Families and providers in Georgia are preparing to pass a law restricting care for transgender children

D. has just completed the 7th grade. She has lots of friends and says she wants to spend as much time with them as possible this summer between volleyball, soccer and trips with her family. As D. counts down the days until summer, she also thinks about another upcoming date, July 1st.

Then Georgia will begin banning transgender children like D. from starting hormone replacement therapy. This spring, Republican lawmakers voted to restrict treatment of minors and also ban gender-affirming surgeries.

With SB 140 set to take effect in just a few weeks, teens, parents and doctors are grappling with how the new rules will impact their lives.

D. says she has felt more like a girl since she was a child, even though that wasn't on her birth certificate. For security reasons we do not identify them. As D. grew older, she began researching and learning medical treatments that could help strengthen her gender identity.

“It was a little eye-opening, like, 'Oh, this is an option, and I really think it's for me,'” says D., sitting at a picnic table with her mother. Amy is sitting in a green neighborhood park.

“I thought, 'Instead of being a father, I could be a mother.' And that made me really happy.”

“You know your child. And when you see them looking in the mirror and telling you what they see and who they want to be, and it gets blocked, you feel powerless.”

Amy, mother of transgender child D. from Georgia, on passing a law restricting gender-specific child care.

School had been hard for a while. D. was bullied for things like the toilet she used. Her mother says it was painful to watch.

“She’s the sunshine, she always has been,” says Amy. “And when you see the loss of light in your child's eyes and see him cry every night…”

After discussions, research, therapy and doctor visits, D. started taking puberty blockers a few months ago. However, just as this began, Georgia lawmakers began debating SB 140. The law allows puberty blockers but prohibits minors from starting hormone therapy after July 1.

Republican supporters of the law said they wanted to protect minors from treatments they might later regret.

“My mom sent me the legal information and I come out in the living room crying,” says D. “And I'm like, 'I don't want to wait until I'm 18. That’s unfair to me.”

Puberty blockers interrupt puberty, but can have health effects if they do so for too long.

Hormone therapy, the next step, allows trans children to go through puberty consistent with their gender identity. D. would like to grow up with people his own age and thinks that at 18 it is too late.

“I think if I couldn't be who I want to be and grow up the way I want, everything would just come to a standstill,” D says.

“You know your child,” Amy says. “And when you see them looking in the mirror and telling you what they see and who they want to be, and it gets blocked, you feel powerless.”

Opponents of SB 140 console each other after the measure advanced at a hearing in the Georgia House of Representatives in March. (Matthew Pearson/WABE)

D. and her parents are now considering what to do next.

“With the July 1st deadline, we are forced to make a decision quicker than we would like,” says Amy. “Yes, we weigh the pros and cons every day and every single conversation.”

Conversations like this are happening in many Georgia homes. Amy is part of a group for parents of trans children and says July 1 is a hot topic.

At least one Georgia family has moved out of the state since SB 140 was signed into law. Others say they are considering it, particularly families with young trans children. Some families fear Georgia will enact even stricter laws, as other states have done this year.

All of this is for providers like Dr. Izzy Lowell complicated.

“It's not what I imagined, but I chose medicine to help people and save lives,” Lowell says.

Lowell specializes in treating transgender patients at QueerMed, her practice near Atlanta. She is licensed in more than 20 states and has an army of attorneys to help her navigate the rapidly changing patchwork of state laws.

“I asked my lawyer in Florida, 'Can I do this particular thing starting today,' and it took me days to figure out if I could do it that day, and by that time it might have been out of date.” says Lowell. “So keeping up with these laws has been extremely difficult, if not impossible, even in one state.”

“My caregivers and I will be there until midnight on June 30 to see patients and admit them before the deadline.”

Dr. Izzy Lowell of QueerMed, an Atlanta-area medical practice that specializes in treating transgender patients.

Lowell's purple office is mostly empty these days. For safety reasons and because some live in states where treatment is restricted, they are treating many patients virtually.

Sometimes families travel across state lines to a pop-up clinic or find a parking lot just across the border where care is legal and sign up for a telemedicine visit from their car.

Abortion providers have adopted similar workarounds as many states restricted access to abortions after the U.S. Supreme Court's Roe v. Wade had been convicted.

“I hope we look back on the short period of time where we as a country were just going in the wrong direction,” Lowell said. “It has taken a real toll on two of my wonderful young teenagers who thrived on the treatment. And they were both so disturbed by it [law] that they hurt themselves.”

WABE could not verify the details due to privacy concerns, but Lowell says the two teens survived. Lowell says she will continue to do everything she can to ensure care meets legal requirements.

“My doctors and I will be up at midnight until June 30 to see patients and admit them before the deadline,” she says.

D. says she is determined to face this new obstacle head on.

“I think people will brush the law aside or there will be ways around it,” she says. “So I don’t think so [lawmakers] will get exactly what they want.”

D. says that she dreams of the beach for now and maybe moving to a bigger city. She's also focused on friends, sports, camping – just being a kid about to grow up.

Medical supplies in a drawer at QueerMed, an Atlanta-area medical practice that specializes in treating transgender patients. (Matthew Pearson/WABE)