As of May 2024, 54 bills have been proposed to ban aspects of gender affirming medical care for transgender and gender expansive Americans.1 Additionally, in 2023 153 similar pieces of legislation were introduced in state legislatures, with 22 of them passing.2 Transgender and gender expansive individuals experience significant mental health disparities, including increased depression, anxiety, and suicidality, not because of their identity but because of the way that people respond to their authenticity.3 Restricting access to gender affirming care is discrimination. This legislation seeking to ban or restrict access to care further perpetuates discriminatory attitudes towards transgender and gender expansive individuals. Significantly, many of these bills and laws directly impact counselors' scope of practice and attempt to cast doubt on the professional expertise of mental health care professionals. In the face of these bills and laws, the Society for Sexual, Affectional, Intersex, and Gender Expansive Identities (SAIGE) upholds the American Counseling Association's commitment to the prevention of harassment in all forms - verbal, physical, sexual, emotional, and psychological - including defending the fundamental human rights of transgender, gender expansive, and LGBTQ+ individuals.4

Gender-affirming interventions are not new or novel and have a well-established use for both cisgender and transgender youth.5 Gender-affirming medical procedures and mental health care are essential and endorsed by the American Academy of Pediatrics, the Endocrine Society, the American Academy of Family Physicians, the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry, the American Medical Association, the United States Association for Transgender Health, and the World Professional Association of Transgender Health.6 SAIGE’s own Competencies for Counseling Transgender Clients,7 which have been endorsed by the American Counseling Association, call for counselors to embrace the full spectrum of gender identity and expression, affirm transgender mental and medical care, and serve as advocates for transgender individuals. Provision of affirming medical care is evidence-based best practice when working with transgender individuals.8

At least 38% of transgender and gender expansive youth now live in a state that is limiting aspects of their medically necessary health care.9 SAIGE recognizes these bills and laws have a damaging psychological effect on an already marginalized group and therefore stands in solidarity with transgender and gender expansive individuals targeted by these acts of legislated hate, in addition to their medical and mental health care providers, their families, and their support systems. SAIGE strongly opposes any prejudicial bills and laws that are in opposition to the ACA’s Code of Ethics and/or SAIGE’s Competencies for Counseling with Transgender Clients.

Written by the SAIGE Public Policy Committee and approved by the SAIGE Board. Endorsed by the ACA Governing Council (June 2024).


Healthcare Restrictions Resources

Professional Organizations Statements in Support of Gender-Affirming Care:

Advocacy Resources

Additional Information: