Population Care

For transgender kids, gender-affirming names can be lifesaving

Tanya Albert Henry , Contributing News Writer

Editor’s note: In a win for transgender students, the U.S. District Court for the Southern District of Indiana in July said that the Brownsburg Community School Corp. did not violate teacher John Kluge’s rights when it decided against accommodating his sincerely held religious beliefs against a policy requiring staff to use transgender students’ preferred names listed in the “PowerSchool” database.

The court said the school district’s policy fulfills the public school’s mission to provide a safe and supportive educational environment for all students. Further, the court concluded “that a name carries with it enough importance to overcome a public school corporation's duty to accommodate a teacher's sincerely held religious beliefs against a policy that requires staff to use transgender students' preferred names when supported by a parent and health care provider.”

An Indiana school district’s policy requiring teachers to use students’ names and pronouns consistent with their gender identities is a key piece to bolstering transgender youths’ physical and mental health, physicians tell a federal court.

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A landmark 2018 study in the Journal of Adolescent Health found that transgender youth who could use accurate names and pronouns experienced 71% fewer symptoms of severe depression, a 34% drop in reported suicidal thoughts and a 65% decrease in suicide attempts, the brief tells the U.S. District Court for the Southern District of Indiana in an amicus brief it filed with several other organizations.

The brief supports the Brownsburg Community School Corp. (BCSC) in a lawsuit challenging its policy requiring school employees to refer to students by names and pronouns they or their parents list in the “PowerSchool” database. A music and orchestra teacher in the district, John Kluge, refused to follow the policy and resigned. He then sued BCSC and is asking the court for an accommodation that would allow him to refuse to use the name listed in PowerSchool and instead only use last names because of his religious beliefs.

The AMA and others ask the court to not let the lawsuit continue, telling the judges that Kluge’s proposed accommodation would make transgender students feel stigmatized and singled out for differential treatment, harming their well-being.

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“In light of the significant challenges that transgender youth face, school communities such as BCSC must prioritize policies that respect and protect the rights of students, including policies that require respect for the names and pronouns that match a student’s gender identity,” the brief says.

The AMA filed the brief in the case—Kluge v. Brownsburg Community School Corp.—along with the American Academy of Pediatrics and its Indiana chapter; the National Association of Social Workers and its Indiana chapter; and Indiana Youth Group Inc., a nonprofit that promotes LGBTQ+ youth safety and healthy development. The AMA also took part in an amicus brief in a similar case in Ohio, Meriwether v. Hartop.

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The AMA and other amici tell the court they are committed to helping ensure transgender children have access to full educational opportunities and that their mental and physical wellbeing are protected. Their brief explains the challenges for transgender youth and the importance of affirming their gender identity.

Academic and medical research has shown transgender youth—which includes more than 100,000 U.S. teenagers—encounter “severe discrimination” in the school environment. Citing data from a number of studies, the brief tells the court surveys of transgender students and youth show that:

  • 78% were discriminated against at school.
  • Over 75% reported symptoms of generalized anxiety disorder in the previous two weeks.
  • 60% engaged in self-harm.
  • 40% were physically threatened or harmed because of their gender identity.
  • 20% attempted suicide in the previous year.

The students also were 1.66 times likelier to be bullied at schools, says the survey research cited in the brief.

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Research shows these numbers go down when transgender children receive support in their gender identity. For example, the Journal of Adolescent Health study and others show that the levels of depression become similar to other youth.

A growing number of education and mental health professionals—including the amici, the National Education Association, the Council on Social Work Education and the American Psychological Association—believe schools should allow transgender students to be referred to by gender-affirming names and pronouns.

“The empirical data and expert consensus support defendant BCSC’s requirement that teachers respect students’ names and pronouns,” the brief concludes. An accommodation for Kluge “would deprive transgender students of a secure and supportive educational environment that increases the opportunity for physical and emotional wellbeing and academic success.”

The AMA Advisory Committee on LGBTQ Issues highlights LGBTQ news and topics related to patients and physicians.