Health Advice



'Hopeless': Idaho trans teens seeking to transition cope without gender-affirming care

Ian Max Stevenson and Becca Savransky, The Idaho Statesman on

Published in Health & Fitness

BOISE, Idaho — Inside a Boise clinic in April, Dr. Marvin Alviso was meeting with a transgender patient who had been on puberty blockers for a year. The Boise teen was ready and “giddy” to start taking testosterone, Alviso said, as part of the next step in his transition. It’s also a step in the slate of practices recommended in gender-affirming medicine.

Alviso was about to prescribe his patient the hormone when he received a message from a nurse to come see her. He left the patient’s room, and the nurse told him the news: The U.S. Supreme Court just allowed Idaho’s gender-affirming care ban for minors to take effect.

“My jaw just dropped,” Alviso told the Idaho Statesman by phone.

The family medicine physician returned to the patient’s room and told him and his guardian that the treatment he sought was now illegal in Idaho. Alviso could no longer prescribe it to him.

“My patient’s face just went blank,” he said. “It was heartbreaking to see that. I felt very helpless.”

The Idaho law, which was allowed to take effect in April, bans a spectrum of medical interventions that doctors around the country use for transgender patients. Many of those patients experience gender dysphoria, which is acute distress felt because of an incongruity between the sex a person was assigned at birth and their gender identity.


In the weeks after the Supreme Court’s ruling, its effect has upended the practices of family physicians around the state who provide gender-affirming care recommended by U.S. medical associations.

The Williams Institute, an LGBTQ+ law center at the University of California Los Angeles, estimated that there are about 1,000 transgender minors in Idaho, and 1,500 trans people between the ages of 18 and 24. Dr. Ashley Davis, who has been administering gender-affirming care in Boise since 2005, guessed that there may be as many as 100 to 200 transgender youth receiving medical treatment.

Davis said the state’s ban will likely make the depression and anxiety transgender teenagers experience worse, and that the law amounts to another effort to “pretend they don’t exist.”

“Now they may be afraid to reach out to their pediatrician or family doctor and ask for help for fear that they or us will get in trouble,” said Davis, a family medicine doctor. She said the effects of the ban will be worse for poorer Idahoans, who cannot afford to fly to Seattle or another city out of state for treatment.


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