transgender rights

Nurse at Trans Health Center Breaks Down Myths in Anti-LGBTQ Legislation

The number of anti-LGBTQ bills that states have filed each year has steadily increased since 2018, when there were 41 recorded. So far in 2022, there have been at least 238 bills targeting LGBTQ Americans.

When nurse practitioner Dallas Ducar reflects on her childhood, she focuses on moments of what she calls "gender euphoria."

"Whether it was wearing the right clothes, getting to wear makeup very briefly, being able to very briefly be referred to as the right pronouns, those were what kept me alive," she told NBCLX. Ducar, 29, didn't transition until she was a legal adult, but she knew at 3 years old that her gender didn't match the body she was born in.

Dallas Ducar sits on an oversized chair designed to fit all kinds of bodies. (PHOTO BY KATE SOSIN FOR THE 19TH)

Her personal experience, in part, is why she disagrees so strongly with Florida's Parental Rights in Education legislation, referred to as the "Don't Say Gay" bill by opponents, signed into law Monday.

Proponents of the law say it gives parents more discretion over what their children learn in school. It includes provisions prohibiting schools from discouraging parental involvement "in critical decisions affecting student's mental, emotional or physical well-being." The law also explicitly bans teaching about "sexual orientation" or "gender identity" in kindergarten through third grade, when most kids are between 5 and 8 years old. Most children have a stable sense of their gender identity by age 4, according to the American Academy of Pediatrics.

"There is no compelling [medical] reason to prevent education around this at all," Ducar said. "If anything, all the evidence we have shows it is directly harmful to youth to not educate."

Those in favor of Florida's new law have often asserted that schools are "indoctrinating" students around gender and sexuality, including Gov. Ron DeSantis. But the idea that children aren't already wondering about these topics is a "myth," said Ducar, who works with trans and gender diverse kids and adults as the CEO of Transhealth Northampton in western Massachusetts.

Photo courtesy Transhealth Northampton.

"I would encourage everyone ... to think about their first time that they had a relationship to gender and what that experience was like because all of us have a moment in our life when we started to come to gender awareness," she explained. "It's not something that's prescribed on us. ... It's something that we come to a realization of."

"We know that we cannot change a child's gender identity, but we can choose whether they talk about it," she added. "We should be creating an open, welcoming, affirming environment where conversations can happen. ... So many of these kids, before they even come through the doors, before they even talk to their friends, have done so much research and self-reflection. That should be celebrated."

Ducar pointed out that part of the problem with ongoing anti-LGBTQ legislation and the conversations around these bills is their focus on sexual orientation and gender identity "issues." "These are not 'issues.' This is just someone's experience of their own life," she said.

So far in 2022, states have filed at least 238 bills that "would limit the rights of LGBTQ Americans," with about half targeting trans people specifically, according to NBC News. They range from limiting trans people's ability to play sports and use the bathroom that aligns with their gender identity to restricting their access to health care. Such legislation has become more frequent over the past few years; in all of 2018, 41 anti-LGBTQ bills were filed. Ducar called what's happening in Texas, in particular, "chilling."

Restrictive laws and attempts to curtail gender-affirming care are frightening and stressful for young trans people, says Sam Ames of The Trevor Project, a nonprofit focused on preventing suicide among LGBTQ youth. The organization has tracked nearly 200 anti-LGBTQ bills in legislatures across the country, and recent letters from Texas Gov. Greg Abbott and Attorney General Ken Paxton that equated gender-affirming care to child abuse. Ames is urging adults to speak up and reach out to any LGBTQ young people in their life. "Tell them you support them and accept them for who they are," Ames says.

Last year, Texas tried and failed to pass a bill that would've made providing gender-affirming care to minors a felony on par with physical or sexual abuse. Last month, Gov. Greg Abbott ordered "licensed professionals" and "members of the general public" to report parents of trans kids to state authorities if they suspect a child is receiving gender-affirming care. He did so after Texas Attorney General Ken Paxton wrote in a nonbinding legal opinion that transition care for minors is child abuse under state law.

Paxton and supporters have argued that this care is "experimental" and "unnecessary," but this assertion contradicts guidance from multiple leading groups of health professionals, such as the American Academy of Pediatrics, American Medical Association, American Nurses Association and American Psychological Association — all of whom have said trans kids need access to gender-affirming care, which is backed by decades of research, and condemned legislation prohibiting it.

Ducar knows firsthand the risks of trans people not getting the care they need, which was all too common even before the recent influx of anti-trans legislation. A 2021 survey from the Center for American Progress found almost half of trans people and 68% of trans people of color have experienced discrimination or mistreatment by a health care provider. Trans people also often struggle to get prescriptions for hormones or hormone blockers, which are regularly given to cisgender people for a myriad of conditions, Ducar said.

"For trans people, there are already so many roadblocks, so many gatekeepers along the way that try to prevent someone from just being believed," she explained. "What's being done in Texas and the 'Don't Say Gay' law, think about how that would compound someone's inability to express themselves."

She added that if she had faced the same limitations as a child, she doesn't "know if [she'd] be alive right now, to be honest with you."

In a survey of young LGBTQ people, 42% reported seriously considering suicide in 2020, and a larger percentage reported struggling with their mental health, according to The Trevor Project. The group's executive director says this is a public health crisis, as states debate laws that will affect LGBTQ youth.

The impact that these legislations will have on LGBTQ kids' mental health is a major concern of Ducar's, who's trained in psychiatry. "Removing one of the only supportive spaces for [an LGBTQ] child ... can have substantial psychiatric and mental health effects," she said.

LGBTQ youth are four times more likely "to seriously consider suicide, to make a plan for suicide and to attempt suicide versus their peers," according to LGBTQ youth advocacy group The Trevor Project.

Ducar didn't grow up with much exposure to the LGBTQ community, but she smiled thinking about what her childhood would've been like if she'd known any trans people or had the chance to talk about gender identity.

"I probably would have been able to come out much earlier. I probably would have been able to find more of those little bits of euphoria at a much earlier age," she said. "I would have probably struggled a lot less with depression and anxiety."