Survey: gender-affirming care bans hurt LGBTQ people, increase fears about personal safety

Bans on gender-affirming care, pushed by Republican politicians as necessary protections for trans youth, are making LGBTQ people feel less safe. 

A national survey from the Human Rights Campaign, the country’s largest LGBTQ advocacy group, found that the proliferation of gender-affirming care bans negatively affects the mental and physical health of about 80% of trans and nonbinary respondents. As much as 94% of respondents reported feeling less safe as an LGBTQ person. 

“These bans make me feel scared and hopeless about the future,” an anonymous genderqueer person from Arizona between the ages of 18 and 34 wrote in the survey. 

The past two years have been record-breaking years for discriminatory legislation targeting queer, nonbinary and transgender Americans. In 2022, more than 200 anti-LGBTQ bills were filed in statehouses across the country. In 2023, that number skyrocketed to more than 500. 

Last year, Arizona Republicans introduced 15 anti-LGBTQ bills. Three of them were signed into law by former Republican Gov. Doug Ducey, including one that bars transgender girls from joining school sports teams that match their gender identity, a ban on gender-affirming surgery and a measure that allows foster and adoption agencies to discriminate against LGBTQ people under the guise of religious beliefs. 

This year, 14 anti-LGBTQ bills were proposed in Arizona, including multiple attacks on drag artists, a prohibition on preferred pronoun use in schools and a bill that forbade schools from allowing trans youth to use bathrooms and other school facilities consistent with their gender identity. 

Gender-affirming care, the widely accepted treatment for gender dysphoria, a condition characterized by intense distress when a person’s gender identity and biological sex are incongruent, has been a top target for anti-LGBTQ lawmakers. 

The Human Rights Campaign reported that 21 states have successfully passed restrictions on gender-affirming care, which can include helping people transition physically via puberty blockers, hormone therapy or gender-confirmation surgeries. 

“A third of all transgender youth in the United States currently live in states where they have lost access to gender-affirming care, or had their access severely limited,” wrote the report’s authors.

In the Grand Canyon State, Republican lawmakers attempted to bar minors from obtaining puberty blockers and hormone therapy last year. Various studies and several medical associations support the treatments as critical, life-saving solutions for trans youth struggling with gender dysphoria. After public outcry, lawmakers amended the bill to prohibit just gender-affirming surgeries, arguing that children shouldn’t be allowed to make irreversible changes they may later regret. 

LGBTQ advocates and trans youth and their families, however, argue that the choice should be left up to them and their doctors, and free from political interference. 

Unless the ban is repealed in the future — an unlikely prospect as long as Republicans hold onto their slim legislative majority — the more than 7,000 trans minors who reside in Arizona are barred from seeking gender-affirming surgeries. And while receiving hormone therapy and puberty blockers are still legal, efforts to prohibit them continue. Among the 14 anti-LGBTQ proposals introduced in the legislature this year was a bill that would have forbidden doctors from prescribing them to minors, the age group which most needs them to prevent the unwanted physical changes that come with puberty. 

But, while anti-LGBTQ hostility from GOP lawmakers is likely to continue, further restrictions on gender-affirming care are almost certainly doomed — at least for the next three years. Democratic Gov. Katie Hobbs has repeatedly vowed to use her veto power to kill any discriminatory legislation that crosses her desk. All eight anti-LGBTQ bills that made it out of the legislature and to Hobbs’ office were swiftly vetoed. 

The rhetoric that accompanies gender-affirming care bans is also a source of concern for LGBTQ people, with 80% of respondents saying that they fear the bans worsen stereotypes, hate and stigma against the community as a whole. 

“I feel attacked, not understood, unseen, hated, and used like a political pawn.” commented a gay man from Nebraska. 

“I feel like I have less value or right to be here than my cisgender neighbors and community. I am now afraid of them, and the harm they might intend towards me,” added a transgender man from Idaho.

Hate crimes and extremism against the LGBTQ community has seen a rise across the country. And Arizona, long one of the worst states for violence against LGBTQ people, continues to top the charts in the region for anti-LGBTQ hate crimes. 

Discriminatory talking points from lawmakers and state leaders only heighten the ongoing dangers LGBTQ people face. Researchers have found that anti-LGBTQ rhetoric emboldens extremist actors and leads to an increase in violent threats. Surveys conducted by the Trevor Project, a suicide prevention organization, concluded that anti-LGBTQ legislation and messaging negatively affects the mental health of LGBTQ youth and raises the already disproportionately high rates at which they consider suicide. 

Restrictions on gender-affirming care are pushing many LGBTQ people to leave or consider leaving hostile states. Over half of trans and nonbinary people say they would move or have already moved from a state that passed a gender-affirming care ban, and 73% wanted to leave their state at the time the survey was administered. 

In the end, the report’s authors concluded, gender-affirming care bans and all the hostile rhetoric that accompanies them only serve to worsen the outlook for LGBTQ people. 

“When anti-LGBTQ+ legislation is introduced, it not only aims to legislate LGBTQ+ people out of all spaces of daily life, it also codifies discrimination and stigma into law,” they wrote. “In addition to directly interfering with the rights of parents and doctors to make the best choices for their children and patients, gender-affirming care bans, and anti-LGBTQ+ legislation in general, can have disastrous effects on the safety, health and well-being of LGBTQ+ people.”