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Individual Oral Paper

LGBTQ+

LGBT: Relationships, Family, and Community Context

4 - (IOP 28) Navigating Uncertainty: Assessing the Immediate Impact of Anti-trans Executive Orders on Transgender Clients, Parents, and Providers

Sunday, November 23, 2025
10:45 AM - 11:00 AM CST
Location: Imperial 11, Level 4
Keywords: Public Policy, LGBTQ+, Adolescents
Recommended Readings: Hughes, L. D., Kidd, K. M., Gamarel, K. E., Operario, D., & Dowshen, N. (2021). “These Laws Will Be Devastating”: Provider Perspectives on Legislation Banning Gender-Affirming Care for Transgender Adolescents. Journal of Adolescent Health, 69(6), 976–982. https://doi.org/10.1016/j.jadohealth.2021.08.020,   Gupta, P., Barrera, E., Boskey, E. R., Kremen, J., & Roberts, S. A. (2023). Exploring the Impact of Legislation Aiming to Ban Gender-Affirming Care on Pediatric Endocrine Providers: A Mixed-Methods Analysis. Journal of the Endocrine Society, 7(10), bvad111. https://doi.org/10.1210/jendso/bvad111,   Price, M., Rakhilin, M., Johansen, K., Collins, E., Pachankis, J. E., Lyon, A. R., & Allen, M. (2024). Gender Affirming Psychotherapy (GAP): An intervention to reduce the mental healthcare “gap” for transgender youth. Psychiatric Services. https://doi.org/10.1176/appi.ps.20230460,   ,  
Background: In states with anti-transgender policies, mental health providers face fear and uncertainty, hindering their ability to deliver gender-affirming evidence-based therapy. In January 2025, several federal anti-transgender executive orders were issued, however, little is known about how these affect providers, transgender youth, and their parents. This study analyzes qualitative data from providers delivering gender-affirming therapy to transgender youth and their parents, highlighting the evolving challenges to care and the need to ensure continued access.

Methods: Mental health providers (N=24) completed a brief online survey in March 2025 on how these orders have affected them, their transgender clients, and their clients’ parents and what supports are needed to continue providing and receiving gender-affirming mental health care in the midst of a nationwide rise in anti-trans policy. Two coders conducted rapid qualitative analysis of provider responses to summarize new challenges and recommended supports.

Results: Three challenges were identified along with 3 corresponding supports needed to mitigate the impact of anti-transgender policy: Difficulty providing care: providers reported an increased fear of legal repercussions amidst more restrictive policies and regression of parents’ affirmation of their transgender children. Accessibility of care: parents feel pressured to relocate or make urgent care decisions before further restrictions. Engagement with care: transgender youth experienced more discrimination and felt discouraged from exploring their gender identity.
Identified supports include more resources on licensure protections (providers), access to support groups, and up-to-date information on preventative care (transgender youth and parents).

Conclusion: Even in states with protections for transgender people, the recent executive orders have negatively affected transgender clients, their parents, and their providers. Much of this results from fear and uncertainty about which executive orders will translate into policy and which will face legal challenges. Strengthening legal protections for providers, fostering support networks for transgender youth and their parents, and equipping individuals with knowledge about preventative care (e.g. how to get a month supply of hormones) remain critical strategies in mitigating these challenges.

Key words: Transgender; Adolescent; Mental Health Providers; Executive Orders; Affirmation

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Describe at least three challenges mental health providers face in delivering gender-affirming care post anti-transgender executive orders and at least one support strategy for each challenge.