By Louis Montclair

For The Journal

A potential landmark Supreme Court ruling could uphold a Tennessee law prohibiting transgender teenagers from accessing gender affirming medical care.

This could uphold laws in states across the country, including Montana, which prohibit medical workers from providing gender affirming care for minors.

However, this ruling would not impact Indian Health Service and it’s services for the transgender community.

In fact, it’s a little known fact that IHS does provide gender affirming care for minors and has for a long time.

The Indian Health Service website states the Two-Spirit/Lesbian Gay Bisexual Transgender community have all the same health concerns as everyone else, but may also face disparities in care, discrimination, and obstacles to and stigma about getting treatment. On the same page there are numerous links to sections of the IHS website that outline the care provided for transgender individuals.

The Fort Peck Service Unit is no exception.

According to the website, the number of services provided for transgender individuals include gender affirming care for minors. Gender Affirming care is health care that may include medical, surgical, mental health, and other non-medical services that helps transgender and non-binary (a gender identity that describes people who don’t exclusively identify as either a man or a woman) people live as their true selves.

In American Indian cultures, the term “Two-Spirit” is used to describe individuals who embody both masculine and feminine spirits, often considered a third gender, and is the preferred term for transgender people within many Native American communities; historically, these individuals often held special roles within their tribes, like healers or spiritual leaders, and were respected for their unique identity rather than stigmatized.

A guide on the website outlines how to access gender affirming care within IHS and/or Tribal Health Facilities for trans minors living in states with care bans and their relatives.

For any American Indian trans minor, it is possible to access gender affirming care within the state, even if there is a ban in place. As long as they are members of a federally recognized tribe and eligible to use IHS facilities for gender affirming care.

Why?

Gender-affirming care is age-appropriate care that is medically necessary for the well-being of many transgender, non-binary, and gender-expansive people who experience symptoms of gender dysphoria or distress that result from having one’s gender identity not match their sex assigned at birth.

By preventing doctors from providing this care or threatening to take children away from parents who support their child in their transition, these bills prevent transgender, non-binary, and gender-expansive youth from accessing medically necessary, safe health care backed by decades of research and supported by every major medical association representing over 1.3 million US doctors.

GAC

Examples of gender-affirming care include:

Social transition 

This involves publicly affirming your gender identity by:

Coming out to others 

Using pronouns that align with your gender identity 

Choosing a different name 

Changing your appearance 

Voice therapy 

Hormone therapy 

This can help older youths and adults develop sex characteristics that align with their gender identity. 

Gender-affirming surgeries 

These can be one or more reconstruction procedures that may be part of a multidisciplinary treatment plan. Examples include:

Orchiectomy, which removes one or both testicles

Vaginoplasty

Hysterectomy, which removes the uterus

Phalloplasty

Puberty blockers 

These can be an option for youth who are questioning their gender.

Counseling psychology

This can help clients feel and think differently about their communication.

Gender-affirming care can be a lengthy process. Patients may be required to have a mental health evaluation before undergoing gender-affirming procedures. 

What is transgender?

Transgender is an umbrella term that covers people whose gender identity is different from  the sex they were assigned at birth. A transgender person may identify as male, female, a combination of both, or neither.

Transgender people may express their gender in ways that don’t follow society’s norms for their assigned sex. Some terms used to describe transgender people include androgynous, multigendered, gender nonconforming, third gender, and “two-spirit.”

Gender identity is a person’s personal sense of their gender, and the desire to express that gender is a normal part of human expression.

Transgender is not a mental illness. International and national health organizations do not recognize being transgender as a mental disorder.

For some transgender individuals, they feel like they were born in the wrong body.