Our Position on HB 454

House Bill 454 is a misguided effort that facilitates potential harm to a vulnerable population by denying them access to critical care and support.

Through the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association, the nation’s pediatricians and children’s hospitals have collectively issued a mental and behavioral healthcare emergency for children across the country. This legislation includes provisions that not only deny care to vulnerable youth and their families but also obligate public and private school officials to betray the confidence of vulnerable students. This will have unintended consequences that will exacerbate this mental healthcare crisis even further.

As children’s hospitals, our job is to save, protect and enhance the lives of the youth and their families in our care. Based on proven research, we know that youth receive the best quality care and best possible outcomes when the patient care team – including the family and clinicians – work together to make medical decisions.

We are opposed to any legislation that places professional discipline or civil penalties on clinicians who are providing support and clinical care based on the decisions made by the family and the patient care team, especially when following internationally recognized guidelines and standards of care. We are also opposed to any legislation that interferes with parental/guardian decision making for the care of their child.

Background: 

Transgender is an umbrella term for people who experience their gender differently from their assigned sex at birth. These individuals experience a consistent and persistent discomfort with gender identity, causing distress. One in 137 American teenagers identifies as transgender.

When an individual expresses anguish over their gender identity vs. sex assigned at birth, the family might choose to seek care at one of Ohio’s children’s hospitals. Ohio is fortunate to have world class institutions providing the best practice, evidence-based care for both children’s and adolescent’s physical and mental health. Our mission for families of transgender youth is no different.

As with all behavioral health aspects of care, there is no one-size-fits-all approach for youth and families experiencing gender identity concerns. Families who come to our clinics are met with a team of experts to assist in the development of a care plan that is age appropriate, ranging from integrated therapy, including psychiatry, social work, endocrinology, and adolescent medicine. Extensive screenings, resources, and supports are provided to families over a prolonged period of time for their careful consideration before beginning any treatments.

Children’s mental and physical health are adversely affected when they feel that their family rejects their diverse expression of gender. Transgender youth who feel rejected by their family are more likely to attempt suicide, develop depression, use illegal drugs, and contract HIV and other sexually transmitted diseases. Sadly, suicide is the second leading cause of death among our young people, with LGBTQ youth being four times more likely to seriously consider suicide, to make a plan for suicide, and to attempt suicide than their peers (see https://www.thetrevorproject.org/research-briefs/estimate-of-how-often-lgbtq-youth-attempt-suicide-in-the-u-s/).

As we all seek to support kids’ mental health during a time of national crisis, it is critical Ohio not adopt laws that target a vulnerable population and restrict access to care.