As a doctor, I know anti-trans legislation isn't about 'family values.' It costs lives.

Lawmakers using so-called culture wars to prohibit medical care for transgender people are dismantling more than medical options; they’re weakening families and communities.

These strategies vilify people for their personal identity and marginalize families at an already tenuous time.

Legislation to restrict safe options for treatment, like puberty blockers, causes fear and consternation. Some families are fleeing their home states and moving where their children can be their authentic selves and receive comprehensive medical care.

The strain over this issue isn’t confined to state capitals. It extends to one of the country’s most established newspapers, where the newsroom is battling over coverage of transgender and gender-affirming health care. Even author J.K. Rowling has weighed in on issues related to the work – work I’ve been doing for seven years in my medical practice.

How not to cover the transgender community: The New York Times was criticized for its reporting on trans issues. Good.

Medical facts vs. culture war fiction

In that time, I’ve seen families search together, with medical guidance, for ways to navigate the gender transition process. It’s often complex and fraught. It’s not one that’s careless and without medical expertise.

In fact, it’s rare that gender transition begins with puberty blockers; instead, it’s a journey that a team of medical specialists work hard to make safe and manageable for the whole family.

At a local protest against proposed Texas bills that would have labeled parents of transgender children "child abusers." The bills failed in 2021.
At a local protest against proposed Texas bills that would have labeled parents of transgender children "child abusers." The bills failed in 2021.

Gender transition can often start socially. That can include the patient using a different name, changing their hair style, wearing specific clothes or a chest binder, or asking family and friends to use different pronouns.

These steps are not required but can be helpful before a patient makes further decisions about their future. Ideally, a social transition also gives that young person’s family time to reflect, consider and accept their child’s path. However, for some parents, this stage is understandably difficult, even when they know intellectually that their child still is the person they’ve raised and always loved.

For some parents, gender change represents loss – a loss of their child as they were, as the parents had perceived their child, or of the adulthood and future the parents envisioned for their child. Though I’ve seen this process play out in hundreds of families, my heart still aches for the difficult, complex march parents make toward acceptance. There can be a painful balancing act between the future their child wants and the one the parents thought their child might have.

'Good kid': Open letter to Texas Attorney General Ken Paxton from the father of a transgender child

'I just hope that he's always confident': Raising LBGTQ+ kids to be strong, successful

That strain can be undeniable, even as I offer families everything from support groups to psychological services. I can offer 50 years of data indicating that puberty blockers are safe and do not have permanent effects on future fertility, and I can reassure parents about the efficacy of using gender-affirming hormones – if that’s their child’s journey.

None of that is the same as the deep, unconditional love and understanding that parents and families can provide as they help a young person through a gender transition. In addition, love and support from communities has the potential to lift up parents and entire families as a child grapples with their transgender identity in a largely cis-gendered society.

Political games aren't a 'family value'

When elected officials work to criminalize medical care, frame parents and doctors as abusing or experimenting on kids, and eliminate schools as safe allies for struggling students, they destroy vital emotional and social frameworks that families need to thrive. When those officials mischaracterize puberty blockers and other types of gender-affirming medical care, it demonizes young people and their families while they’re trying to work through an already difficult time.

These political games put additional obstacles in patients’ path, which can include becoming homeless, being shunned from a house of worship and facing a rate of substance use two to three times higher than it is for cisgender people. Eighty-two percent of transgender teens consider suicide.

I’m not clear on how that promotes family values.

Is another person's identity threatening to you?: Anti-transgender rules, rhetoric and legislation stain America's soul

It’s OK not to understand gender dysphoria. It’s a complex condition and, like any medical field, we’re always seeking to learn more. I’m asking lawmakers to take a closer look at the impact they’re having on these young people and their families. Each anti-transgender proposal, sensationalist news broadcast and cruel meme lobbed on social media diminishes the real lives at stake and fractures families and communities.

My proposal is backed both with medical evidence and compassion: I ask legislators to humanize the victims of their culture wars. I ask that the doctor/patient relationship remain sacrosanct. I ask parents to look at their children with love, always.

When I meet the parents of my patients, I tell them that support from communities, religious institutions and schools can make a wonderfully positive difference in the life of their child. My practice guides patients at every step, medically and psychologically, because my goal is for these kids to be healthy and happy, long into the future.

Opinion alerts: Get columns from your favorite columnists + expert analysis on top issues, delivered straight to your device through the USA TODAY app. Don't have the app? Download it for free from your app store.

That outcome is most likely when parents, teachers, religious and community leaders and yes, even politicians, want that, too. A gender transition is challenging, but it doesn’t have to steer us from that goal.

Politics shouldn’t tell the story of gender transition; young trans people should, as they attempt to carve out their future.

Legislators can choose to help families and communities build that future, or they can choose to dismantle it.

David Rosenthal
David Rosenthal

David Rosenthal, D.O., Ph.D., is the founding medical director of the Center for Transgender Care; the medical director for the Center for Young Adult, Adolescent and Pediatric HIV; and an attending physician in the Division of Allergy/Immunology at Northwell Health.

You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter. To respond to a column, submit a comment to letters@usatoday.com.

This article originally appeared on USA TODAY: Anti-trans bills aren't pro 'family values.' Data show they cost lives