Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Governor Abbott’s decree: medically harmful, scientifically unfounded, and unethical

Michael Morse, MD and Christian Moser, MD
Policy
March 12, 2022
1 Shares
Share
Tweet
Share

On February 22nd, Governor Greg Abbott of Texas turned essential medical treatments for transgender adolescents into a crime, ordering the state to investigate them as “child abuse.”

The following day, a patient came to one of us (Dr. Morse), and through sobs recounted the gender identity-related maltreatment that she had experienced throughout her youth. She had survived bullying at school, transphobic slurs in the streets, and multiple threats of physical assault. She carries emotional scars, including nightmares and flashbacks, related to these experiences. “What the governor said flips the truth about abuse on its head. We’re the ones who have faced abuse and discrimination,” she said. “And now he is threatening to turn those who want to help us—our parents and doctors—into criminals.”

Joelle is a 17-year-old young woman who I have seen in my mental health clinic for the past three years. (My patient’s name and identifying details changed to protect patient confidentiality.)  Although she was born with “male” sexual organs, and was assigned the gender of male at birth, Joelle knew herself to be female from early childhood. She was blessed with parents who accepted her gender identity. They supported her choice to wear dresses, paint her nails, and play with dolls. They told her that she would always be their child and she would always be loved. The acceptance she found at home helped her weather the discrimination that she faced outside.

As puberty began, Joelle experienced distress associated with starting to develop a masculine body. This distress associated with having a body that differs from one’s gender identity is a medical syndrome known as gender dysphoria. To treat gender dysphoria, Joelle received puberty blockers. These medications paused the growth of facial hair and reduced the development of muscle bulk – leading her gender dysphoria to recede. She is now considering medical procedures which would allow her body to fully align with her female gender. Although this gender-affirming care has promoted her mental health, providing such care would be illegal in our second largest state if Gov. Abbott’s directive goes into effect. Furthermore, doctors who support this treatment, like me, will be considered to be criminals engaged in child abuse.

As physicians who are mental health specialists at Georgetown University, we vehemently reject the governor’s directive as medically harmful, scientifically unfounded, and unethical.

Numerous scientific studies demonstrate that gender-affirming care is beneficial to mental health. This research shows that providing youth access to gender-affirming hormone therapy in adolescence is associated with improved mental health outcomes, compared to deferring this care until adulthood. Treatments such as gender-affirming hormone therapy and chest reconstruction are associated with decreased symptoms of depression, decreased suicidal thinking and behavior, and improved self-image.

While medical care helps trans people, transphobic directives like Governor Abbott’s dehumanize trans people and legitimize violence against them. Such directives foster an environment hospitable to physical assault and murder. Governor Abbott’s directive contributes to a culture of fear that damages trans youth mental health throughout the country. My patient Joelle is just one example. Just as anti-Black racism negatively impacts Black youth mental health and has been shown to correlate with suicidality, discrimination against trans and other queer youth has far-reaching harms. It drives elevated rates of depression, anxiety, and suicide.

But there is hope. Acceptance of and respect for trans people fosters resilience. For example, supporting trans youth by respecting their chosen pronouns and creating affirming spaces is associated with lower rates of suicide attempts. Just as Joelle’s parents unflinching love helped her to bear the storm she faced—our solidarity with trans youth today will help to face down this newest form of discrimination.

As physicians, we are bound by our ethical principles to help patients and to avoid doing harm. We are guided by strong scientific evidence that gender-affirming care improves, and sometimes saves, the lives of young people like Joelle. We are committed to providing gender-affirming care to trans patients, to providing mental health care to patients affected by transphobia, racism, and other forms of discrimination, and to fighting back against those that attack our patients and our values.

Michael Morse is a child and adolescent psychiatrist. Christian Moser is a psychiatry resident.

Image credit: Shutterstock.com

Prev

Remove race from clinical guidelines

March 12, 2022 Kevin 2
…
Next

Requesting disability accommodations in medical school [PODCAST]

March 12, 2022 Kevin 0
…

Tagged as: Psychiatry

Post navigation

< Previous Post
Remove race from clinical guidelines
Next Post >
Requesting disability accommodations in medical school [PODCAST]

Related Posts

  • Why travel bans in response to Omicron are harmful

    Michelle Verghese
  • It is unethical for the United States to send hydroxychloroquine to Brazil

    Charles E. Binkley, MD
  • Unethical policy: Resuming federal lethal injections during a global pandemic

    Charles E. Binkley, MD

More in Policy

  • Why the WHO’s pandemic accord is critical for global health care

    Elizabeth Métraux
  • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

    Robert Pearl, MD
  • Unveiling the intricate link between housing costs and health care

    Harvey Castro, MD, MBA
  • Uncovering the truth about racial health inequities in America: a book review

    John Paul Mikhaiel, MD
  • Why affirmative action is crucial for health equity and social justice in medicine

    Katrina Gipson, MD, MPH
  • The untold story of Hispanic/Latino health: Why subgroup data matters

    Matthew B. Alonso
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
  • Recent Posts

    • Master time management with 7 productivity strategies for optimal results

      Farzana Hoque, MD | Physician
    • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

      Hoag Memorial Hospital Presbyterian | Conditions
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the WHO’s pandemic accord is critical for global health care

      Elizabeth Métraux | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • What Was Tied to Lower Long COVID Risk?
  • Chemo-Free Approach Works in Subset of Patients With HER2+ Early Breast Cancer
  • Two-Drug Combo Wins for Refractory Gout
  • First-in-Class Sjogren's Drug Passes Mid-Stage Test
  • Pricey Drug Combo Boosts PFS in First-Line Advanced Ovarian Cancer

Meeting Coverage

  • Chemo-Free Approach Works in Subset of Patients With HER2+ Early Breast Cancer
  • Two-Drug Combo Wins for Refractory Gout
  • First-in-Class Sjogren's Drug Passes Mid-Stage Test
  • Pricey Drug Combo Boosts PFS in First-Line Advanced Ovarian Cancer
  • Cardiovascular Risk Models Still Fall Short for Arthritis Patients
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
  • Recent Posts

    • Master time management with 7 productivity strategies for optimal results

      Farzana Hoque, MD | Physician
    • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

      Hoag Memorial Hospital Presbyterian | Conditions
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the WHO’s pandemic accord is critical for global health care

      Elizabeth Métraux | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...