Supporting The Well-Being Of All Children

Monday, March 8, 2021

Pediatricians commit themselves to supporting the health and well-being of all children and families so that the children they care for can thrive in all areas of life including athletics, access to accommodations and healthcare. Unfortunately, several bills currently working their way through the Tennessee state legislature would cause unnecessary harm to children and families in our state. These bills impact the lives of a small percentage of the population but potentially do significant harm to these families. 

While only 1.8 percent of youth identify as transgender and another 1.6 percent are reportedly questioning or gender diverse, transgender kids may already have trouble feeling safe at school and are at a much higher risk of depression or suicide. In fact, over 50 percent of
transgender children report suicidal thoughts and one-third actually attempt suicide. These risks are highest when they experience bullying or exclusion. 

Multiple bills under consideration in the Tennessee General Assembly do nothing but add to the feeling of exclusion that these youth already feel, by restricting their access to healthcare, where they can use the bathroom, and what sports team they play on. Without any real-life examples of any problems in medical care, a violation of privacy, or a true impact to female student athletes, we respectfully recommend that they should not pass.

Research shows that children allowed to affirm their gender identity by living as they identify have a lower risk of suicide. These children already face many obstacles even without the state legislature passing bills that would seek to exclude them. Of most concern to pediatricians and parents across Tennessee is House Bill 578/ Senate Bill 657 that would restrict access to specialty care for transgender youth and impose criminal penalties on doctors and parents who provide or seek that care. This bill would require three doctors to sign off on treatment decisions, require both parents’ consent and prohibit hormone therapy treatment in some cases. Specialists skilled in providing care for these rare cases are already scarce enough, but the threat of a criminal penalty in decision making between a doctor and patient and family will only make this care harder to find. The Tennessee Chapter of the American Academy of Pediatrics is incorporated in the state of Tennessee.

While some supporters of these bills make it sound like these decisions are hastily decided or on a whim of a parent or child, in reality these families struggle through these matters and carefully make these decisions with guidance from their healthcare providers and mental health professionals. Extensively researched and carefully crafted professional guidelines by national and international specialty organizations already exist that doctors follow in these cases. Once again, there are no Tennessee cited problems. This unnecessarily injects government into  the exam room and into very personal decisions.

The American Academy of Pediatrics states that “any discrimination based on gender identity or expression, real or perceived is damaging to the socioemotional health of children, families, and society.” These bills miss an opportunity to look forward in our state and to approach diversity with a nonjudgmental approach. We are hopeful that our lawmakers will defeat these efforts and support these families.

Anna Morad, MD, TNAAP President; Jason Yaun, MD, TNAAP Vice President, Dorothy Sinard, MD, FAAP Barbara Dentz, MD, FAAP; Hunter Butler, MD, FAAP; Cassandra Brady, MD, FAAP


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