Substance use joint with joint with women, gender equity and hospitals.

At this time, I would like to remind everyone to silence all electronic devices.

Also at this point going forward, no women's approach to theirs.

No one.

Chair, we're ready to begin.

Good afternoon, and welcome to today's hearing on access to gender affirming care and associated mental health outcomes for transgender and non-binary youth.

My name is Councilmember Tiffany Kavan.

My pronouns are she, her.

I'm the chair of the New York City Council's Committee on Mental Health and Substance Use.

Thank you also to Councilmember Narcis, Chair of Hospitals Committee, and Councilmember Faries, Chair of Women and Gender Equity Committee for joining our committee in holding this hearing.

Before we begin, I'd like to recognize that we are joined by Public Advocate Jumani Williams, Councilmember Harvey Epstein, Councilmember Simkefelder, Councilmember Centus, and Councilmember Ariola on Zoom.

Today, the committees are convening to discuss access to gender affirming care in New York City and its role in improving health mental health care outcomes for transgender and non-binary youth.

It's no secret that transgender and non-binary New Yorkers have recently faced a barrage of threats, challenges, and intimidation from the federal government.

Several institutions in our city have, unfortunately, capitulated to these pressures, and as a city, we are all worse off for it.

Gender affirming care not only allows individuals to live as their true selves, but it is also strongly associated with improved mental health outcomes for transgender and non-binary people.

Transgender and non-binary youth, especially are disproportionately burdened by poor mental health outcomes, driven by reduced social support and heightened stigma and discrimination.

Yet research consistently shows that access to gender-affirming interventions is associated with roughly 60% lower odds of moderate to severe depression, and over 70% lower odds of suicidality in youth.

70% lower odds of suicidality.

Today, we will also be hearing three pieces of legislation relating to our oversight topic.

One, Introduction 949, sponsored by Councilmember Shulman, which would require the Department of Health and Mental Hygiene to create and make available on their website LGBTQI Plus Health and Gender Affirming Care Resources and a Searchable Map of LGBTQI Plus Health Services.

Resolution 208, sponsored by Councilmember Hanief, which calls on the New York State Legislature to pass and the governor to sign legislation that mandates all medical students in New York State receive anti-biased training.

And my own legislation, resolution 547, which calls on the New York State Legislature to pass and the governor to sign legislation which establishes a gender-affirming care access program to provide support and increase access to gender affirming care.

I would like to thank the committee staff who work to prepare for this hearing as well as my own staff.

And I will now pass the mic to Councilmember.

Oh, and we're joined by Councilmember Aldwall, and now I will pass it over to co-chair, um, Councilmember Narcis.

Hi, good afternoon.

I am Councilmember Mercedes Narcisse, Chair of Committee on Hospital.

I'm joined by my colleagues, Councilmember Tiffany Caban, Chair of the Committee on Mental Health and Substance Use, and Councilmember Amanda Ferallas, Chair of the Committee on Women and Gender Equity.

Thank you for joining us today for the for this oversight hearing on access to gender affirming care and associated with mental health outcomes for transgender and non-binary youth.

This type of care can include social affirmation like adopting gender, affirming hair, clothing, and names, or medical affirmations, such as puberty blockers, hormone therapy, and gender affirming surgeries.

Transgender and non-binary youth experience significantly higher rates of anxiety, depression, mood disorders, and societal ideations than their cisgender peers, largely due to stigma, discrimination, and social rejection and barriers to care that this individual's experience.

Research shows that access to gender affirming care can substantially improve mental health outcome for transgender and non-binary youth.

Despite local efforts to support, we know that the federal side is not on our side.

The federal government is taking actions to limit access to gender affirming care.

These actions at the federal level present challenges for health in hospital and DOHMH to continue providing the care that people need and deserve in our city.

As a registered nurse and a chair of a hospital committee, I am committed to ensure that every individual in our city get the care they deserve and needs to get through lives.

And what we need to do is continue pushing forward and making sure the bigotry around us, the policies that are not on our favors for us to continue addressing them.

And today we look forward to a hearing from New York City Health and Hospitals and DOHMH about the broader state of gender affirming care access for our youth across the city of New York, including their availability of services at H facilities, DOHMH, and the programs and other city supported efforts.

We also seek their feedback on legislation before the committee.

Together, we must work to ensure that transgender and non-binary youth have access to the care they deserve, and that our local hospital and health department can continue to provide such services.

Before we begin, I'd like to thank committee staff, senior legislative counsel, Ria Ogazarwa, a policy analyst, Manu Butt, as well as a committee brand new, brand new legislative analyst, Raina Lee.

Welcome for their hard work and preparing for this hearing.

I also like to thank my staff, um, Frank Shea, Courtney Lee, and of course um Joshina Jalo.

I would like to recognize that we have been John Whoells like we don't miss anybody.

You got everybody.

So I will now turn it over to Chair Ferrari.

Thank you.

Thank you so much.

Good afternoon, everyone.

I'm Council Member Amanda Farias, uh pronouns she, her, and I get to chair the Committee on Women and Gender Equity.

We're excited to join the Committee on Mental Health and Substance Abuse and the Committee on Hospitals and their chairs, Chair Caban and Chair Narcisse for today's oversight hearing on access to gender affirming care and associated mental health outcomes for transgender and non-binary youth.

As stated by my colleagues, access to gender affirming care is a life-saving medical necessity that dramatically improves the mental health and overall well-being of gender-diverse, transgender, and non-binary children and adolescents.

Every child deserves to grow up feeling supported in who they are.

And supporting transgender and non-binary youth means defending their right to health care.

Currently, access to gender-affirming care for young people is under attack nationwide.

An analysis by the human rights campaign found that 27 states plus Puerto Rico have successfully passed bans on gender-affirming care for transgender and non-binary youth affecting 48% of transgender youth nationwide.

A recent survey found that 87% of transgender and non-binary youth and young people whose used hormones to support their gender transition or expression were concerned about losing access to this care.

These laws interfere with the ability of transgender youth, their families, and their providers to make the health care decisions that are right for them and access the medical care they need and can have devastating consequences.

It is well documented that transgender and non-binary children experience anxiety and depression at higher rates than their cisgender peers, according to a 2025 survey published by the Trevor Project.

Transgender and non-binary young people who were unable to access the hormones they wanted were nearly twice as likely to attempt suicide than those who could.