Social Workers Have Ethical Responsibility to Fight Bans on Gender-Affirming Care | NASW Member Voices

Apr 6, 2023

two people standing together at a window

By Robin M. Mathy

What sex are you? The answer to that question was assigned to you at birth. You did not choose it, and the answer shapes much of the course of your life.

For nearly everyone, biological and gender distinctions are aligned. However, experts say, 1.43% of adolescents aged 13-17 and 0.52% of all adults aged 18 and older in the U.S. identify as transgender. Less than 0.3% of adolescents meet criteria for gender dysphoria and request or receive gender-affirming healthcare, according to the study, Size and Distribution of Transgender and Gender Nonconforming Populations: A Narrative Review.

Since 2021, 30 states have banned gender-affirming healthcare despite research demonstrating improved mental health and well-being for youth who receive treatment. Experts say that most professional health organizations support gender-affirming care.

On March 28, three days before the 2023 Transgender Day of Visibility, the National Association of Social Workers issued a news release that joined with other professional organizations opposing bans on gender-affirming healthcare, calling upon “all members of the social work profession to support, promote, affirm and ‘protect the rights, legal benefits, and privileges of people of all gender identities and expressions.”

Nevertheless, the NASW proclamation needed to go further and emphasize the organization’s ethical commitment to challenging social injustice and social workers’ ethical responsibilities to the broader society, as stated in Section 6 of the 2021 NASW Code of Ethics. I do not identify as transgender, although I am a woman who transitioned, with gender-affirming surgery in 1996, ending years of a chronic eating disorder and suicidality after a gay psychiatrist had the wisdom to help me begin transitioning during a hospitalization following an attempted suicide. Not receiving gender-affirming healthcare in adolescence led to physical masculinization that was terrifying and repulsive.

After years of ongoing therapy, I earned my MSW and became a licensed social worker. I have never been “out” before, ordinarily confining my disclosures to clinical supervisors, diversity venues, and certain healthcare professionals. As a licensed social worker who has transitioned, I have the lived and professional experience to understand the suffering and repulsion of living with a body discordant with one’s experienced and expressed gender. I recognize the importance of the support from professionals that alleviates mental health issues with gender-affirming healthcare. I call upon all social workers to fulfill their ethical responsibilities to promote social change and take action to oppose bans on gender-affirming care and work to repeal them in states where they have been enacted. Fulfilling your ethical responsibilities will help save the lives of transgender and gender-diverse adolescents.

Disclaimer: The National Association of Social Workers invites members to share their expertise and experiences through Member Voices. This blog was prepared by Robin M. Mathy in her personal capacity and does not necessarily reflect the view of the National Association of Social Workers.

Robin M. Mathy is a volunteer therapist at A Home Within. It provides free, ongoing therapy for current and former foster children — a disproportionate percentage of whom are LGBTQ. You can reach Robin at