Thanks to Texas’ governor and attorney general, Greg Abbott and Ken Paxton, and officials in 14 other states, an estimated 58,200 transgender youth and young adults ages 13 and older are in danger of being denied access to gender-affirming healthcare, according to a new report from the Williams Institute at UCLA School of Law.

As of March 18, the institute reports, 15 states have restricted access to gender-affirming care or are currently considering laws that would do so. These bills, according to Williams Institute research, jeopardize access to care for 54,000 transgender youth ages 13-17, which is nearly one-third of the estimated 150,000 transgender youth in the U.S. And more than 4,000 young adults ages 18 to 20 in Alabama, North Carolina and Oklahoma would also be at risk of losing access to gender-affirming care under proposed bills that would apply to young people over the age of 18.

The bills carry severe penalties for health care providers — and in Texas families — who provide or seek out gender-affirming care for minors. About half of the bills prohibit insurance companies from offering coverage or restrict the use of state funds for gender-affirming care.

Texas Gov. Greg Abbott issued an executive order on Feb. 22 instructing the Department of Family and Protective Services to investigative giving their trans children access to gender-affirming healthcare and requiring all mandatory reporters to report those families and any medical professionals providing such care. Abbott issued his order the day after Paxton issued a non-binding opinion declaring that gender-affirming healthcare for trans youth is child abuse under Texas law.

Abbott’s order impacts as many as 13,800 transgender youth in the state, the Williams Institute estimates.

Gender-affirming medical care includes the use of hormones to delay puberty and to promote physical development that is consistent with a child’s gender identity. It is recommended for transgender youth by the American Academy of Pediatrics and the Endocrine Society.

Kerith J. Conron, the Blachford-Cooper distinguished scholar and research director at the Williams Institute and lead author of the study, said, “A growing body of research shows that gender-affirming care improves mental health and overall well-being of transgender people, including youth. Efforts that support transgender youth in living according to their gender identity are associated with better mental health.”

Prior research from the Williams Institute found that the risk of past-year suicide attempts was lower among transgender people who wanted and received gender-affirming medical care.

— Tammye Nash