The segment will feature some mentions of suicide across dozens of states. *** big issue for legislators is health care for transgender people, particularly the subset known as gender affirming care. In 2023 alone, legislators have introduced more than 100 bills across 31 states that would restrict gender affirming care. That's according to civil rights advocates at the AC L U. The bills usually address health care for folks under 18. It's part of *** broader push to restrict aspects of transgender life. Alongside recent laws governing the presence of trans people and everything from bathrooms to sports. Transgender people say these laws are an attack on their human rights and access to basic health care. I could stand here and tell you about the times I attempted to end my life because I didn't have access to gender affirming care. But I know I know you don't care. I see you sneering at us. I take issue with the notion of describing some of the care particularly surgeries as mutilation as someone who has undergone gender affirming surgery. I know the light it brought to my life. Legislative sponsors of these bills tend to be Republicans. They say providing this care is *** threat to the well being of Children as adults, we understand *** child's brain is not fully formed and cannot comprehend the ramifications of making irreversible medical decisions. And so it's my hope in the hope of this bill that by the age of 18, they will not want to pursue further physical or chemical treatments or pursue those treatments. So what exactly is gender affirming care? It's *** set of guidelines for doctors that tell them to support and affirm *** patient's gender identity when it doesn't match how they were assigned at birth. It includes everything from using proper pronouns with patients to counseling and therapy and medical options like puberty, blockers, hormones and yes, sometimes surgery, radiologist and breast imaging. Doctor Evelyn Carroll, *** trans woman herself told us gender affirming care by its nature has to be pretty broad. Gender affirmation is gonna look different for everyone. I like to say that if you know one transgender person, you know one transgender person and for some people uh that may include hormones and surgeries but for others, um often there is no medical component of their gender, of their gender affirmation studies show this care can be lifesaving directly linking gender affirming care to lower rates of depression and suicidality that really matters for the transgender community. *** study published last year in the journal of interpersonal violence found that 82% of transgender people surveyed reported suicidality and 40% had attempted suicide. It's also worth noting almost every relevant large medical association is on board with the basic concept of providing non judgmental care that affirms *** patient's gender identity. We reached out to the American Medical Association, American Psychological Association, American Academy of Pediatrics, endocrine Society, World Professional Association for Transgender Health or W path American Academy of Obstetrics and Gynecologists. All of them support gender affirming care and have set up standards for how to provide that care responsibly. While specific guidance around issues like age minimums for certain treatments can vary. They're on the same page about the broader framework. While not everybody chooses to medically transition, most bills have sought to prevent folks under 18 from accessing puberty blockers and hormone therapy as well as surgeries. American Academy of Pediatrics guidance asks doctors, parents and young patients to work together to figure out which treatments are right for them. Doctor Jason Rafferty led the development of their guidance and he'll be helping us understand some of the most common medical treatments. Let's take *** look at puberty blockers. If *** young person is considering *** transition or just isn't sure of their gender identity, *** doctor can prescribe these to give *** kid more time to figure things out. Best practices dictate that these aren't prescribed until *** child is at puberty age, puberty blockers can be very valuable at that stage because um especially for *** young person who feels that their body is beginning to change. They don't have control. It's really distressing puberty resumes after *** patient stops taking their blockers and most of their effects are reversible. But the threat of long term bone density loss has led some European institutions to pause their use. Rafferty told us that that specific issue can occur if blockers are used for too long or too late into puberty. The American Academy of Pediatrics also notes more research is needed into potential risks to fertility. Patients can also undergo hormone therapy, getting either testosterone or estrogen to align more closely with their gender. These treatments are meant for later into puberty and aren't considered under guidelines until age 14. At the earliest, most providers wait until *** patient is at least 16 hormones have less reversible effects on things like voice hair, follicles express size and potentially fertility. We wanna make sure that young people can sort of reflect back and sort of be able to talk through why this is gonna be beneficial for them. We want to make sure that, you know, adults are really thinking through reversible irreversible when it comes to sort of effects, side effects, things like that after months or years of blockers and or hormone therapy, patients who want to go further can get top end or bottom surgery by and large surgery is reserved for adult populations above the age of majority. There are some exceptions specifically for what is referred to as top surgery, um, which would be sort of, you know, manipulating the chest, uh, for *** mature, um, you know, uh, 16 or 17 year old on *** case by case basis. W path guidance does open the door for it to happen at age 15. But only in countries where 15 is the age of majority, meaning the age where *** person is legally an adult, the US is not one of them. The age of majority here is 18 years old. Even then Rafferty explained that any surgery for minors isn't something doctors take lightly. It is usually ***, um, you know, *** fairly intensive process of multiple team members weighing in to make sure that this is *** qualifying, you know, sort of case that this would be *** sort of exception. Um, when we talk about bottom surgery, which would include any sort of sterilizing procedure or, uh, any sort of genital procedure, um, that is not something that any, you know, existing protocol today is really sort of, um, endorsing under the age of majority.