Life

Gender-Affirming Care Doesn’t Just Help Trans Youth Survive. It Allows Them to Flourish.

Photo of the author free climbing up a sheer rock face with the silhouette of people protesting in support of trans rights overlaid below
Photo illustration by Slate. Photo by Alexander Chen.

This post is part of Outward, Slate’s home for coverage of LGBTQ life, thought, and culture. Read more here.

“Where are your gym clothes?”

“I lost them.”

“Again?” my mom said, exasperated. I knew it would be frustrating for her, replacing my gym clothes for the third time that year as a single mom. I hadn’t really lost my gym clothes, though. I knew exactly where they were—wedged behind the tall bush at the back of the school property, where I’d lobbed them right before PE class. The last two sets had been “lost” in similar fashion—tucked under a stairwell, secreted behind a tree—each time so I wouldn’t have to go to PE that day.

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The reason I dreaded going to PE was that, although I didn’t realize it at the time, I was a transgender boy. All I knew was I hated the changes that were happening to my body during puberty. I hated that we had to change in the locker rooms. I hated having to wear the gym clothes because they were more revealing than the bulky clothes I wore to school every day. And I hated the gender-segregated teams and activities, where I was forced to play “girls” sports rather than “boys” sports. The thing was, aside from the gender dysphoria, I really liked PE. I liked running and hiking. I was an excellent third baseman. I enjoyed developing teamwork and camaraderie with my friends. But the gender-related anxiety would build and build, culminating in these moments of blind panic where I would chuck my gym clothes into a bush right before class.

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Afterward, confused and embarrassed, I couldn’t bring myself to return to these sites of shame, so that the landscape of my school ended up dotted with these little no-go zones, a topographic record of the inner pain of one defeated trans kid at the turn of the century who had no idea that transgender people existed and no way of understanding why he felt the way he did. And each time, I knew I would have to trudge my way home after school to lie to my single mother’s face about why she would have to scrape up the money to replace my gym clothes. Again.

This year, more than half of all U.S. states are considering bills that would ban transgender minors from being able to access gender-affirming health care, being able to participate in school sports consistent with their gender identity, or both. On Tuesday, the Arkansas Legislature overrode the Republican governor’s veto to pass a bill banning gender-affirming care for trans minors. The state already passed a law prohibiting transgender women and girls from participating in school sports. A new bill sponsored by North Carolina Republicans would ban gender-affirming care for children and adults under the age of 21 and compel school officials to report students’ “gender nonconformity” to their parents.

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Many doctors, parents, and transgender youth themselves have testified eloquently about how gender-affirming health care and school inclusion save the lives of trans youth by reducing their risk for suicide—and how, conversely, these bills will almost certainly cost lives by sending trans youth the message that society reviles and fears transgender people. These bills are opposed by major sports bodies such as the NCAA as well as every major U.S. medical organization, including the American Medical Association, the American Psychological Association, the American Academy of Pediatrics, and the Endocrine Society.

Lost in this debate is that there is more at stake than the survival of transgender youth, as important as that is. More than that, we should aspire to build a society where transgender youth—as well as all youth—are able to thrive and unlock their full potential.

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The truth is it took me years to fully understand how profoundly I was affected by not being able to live authentically as a boy in my younger years. On the outside, I must have looked like a success to everyone else. After school I went on to attend Oxford University and Harvard Law School, where I was the first openly transgender editor of the Harvard Law Review; to secure prestigious federal clerkships; and, at the age of 31, to be named the founding director of Harvard Law School’s LGBTQ+ Advocacy Clinic. But in the process, I was also working myself into the ground and developing neck, back, and wrist problems from too many hours chained to my desk and squinting at screens.

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One of the greatest blessings of accessing gender-affirming health care has been rediscovering my childhood love for sports and the outdoors. I started rock climbing. I learned how to scuba dive. I joined a recreational men’s rugby league. Becoming more active has straightened out my health problems and helped me achieve better work-life balance. But more importantly, it’s also helped me realize that I didn’t flake out of PE class so many times as a kid because I was an Asian nerd, I didn’t like sports, I wasn’t athletic, or I was just plain lazy—all things I accused myself of at the time. Instead, I couldn’t be physically active as a teenager when doing so emphasized how wrong I felt in my body, how my school gendered me incorrectly, and how impossible it seemed that I would ever inhabit the world and my body in a way that felt right to me. Growing up transgender is like being trapped in COVID quarantine, except you’re stuck in your body instead of your house, there’s no vaccine on the horizon, and you have to live like this for the rest of your life.

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Transgender people suffer from disproportionately poor lifelong health outcomes and lower life expectancy. This problem is commonly attributed to the gender dysphoria that many transgender young people feel about their bodies. But the truth is that gender dysphoria is treatable when transgender young people are able to access gender-affirming health care and live authentically as themselves. But when politicians tell trans youth that their bodies exclude them from participation in sports, and also prevent them from accessing the gender-affirming care they need to feel comfortable in their bodies, transgender youth are deprived of the lifelong benefits of being physically active. These benefits include not only better physical health, but also developing the social skills, sportsmanship, and character that many other young people find through sports. It’s like knowing that there’s a vaccine out there, but the state isn’t going to let you have it.

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That’s why it breaks my heart when amazingly courageous young transgender activists like Jazz Jennings, whose battle to play girls soccer inspired the U.S. Soccer Federation to create transgender-inclusive policies, are viciously attacked merely for seeking to live authentically as themselves—and when the Arkansas Legislature forces through the most extreme legislation in the country threatening doctors with losing their licenses for providing any form of gender-affirming care to transgender youth.

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Recently, I led a multipitch free climb for the first time when I climbed Corrugation Corner, a legendary 500-feet ascent up a sheer rock face at Lover’s Leap in South Lake Tahoe, California. Leading a free climb means climbing a route without a rope above you, placing protection in the rock as you ascend so that if you fall, the rope catches on the last piece of protection you placed below you. When I finally reached the top, the valley floor opened up and the horizon stretched forever.

It felt like I could accomplish anything. I just want trans kids to be able to have the same feeling.

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