Abstract：
Purpose: In the past 2 years, nearly all 50 states have debated bills seeking to ban minors\' access to gender-affirming medical interventions, with many being passed into law. This study documents gender-diverse youths\' (GDY) and their caregivers\' experiences as they grapple with how such laws impact their families. Methods: Sixteen GDY and 16 caregivers participating in a longitudinal study of the impact of gender-affirming care on GDYs\' well-being were interviewed about how the legal and social discourse was impacting them and their families. When interviewed, some participants had completed only the initial intake, others had completed the intake and an initial medical consultation, and a few had recently started gender-affirming hormones. Thematic analysis was used to identify common threads in the youths\' and caregivers\' experiences. Results: Four main themes were identified: Direct effects of losing access to gender-affirming medical interventions, reflecting how losing access to care would impact well-being; growing hostility toward the gender-diverse community, noting increasing social negativity; personal and social upheaval, reflecting the many aspects of families\' lives affected; and galvanization into social action, documenting drives to effect social change. Conclusion: Laws banning gender-affirming medical interventions impact GDY and their families beyond limiting access to medical care. They increase the social stressors, cause social network disruptions, increase hostility toward the gender-diverse community, and lead some GDY and caregivers to engage more politically to protect their community. Gender-affirming health care providers need to recognize how the social and political environment impact GDY and their families to provide high-quality, person-centered care.
摘要：
目的：在过去的两年里，几乎所有50个州都在辩论旨在禁止未成年人获得确认性别的医疗干预措施的法案，许多被通过成为法律。这项研究记录了性别多样化的年轻人（GDY）及其照顾者在努力解决这些法律如何影响其家庭时的经历。方法：16名GDY和16名护理人员参与了一项关于性别确认护理对GDY幸福感影响的纵向研究，并就法律和社会话语如何影响他们及其家人进行了采访。面试时,一些参与者只完成了最初的摄入，其他人完成了摄入和初步医疗咨询，一些人最近开始使用性别确认激素。主题分析用于确定年轻人和护理人员经历中的共同点。结果：确定了四个主要主题：失去获得确认性别的医疗干预措施的直接影响，反映了失去获得护理的机会会如何影响福祉；对性别多样化社区的敌意日益加剧，注意到社会消极情绪的增加；个人和社会动荡，反映了受影响的家庭生活的许多方面；并激发了社会行动，记录影响社会变革的动力。结论：禁止性别确认医疗干预措施的法律对GDY及其家人的影响超出了限制获得医疗服务的范围。他们增加了社会压力，导致社交网络中断，增加对性别多样化社区的敌意，并引导一些GDY和护理人员在政治上更多地参与保护他们的社区。确认性别的医疗保健提供者需要认识到社会和政治环境如何影响GDY及其家庭，以提供高质量，以人为中心的护理。
