ATLANTA — April cries every time her 10-year-old transgender daughter’s heart is broken.
It breaks when she’s not invited to sleepovers. It breaks when relatives refuse to call her by the name she goes by. It breaks when she is pushed too far to talk about her feelings in therapy.
And now it’s breaking, April says, because the family is planning to move in the next 12 months to a northern state because of a new Georgia law that goes into effect July 1. That law, known by its legislative name SB 140, would greatly curtail the treatment available to transgender children under 18, such as gender-affirming hormone therapy or surgery to align with their gender identity.
“I got to tell you, I cry every day, every time I think about how horrible people are,” April said. “I thought about quitting my job and staying home to protect her, but I can’t protect her forever. It feels impossible.”
As the date of the new law approaches, parents of transgender children, medical leaders invested in their care and advocates of the LGBTQ+ population say a sense of despair and fear has seized the community.
Because of these concerns, The Atlanta Journal-Constitution has agreed to publish only the middle names of the parents in this article to protect them and their children from potential harassment. Details such as where they live in metro Atlanta or specific incidents that could identify them have been purposely limited.
Parents with the financial means have left or plan to leave Georgia to protect their children. Those who can’t leave — often minorities and working-class families — are having detailed discussions with therapists and physicians about options, members of the community say.
Medical professionals said they plan to continue to provide health care services but are loathe to call much attention to their practice to avoid repercussions.
“I think that people who want to go into medicine might not want to practice in Georgia,” said Linda Grabbe, an assistant professor in the school of nursing at Emory University and mother of an adult transgender daughter. “There will be a brain drain and providers won’t want to come to Georgia.”
Proponents of the law said it is not meant to push Georgians out of the state, but to protect minors from irreversible treatments at such a young age. State Sen. Carden Summers (R-Cordele) has said opponents have twisted the law’s intent as anti-transgender, when in fact it is about stemming what he sees as an alarming rise in gender dysphoria diagnoses.
The deep political divisions over transgender care belie a strong consensus in the medical community. Medical associations like the American Academy of Pediatrics and the American Psychological Association say hormone and other gender-affirming treatments are not only appropriate for many minors, in some cases, they can be life-saving.
Researchers said the law could have a devastating impact on the transgender community. Transgender people are among the most vulnerable Americans, whether it be in the classroom, on the job, at the doctor’s office or in the political arena, said Giacomo Negro, professor of organization and management at Emory University.
A recent survey of the LGBTQ+ community in the South he conducted with the Center for Civil and Human Rights found that transgender men and women often avoid seeking health care because of discrimination — including being misgendered. Those between the ages of 18-29 also were more likely to say they felt unwelcome at religious gatherings.
More than 25% skipped class at least once during high school to avoid or minimize discriminatory treatment, and many avoided social activities because of societal issues over their identity, he said.
According to a 2022 study by the Trevor Project, which focuses on suicide prevention among the LGBTQ+ community, about 55% of transgender and non-binary youth considered suicide in Georgia. That compares to 46% of all Georgia LGBTQ+ youth who considered ending their lives. Among straight and gender-conforming youths, rates of suicidal thoughts are far lower, the study found.
Because many people don’t understand that gender identity does not always correspond to biological sex, they hope their transgender children will “grow out of it” as they get older. But, Negro says, “anything that disrupts the natural process of discovering one’s identity is not helpful.”
Arthur, a father of two transgender children — one a college-aged adult and another a pre-teen — said he and his wife are moving soon to make the transition for their youngest transgender child easier in a state that is more accepting.
His son is 12 and is on puberty blockers, but not yet on hormones. If the family started him on hormones before July 1, his son would be grandfathered in as the law allows those already receiving certain treatments to continue doing so. But Chris said his son says he’s not yet ready for hormones, which means they would not be available to him once the law takes effect.
“That is earlier than he basically thought he would be ready to start male puberty. The other option that we would have would be to try to delay that indefinitely, but the human body needs to go through puberty. You can’t keep someone on puberty blockers until they’re 18.”
And because lawmakers have targeted the transgender community, Arthur doesn’t want to risk more stringent legislation down the road.
“One of the biggest concerns of raising trans youth is there are very high levels of depression and suicidality and the way you prevent that from being a problem is through affirming and accepting them,” he said.
Vivian, the mother of a transgender son, said how the new law impacts families depends on the age of the child. Parents of transgender youth who are very young or closer to 18 may face fewer challenges if they have already started on their transition journey or are close to the end. Those in the middle, however, may struggle.
For families that have to consider moving, it also puts a lot of pressure on the transgender child, she said.
“There are layers of guilt that they are uprooting the family,” Vivian said.
Among the many things that anger her about the issue is the lack of knowledge about the transgender community. While support for LGBTQ+ rights has steadily grown over the decades — as many as 71% of Americans backed marriage equality in a 2022 Gallup poll — the transgender community has not seen the same embrace as others.
Debates over whether transgender people should be allowed to use bathrooms corresponding to their identity or if it is fair for trans women to participate in women’s sport have been divisive, even among supporters of the community. As a result, transgender citizens have become a political football.
“One of the biggest drivers is fear,” Vivian said. “The public doesn’t know what trans is and politicians exploit the community as a wedge issue.”
Dr. Jason Schneider, an Emory University physician who provides health care for transgender people, said the law has already had a chilling effect in Georgia. Physicians are keeping their heads down to avoid running afoul of the law and others are reexamining whether their practice is a good fit in the current climate.
Some physicians are hoping that there will be workarounds for young people, such as telehealth from transgender-affirming states or private funding to help struggling families travel for procedures, Schneider said.
And transgender clients of all varieties, including adults, are wondering if this is just the beginning of legislation against their health.
“No one is safe,” he said. “That’s the point everyone is making in advocacy circles.”
Denise, the mother of a 7-year-old transgender child, has already fled the state and said it is the best decision she’s made. What scared her the most in Georgia was how much legislators ignored the pleas of parents of transgender children and their embrace of disproven science on the ability of minors to make decisions.
“We decided to make the move because we could see the rhetoric ratcheting up,” she said.
The family moved to a liberal blue state, but live in an area that is conservative. Nonetheless, she says it is still more supportive than the most open-minded parts of metro Atlanta.
“This is an area that has policies that really support the child,” Denise said.
