According to experts, transgender kids, particularly those with eating disorders, could suffer greatly from the restrictions on gender-affirming care that Republicans in Congress and President-elect Donald Trump have proposed.
According to Jessie Menzel, a psychologist and vice president of development at Equip Health, which offers virtual mental health care for individuals with eating disorders, gender-affirming care—which includes mental health counseling, occasionally hormone therapy, and puberty-suppressing medication—is an essential component of care for trans teens with eating disorders.
Young persons who identify as trans have a high prevalence of eating issues. To get their bodies to fit a male or female ideal, many starve themselves or engage in other unhealthy eating habits.According to studies, compared to 9% of the general population, 25% to over 50% of transgender people have experienced eating disorders.
However, minors who suffer from gender dysphoria—the severe discomfort that arises from a mismatch between one’s sex given at birth and one’s gender identity—are finding it more and more difficult to access transition-related care. According to the majority of American medical societies, transition-related care is crucial for children who are experiencing gender dysphoria.
Such care for those under the age of 18 is already prohibited in 26 states, and Trump promised to impose national regulations. Trump has pledged to outlaw gender-affirming medical procedures for children and to punish physicians who administer them. This month, the House and Senate passed a large budget measure that forbids the use of military health insurance to pay for gender-affirming care for service members’ children.
According to public opinion surveys, Americans have differing views on how to care for minors throughout transitions. According to a June Gallup poll, 51% of participants believed that gender change is immoral, yet 60% were against legislation that would prohibit care associated to transition.
Many who oppose such therapy argue that there is a lack of long-term data on potential adverse effects and that children are too young to comprehend the risks of hormone therapies. Puberty-blocking medicines can temporarily lower bone density, but their effects are generally reversible. Most of that bone loss can be restored by taking the hormones estrogen or testosterone, which many trans teenagers eventually receive. Hospitals must obtain parental approval before providing any transition-related therapy, and gender-affirming surgery is rarely performed on kids younger than 18.
However, prohibiting that kind of care can also be harmful, and governmental prohibitions have been connected to a rise in transgender youth suicide attempts. According to Menzel, extra limitations might cause eating problems in children and make recovery more difficult for those who already have them.
According to Menzel, there will undoubtedly be a rise in eating disorders among these people.
Around the age of 14, Carsen Rhys Beckwith, 27, of Kansas City, Missouri, claimed that they started to acquire the curves that are normally associated with feminine bodies, which led to the development of an eating disorder.
Beckwith, however, didn’t feel feminine. They desired a more manly and muscular appearance.
According to Beckwith, who identifies as nonbinary and transmasculine, “my body was developing in a way that didn’t match how my identity was developing.”
Beckwith started working out at the gym frequently and losing weight in an attempt to transform their body in the only way possible.
According to Beckwith, it began with calorie counting. After some time, Beckwith was only eating one piece of fruit per day. Since I didn’t need to eat until supper, I would offer my pals the most of my lunch.
Feeling more at home in their bodies
Receiving gender-affirming care—a complete strategy that affirms a young person’s feelings, offers psychiatric support, and frequently involves hormone therapies—can lessen the need for weight loss among trans youth with eating disorders, according to Menzel.
According to Menzel, having someone who is ready to listen to them can change their lives. It can make a huge impact just to have someone who is prepared to confirm their identity.
Hormones that halt puberty can temporarily prevent trans kids from growing more adult bodies, allowing them to use therapy to explore their gender identities, Menzel said. Other hormonal treatments, such testosterone and estrogen, which are usually used later in adolescence, can assist kids in developing bodies that correspond with their gender identification.
Gender-affirming care can help kids feel better about their bodies and their connections with food, according to pediatrician Dr. Ellen Rome, who leads the Cleveland Clinic Children’s Hospital’s center for adolescent medicine.
According to Rome, eating disorder symptoms are frequently quite straightforward to eliminate when a child is living as they like to be.
Doctors are no longer permitted to prescribe the drugs to new patients under the age of 18, even though Ohio’s restriction permits minors who are already receiving gender-affirming therapies to continue getting it.
Rome stated, “They have removed that tool from our toolbox.”
Starvation as a coping strategy
Like trans rights generally, gender-affirming care has gained political attention.
Trump made bogus claims that youngsters were having gender-affirming surgery during the school day while he was running for president.
According to Tiffany Justice, a co-founder of the well-known conservative organization Moms for Liberty, gender-affirming care for youngsters is snake oil and child abuse. Her group is attempting to outlaw this practice in every state.
The American Academy of Pediatrics, the American Medical Association, and the American Academy of Child and Adolescent Psychiatry are among the major U.S. medical associations that support gender-affirming care. Trans youth who receive gender-affirming care have much lower rates of substance use, sadness and anxiety, suicide attempts, HIV medication adherence, and dangerous self-prescribed hormone usage, according to the American Medical Association.
According to Dr. Jason Nagata, an associate professor of pediatrics at the University of California, San Francisco, children who are extremely unhappy and have no other means of delaying puberty may resort to self-help.
For instance, trans males may abstain from eating since they are aware that they won’t start menstruating if they don’t consume enough calories each day, according to Nagata.
According to Nagata, some people would purposefully limit their food intake in an effort to stop their periods. We’ve seen that a lot, especially when people are unable to receive care that is gender affirming.
According to Nagata, trans females occasionally attempt to postpone the consequences of puberty by starving themselves. They can stop themselves from getting Adam’s apples or facial hair if they truly limit their dietary consumption.
According to Nagata, eating problems can be fatal.
After opioid addiction, anorexia, a disorder in which sufferers drastically reduce their caloric intake, has the second-highest death rate of any mental illness. It can lead to brain damage, anemia, bone loss, and irregular heartbeats. Within four years of receiving a diagnosis of anorexia, almost 5% of persons pass away. Relapse rates are high even with thorough treatment. More than half of anorexics do not fully recover.
According to research, governmental prohibitions on gender-affirming care exacerbate the stress and worry that many transgender people already experience. The day following the November election, calls to a mental health crisis line operated by The Trevor Project, a nonprofit that aims to prevent suicide among LGBTQ adolescents, increased by 700%. According to a recent study published in Nature, jurisdictions that prohibited gender-affirming care for children saw a 72% rise in trans youth suicide attempts.
According to Menzel, there are higher instances of self-harm and suicide among trans youngsters and eating disorder sufferers. Menzel expects that more trans kids may seek methods to halt the process themselves if lawmakers outlaw hormones that block puberty.
Finding peace
According to Beckwith, the assistance of other transgender individuals and transition-related medical care are responsible for their rehabilitation.
Beckwith started taking testosterone eight years ago, which they say is life-saving. Although they still sometimes need to be reminded to eat more, Beckwith said they are much healthier than they were in college, when they contemplated suicide.
I still have days when I have thoughts that creep back in, said Beckwith, a program director at Project HEAL, an advocacy group that aims to increase access to treatment for eating disorders. Thanks to mental health counseling, I have so much more practice now in rewiring those thoughts and leaning on the people around me who can affirm me and lift me up.
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