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Arkansas Transgender Youth Treatment Ban Alarms IOL Experts

April 08, 2021

Arkansas lawmakers classified recent legislation restricting procedures for transgender youth as protection but psychologists at the Institute of Living (IOL) say the law could actually do more harm than good.

The bill, approved when the state’s legislature overrode the governor’s veto, made Arkansas the first state in the country with a law banning gender-affirming treatments for people under 18, even with parental consent.

“We are saddened by this; it is very disheartening to see them pass legislation blocking individuals from receiving treatments that can be life-saving,” said Dr. Derek Fenwick, a licensed clinical psychologist with Young Adult Services – The Right Track/LGBTQ Specialty at the IOL.

The impetus for the bill, sponsors said, was concern that treatments like hormone therapy could be given to children too young to fully comprehend the concept of gender identity, but Dr. Laura Saunders, clinical coordinator of The Right Track, said there is no standard timeline for such understanding.

“Every single individual’s gender journey is different. There isn’t one way to express and explore gender. There is much exploration and inner reflection that goes on for years before gender nonconforming expression,” she said, defining gender identity as the internal feeling of maleness or femaleness vs. the sex designated biologically at birth. “There are children who show signs of gender nonconformity in toddlerhood and early elementary years.”

By age 3, Dr. Fenwick said, a child’s gender identity is generally established except in individuals who are more gender fluid, or identifying as neither male nor female.

“Some children may express a gender identity that is different from their sex assigned at birth from an early age, while for others it may be around puberty with development of secondary sex characteristics, creating what we call ‘gender dysphoria,’ or confusion, for them,” he said.

Both stressed the prevalence of depression, anxiety and suicide in transgender youth, who often lack social and familial support.

A 2020 study by The Trever Project revealed that 40 percent of LGBTQ respondents seriously considered suicide in the preceding 12 months. The number was more than half among transgender and nonbinary respondents.

“Affirming one’s gender identity is consistently associated with lower rates of suicide attempts,” Dr. Fenwick said. “Even youth who reported having their pronouns respected by people in their lives attempted suicide at half the rate of those who did not.”

Besides pronouns, youth benefit from access to counseling and treatments that make them feel validated in the gender they self-identify for themselves.

“We have seen it in our Intensive Outpatient Program that the first psychological impacts are huge,” Dr. Fenwick said. “Although effects from treatments can take time, the psychological impact occurs immediately with a brightening and hopefulness for these individuals.”

At home, parents can also help ease their child’s struggles.

Dr. Saunders suggested:

• Allowing the child to talk about and express their gender non-conforming feelings and behavior to help them understand. Professional guidance can help parents with this, she said.
• Starting a conversation with the child about how they feel on the inside – more like a boy or more like a girl? This can help them understand that internal feelings can differ from external sex.
• Seeking professional help if a child seems distressed about gender confusion.