Medical Providers,

Open Letter from North Carolina Medical Providers

North Carolina General Assembly,

As medical professionals serving North Carolinians, we have an obligation to advocate for the health of all of our patients and oppose discrimination. That’s why we urge you to reject any legislation targeting LGBTQ people for discrimination. We specifically are concerned about - and oppose – a slate of anti-LGBTQ bills, including two that particularly target transgender youth. These bills are HB358, SB514 and SB515. 

Opposing SB514 & SB515

SB514 would prohibit transgender young people from receiving any trans-affirming care and penalize medical professionals who provide transition-related care. It also essentially requires public employees – such as teachers, administrators, or counselors – to “out” transgender students to their parents, potentially before they are ready to share. And it protects the dangerous practice of anti-LGBTQ “conversion therapy,” the debunked practice of attempting to change someone’s sexual orientation or gender identity.

SB515, meanwhile, would allow any medical provider – defined so broadly to reach all health care entities as well as individual staff at hospitals, nursing homes, clinics, or pharmacies – to refuse to provide any service or treatment anything they object to on the basis of conscience, including even providing information or referrals. It in effect establishes a broad and dangerous “license to discriminate” against vulnerable communities, including LGBTQ people, pregnant people, or people of differing faith backgrounds. 

It is our duty as medical professionals to do no harm – but withholding medically necessary care from LGBTQ patients and other vulnerable groups would, without any doubt, cause significant short- and long-term harm.

These bills run counter to evidence in the medical community that improving access to LGBTQ-affirming care is a central means of improving health outcomes for LGBTQ people. Major medical associations, including the American Medical Association, the American Academy of Pediatrics, and the American Academy of Family Physicians, recognize that supporting transgender youth is critical to their health and well-being.

That’s why SB514 is so specifically concerning: Many credible studies of trans youth populations have demonstrated that gender-affirming care is linked to significantly reduced rates of depression, anxiety, substance abuse, and suicide attempts. Gender-affirming care reduces reliance on self-prescribed and self-administered hormone use, which can be dangerous without the oversight of a physician. Gender-affirming care saves lives and allows trans young people to thrive.

SB 514 would not only violate the dignity and freedom of transgender young people – it is also an attempt to prohibit medical professionals from doing our jobs, an effort to force us to violate existing standards of medical care for transgender patients. And if we follow the standards of care of the medical community, we could be punished by the state and lose our license. 

Opposing HB358

We also strongly oppose HB358, which would harm the development of our transgender patients and others by restricting transgender students from participating in school athletics.

Participation in athletics is a vital part of students’ well-being, including their physical, social, and emotional health; involvement in student sports provides young people with lessons about leadership, self-discipline, success, and failure. Transgender students, like other students, deserve the same chances to learn teamwork, sportsmanship, leadership and self-discipline, and to build a sense of belonging with their peers. When we tell transgender girls that they can't play girls' sports – or transgender boys that they can't play boys' sports – they miss out, and being excluded can lead to harmful outcomes with regard to social and emotional wellbeing.

Beyond that, we have significant concerns about the ethical and legal implications of HB358. The methods proposed for identifying trans athletes are invasive, and releasing the results of the methods are illegal under medical privacy laws. Releasing the results could also traumatically “out” a child, forcing them to disclose their gender identity, before they may be ready to share.

Supporting Dignity & Respect for All

We believe that all people, including LGBTQ people, should be treated with dignity and respect no matter where they live. For all of these reasons, we stand united in opposition to the anti-transgender SB514 and HB358 and the broadly concerning SB515 and in support of LGBTQ-affirming care across North Carolina. 

We ask that you trust our professional care, lead with compassion, and oppose anti-LGBTQ legislation in North Carolina.