Center: Self-harm at ‘all-time high’ among Iowa LGBTQ youth

CEDAR RAPIDS — Lori Ampey has lost track of the number of times in the last year she has rushed to the hospital to hold the hand of a parent of a transgender child who harmed themselves, or sat next to a child — her arm wrapped around them — contemplating doing the same.

Ampey said she often takes panicked phone calls from worried parents and teens in pain searching for answers and acceptance in a shifting, polarized political environment where they feel targeted. As director for the LGBTQ+ Youth Center at Tanager Place in Cedar Rapids, Ampey sees firsthand the stress youth and young adults face daily.

“The self-harm is at an all-time high for sure,” Ampey said. “More kids (are) making frequent trips to the hospital.”

She shared an anecdote of a child who had been coming to the center since it opened four years ago. Their mother uprooted and moved the family to another community, feeling it safer to get farther away from what the family viewed as harmful political rhetoric against transgender and LGBTQ+ individuals. But, away from the center and its support network, the teen felt more isolated and attempted suicide.

Last month, the family moved back to Cedar Rapids, and last week was their first day back at the youth center.

“The mother said she saw a smile again on her child’s face that she hadn’t seen in eight months,” Ampey said.

Center sees growing need for support, safe spaces

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Ampey and Tanager Chief Executive Officer Okpara Rice said they’re seeing increased need for mental health and community-based support and programs for LGBTQ+ youth, particularly transgender youth, in the wake of passage of recent laws by the Republican-led Iowa Legislature banning gender-affirming care for minors and restricting LGBTQ education in schools.

“I don’t know that they understand the damage they’re doing,” Ampey said of lawmakers. “At the end of the day, it’s them that are making these kids feel unworthy and unloved and like they don’t belong on this Earth.”

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A Des Moines Register/Mediacom Iowa Poll from March found majorities of Iowans supported legislation to restrict how teachers can discuss gender identity or sexual orientation and ban gender-affirming care for transgender minors.

The center provides a safe and confidential environment for LGBTQ+ youth, families and allies, where children and teens can express themselves and find support among new friends and mentors, Ampey said. It offers support groups, mentoring programs, social gatherings, community service projects, health initiative classes, parent workshops, financial literacy, tutoring and career exploration.

The center serves dozens of families, with small groups of children and teens numbering anywhere from 12 to 20, and adult groups with anywhere from 31 to 57 members. It draws families from surrounding communities big and small, urban and rural — from Oelwein to Waterloo to Iowa City.

The Gazette reached out through Ampey to see if any would be willing to talk about their experiences and challenges posed by Iowa’s new law. Ampey said none were willing to talk on the record out of fear of being harassed.

The center recently started a support group for transgender youth and their parents, in response to the new Iowa law prohibiting the use of puberty blockers, hormones and surgeries to treat gender dysphoria for those under 18, regardless of parental consent.

“We need more programs for transgender youth,” Ampey said, adding “parents are scared” and grappling with how to access medical care “to help their child be comfortable with who they are.” She said many are traveling out of state to seek care in Illinois and Minnesota.

Health providers still are able to see LGBTQ children in their offices but cannot provide gender-affirming treatments. Medical professionals who violate the law could be subject to discipline from a state licensing board, and individuals can bring lawsuits against doctors who continue providing gender-affirming care.

The UnityPoint LGBTQ Clinic in Cedar Falls has partnered with and is referring children and their families to 13 clinics in Minnesota, Wisconsin and Illinois to continue receiving care, the Waterloo-Cedar Falls Courier reported.

The Tanager center also recently hosted Pfund Foundation out of Minneapolis, which is working to raise money to help pay transportation costs for youth from North Dakota, South Dakota and Iowa to receive care out-of-state. Money raised would also be used to cover tuition costs for remote schools that are welcoming to all gender identities in cases where students' local districts are not safe spaces for trans and queer youth, as well as cash grants to support organizations like Tanager.

Mental health and suicide risk

Republican supporters of the legislation have argued that minors aren't mature enough to fully comprehend the potential consequences of medically transitioning, even though providers require parental permission. Iowa Republican Gov. Kim Reynolds and GOP lawmakers said they do not believe the science is settled on the long-term impacts of gender-affirming care, citing other countries that have restricted the treatments.

Major medical groups in the United States, including the American Medical Association, American Psychological Association and the American Academy of Pediatrics, say the treatments are safe and the vast majority of studies show that the care leads to better mental health outcomes.

Lawmakers also heard testimony from Iowa doctors who said providing gender-affirming care to minors is a methodical, deeply personalized process that involves multiple doctors and parental consent.

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Gender dysphoria is a recognized diagnosis by the American Psychiatric Association, treatment for which may include affirming the patient's gender through social transitioning and sometimes cross-sex hormones and surgeries.

Reynolds also signed into law measures prohibiting instruction on gender identity or sexual orientation before seventh grade; requiring schools to notify parents if a student requests to use new pronouns; and prohibiting transgender individuals from using school bathrooms or changing facilities that align with their gender identity.

Attempts to force a transgender person to align with their gender assigned at birth — sometimes referred to as conversion therapy — can be harmful, according to the association. Such policies encourage people to hide aspects of their identity, which can lead to mental health problems such as depression, anxiety, low self-esteem and suicide, according to the association.

A 2022 national survey by The Trevor Project, a nonprofit that focuses on suicide prevention in the LGBTQ community, found that 45 percent of LGBTQ youth seriously considered attempting suicide, including more than half of transgender and nonbinary children. Nearly one in five transgender and nonbinary youth attempted suicide and LGBTQ youth of color reported higher rates than their white peers, according to the survey. That builds on what the Centers for Disease Control and Prevention found in its national survey of high schoolers. According to the CDC survey, LGBTQ+ high school students were about four times more likely to attempt suicide than their peers.

“LGBTQ youth are not inherently prone to suicide risk because of their sexual orientation or gender identity but rather placed at higher risk because of how they are mistreated and stigmatized in society,” according to The Trevor Project.

Families talk of leaving Iowa for other states

Rice, the Tanager CEO, said some families have discussed leaving Iowa for states where the laws and political climate are more welcoming of transgender individuals.

“The parents that I’ve spoken to, there’s a real sense … that this is not a safe place for my child,” he said.

He said some families are experiencing “a lot of pain,” feeling Iowa has “gone backward” from being more inclusive to “more stigmatization” around LGBTQ people.

Iowa lawmakers added gender identity as a protected class to the Iowa Civil Rights Act in 2007, and Iowa was one of the earliest states to affirm same-sex marriage.

Lost in the culture war battle, Rice said, is a focus on the well-being of a group of vulnerable children.

"These are young people, young lives who are trying to figure out who they are — figure out their place in life — that has nothing to do with any acronyms that they happen to identify with,“ he said. ”We need to care about kids — all kids — and understand they’re just trying to grow up and live and figure out who they are and what they want to do with their lives.”

He said he’s hopeful “the pendulum will swing back” to make Iowa more inclusive. In the meantime, the center is faced with growing demand to provide services to teens and their parents with “no natural funding stream.”

Rice said the Tanager center relies on grants and donations, including support from United Way, to fund the center and its activities. Fortunately, he said a couple recently made an unsolicited $75,000 donation because they were “outraged” by the new state laws.

“It’s not all doom and gloom,” Rice said. “There are people out there who still really care and understand that these young people need that love and support.”

He and Ampey said support for LGBTQ+ youth has gotten stronger in the wake of the new laws, but allies in the community still need to use their voice to be a “counterbalance” to anti-LGBTQ messages.

“We are talking about young people and children here who are in pain, who are bullied, who are treated less than,” Rice said. “How is that OK for anybody who purports to care about another human being? It’s not. The world has beat the hell out of them.”

Regardless of the prevailing political sentiment, Rice said Tanager will continue providing services and support for LGBTQ+ youth.

“We’re not changing anything we were doing. Laws may change … but this will always be a safe harbor for those kids,” he said. “We’ll still be here. … This program saves lives.”

Comments: (319) 398-8499; tom.barton@thegazette.com