). Gender identity disorder in young boys: A parent-and peer-based treatment protocol. Clinical Child Psychology and Psychiatry, 7(3), 360-376.

Turban JL. How Doctors Help Transgender Kids Thrive. The New York Times. April 8, 2017.


About Dr Jack Turban

Jack Turban MD MHS is a writer and resident child and adolescent psychiatrist at Harvard Medical School, where his research focuses on pediatric gender identity.  His writing about neuroscience and children’s mental health has appeared in The New York Times, Scientific American, The Journal of the American Academy of Child & Adolescent Psychiatry, and Kevin MD among others. He writes the Political Minds blog for Psychology Today, exploring the intersection of politics and children’s mental health.

Tweet questions or comments @jack_turban

*This post was originally published on Jack’s Psychology Today column.

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