April 22, 2021


The American Art Therapy Association (AATA) stands in support of transgender youth. We are outraged by the onslaught of recent state legislation proposed across the country prohibiting gender-affirming care for transgender youth and banning transgender youth from participating on sports teams according to their gender identity. Simply put, these bills are dangerous because they systematically endanger the health and well-being of transgender youth. Moreover, they have created widespread fear, anxiety, and stigmatization in the community and will likely exacerbate the disproportionate mental health challenges transgender youth experience.

Already this year, a record number of state bills have been introduced attacking the transgender community, according to the Human Rights Campaign. Many of these bills single out transgender youth: 31 state legislatures have introduced bills that ban transgender athletes from participating in sports consistent with their gender identities, and another 20 states have introduced bills that prohibit or impede the administration of gender-affirming medical treatment to minors. This month, the first proposal to outlaw affirming medical care became law in Arkansas, when the legislature voted to override the Governor’s veto of the bill. In a Washington Post opinion piece, Governor Asa Hutchinson explained he “vetoed this bill because it creates new standards of legislative interference with physicians and parents as they deal with some of the most complex and sensitive matters concerning youth.” And in March, Mississippi became the first state to ban transgender athletes from competing in women and girls’ sports.

Transgender youth experience anxiety and depression at nearly 10 times the rate of their cisgender peers, and the evidence demonstrates that the affirmative approach in both social interaction as well as medical and behavioral health treatment are critical for the well-being of these young people. Transgender children who have socially transitioned demonstrate comparable levels of self-worth and depression as non-transgender children, both in studies involving parents’ reporting on their children’s mental health and youth self-reporting. Social transition can include but is not limited to being out as transgender, and using pronouns, a name, physical appearance, and/or the bathroom that aligns with their gender identity.

Playing on sports teams offers numerous positive outcomes for adolescents and children, including improved self-esteem, higher grades, and greater educational as well as occupational aspirations. Because gender identity is central to how young people perceive themselves, forcing them to conform their gender identity to their assigned sex at birth as a requisite to participate in sports amounts to banning them from athletic competition altogether. Transgender youth should not be denied the many benefits sports offer young people.

Pubertal suppression and hormone therapy are two components of affirming medical care for youth that are supported by empirical evidence and would be outlawed by many of the proposed bills. Commonly known as “puberty blockers,” pubertal suppression delays the onset of puberty and is associated with decreased behavioral and emotional problems as well as decreased depressive symptoms. Hormone therapy is used to promote gender-affirming physical changes and is associated with positive effects on body image and overall psychological well-being as well as reduced suicidality.

Bills prohibiting gender-affirming health care have been unanimously opposed by the medical field. “With alarm and dismay, pediatricians have watched bills advance through state legislatures across the country with the sole purpose of threatening the health and well-being of transgender youth,” said Dr. Lee Savio Beers, President of the American Academy of Pediatrics. In a letter opposing HB 33 in Missouri, the American Medical Association reminded lawmakers that “improved body satisfaction and self-esteem following the receipt of gender-affirming care is protective against poorer mental health and supports healthy relationships with parents and peers.”

As mental health professionals, art therapists support safe and inclusive environments for all young people to thrive. The American Art Therapy Association opposes policies that would harm the mental health of transgender youth, and strongly urges lawmakers to oppose such proposals, including those that prohibit gender-affirming health care or ban participation in sports.

We encourage you to find out if legislation targeting transgender youth is being considered in your state and to contact your state legislators about it.

Resources to learn more: