What South Dakota Doesn’t Get About Transgender Children

Early in my medical training, I read a landmark case study about a 12-year-old boy who wrote a suicide note to his mother saying he would rather die than go through puberty. I later met teenagers who tightly bound their chests — knowing that it could result in fractured ribs — because the emotional pain of seeing their breasts was much worse than any imaginable physical pain.

These children are transgender, and they account for almost 2 percent of youth in the United States. They are suffering from the psychological pain of having a body that doesn’t match their gender identity. I’ve dedicated my medical and research career to better understanding their mental health.

Over the past few decades, physicians have learned how to help these young people. In the past, doctors tried to force them to be cisgender, to identify with the sex they were assigned at birth. New research shows that this approach is associated with their attempting suicide. Having learned from these mistakes, we now follow new protocols that guide us to accept and affirm transgender youths in their transgender identities. We often use medications that prevent some of the physical changes of puberty that cause these adolescents distress.