Thread by @DrScottHadland

As a pediatrician & dad, I want to respond to 2 news stories out of Texas:

(1) Legislature voted yesterday to ban gender-affirming care for teens & (2) Adolescent medicine docs were pushed out of @dellchildrens in Austin for providing care. #LGBTQ 🧵 1/

Gender-affirming care is not merely hormones & surgeries despite how lawmakers frame it.

It is broader support: a safe space to ask questions, be welcomed & be affirmed, be cared for holistically.🌈

Banning gender-affirming care has a chilling effect, shutting down ALL care. 2/

So in Austin, when Adolescent Med docs were pushed out of @dellchildrens, thousands of families were left without a place to go, to be respected (rather than rejected), to ask questions. 3/ texastribune.org/2023/05/13/aus…

Many, many major professional medical organizations who have reviewed the science recommend that teens & families receive gender-affirming care, and all oppose bans of the type soon to be enacted by Texas. (Pic per @jack_turban & JAMA…) 4/

Not all teens & families receive medical or surgical care. In fact, most don’t. If they do, it’s a family-centered decision, often made with a team of interdisciplinary healthcare professionals and with teen assent & parental consent — a highly personalized, informed decision. 5/

Lawmakers like to showcase ppl who had surgeries & regret it. My heart goes out to these folks. But these instances are rare. Studies show them to be in the single-digit %s.

Most teens & families who proceed with care find it life-changing — indeed, often lifesaving. 6/

But the take-home here is that gender-affirming care is highly individualized, family-centered, & occurs amid careful, thoughtful, caring medical practice.

These decisions should be made in a clinic, & not in a state legislature amid fear-mongering, fire-stoking politicking. 7/

As per my colleagues in Adolescent Medicine at @dellchildrens who were pushed out…

I am Chief of Adolescent Med at a major hospital & med school. Let me tell you who we are and what we do: 8/ jamanetwork.com/journals/jamap…

Adolescent Med docs like me do the things that many pediatricians / family docs find challenging, caring for:

- eating disorders
- addiction
- mental health (depression, anxiety, trauma)
- menstrual problems
- weight management
- STIs, reproductive health concerns
9/

We are precisely who you want if your teen is working through their gender identity or sexual orientation. We provide comprehensive, developmentally responsive care for a range of conditions. We spend more time with patients (30-60 min, often). 10/

Adolescent Med docs always do what’s right for teens & families, typically at the expense of time — and, quite bluntly, money. Our workforce is among the lowest paid in medicine. We do this work because we love it. 11/

So when Adolescent Med docs got pushed out of practice at @dellchildrens, understand that thousands of teens & families lost trusted clinicians caring for a range of conditions, & that there will be few, if any, other places where they can receive that same high quality care. 12/

People may respond to this thread & say: Well, that’s what you get for living in Texas.

No. LGBTQ people live everywhere, & many live in Texas. That is their home. No deserves to be stigmatized.

(And FWIW, life here is Mass. for LGBTQ ppl isn’t always perfect either.) 13/

We have a duty to call out injustice & discrimination against LGB, transgender, & gender-diverse teens & families everywhere.

What’s happening in Texas affects everyone, everywhere, and must be stopped. 14/

To the nearly 30,000 transgender & gender-diverse teens of Texas & your families, know this:

You are loved. People all across this country see you, care about you, & are standing up for you. 🌈🏳️‍⚧️ 15/15