The Relentless School Nurse: Mental Health Matters – How Project 2025 Would Harm Kids and Teenagers

As part of an ongoing series of perspective pieces written by nurses leading up to the 2024 presidential election, Denver psychiatric nurse Lucia Osler, BSN, RN, addresses the critical intersection of mental healthcare and LGBTQ+ rights. Her essay highlights how the election’s outcome could dramatically impact the vulnerable youth she serves, particularly transgender teenagers who are already experiencing heightened anxiety about their future.

As an adolescent mental health nurse, Osler draws from her daily experiences working with teenagers who are navigating unprecedented challenges. She points to the lingering effects of COVID-19 on youth socialization and the harmful impact of social media while emphasizing that transgender youth face additional burdens of discrimination that could intensify depending on the election’s outcome.

The urgency of her message is underscored by recent polling showing that 67% of transgender people are already making contingency plans to modify their healthcare arrangements as the election approaches. Osler joins a growing chorus of healthcare professionals warning about the potential nationwide implementation of policies that could restrict access to gender-affirming care, despite medical organizations’ consensus supporting such treatment as essential for trans youth’s mental health and well-being.

I’m a mental health nurse for teenagers, and I love my job. Every day, I work with kids to help them cope in a stressful and uncertain world. At the end of the day, my goal is to empower them to take care of their mental health, to form healthy relationships and look hopefully towards the future. It’s not easy in 2024.

Because kids are struggling right now. In the aftermath of Covid-19 they lost vital years of socialization through online learning. And the rise of addictive social media algorithms have damaged attention spans and led to a rash of cyber-bullying. Teenagers should be worried about making friends and doing well in school. But LGBT kids, especially teenagers, are worried about the government enabling their discrimination nationwide.

Today’s teens face unprecedented challenges. And for no group is this truer than members of the transgender community. I regularly work with these kids, they have to overcome discrimination in their schools, discrimination in their homes, and if Donald Trump and the GOP win, they’ll face tremendous discrimination in their country.

Medical organizations agree unanimously that gender-affirming care is necessary for the mental health and well-being of trans kids. (This includes the American Academy of Child and Adolescent Psychiatry.) These kids and teenagers need professional support and access to healthcare, not conversion therapy and “pray the gay away” programs, as advocated by many Republicans.

Because we have to be clear about what Project 2025 intends for them: more discrimination and fewer protections under a decimated Title IX. Kids legally forced into the wrong bathrooms, teachers forced to use names and pronouns that will harm children’s mental health and distract them from learning. Republicans could even go as far as to ban gender-affirming care for trans kids nationwide, as they’ve already done in red states like Florida, Ohio and Utah. Republican politicians would force every trans kid in America to undergo a puberty that will permanently alter their bodies in painful, irreversible ways. Against the advice of psychiatrists, therapists, nurses and other experts; against the wishes of supportive parents, the government would be weaponized against these kids. We must not mince words, Donald Trump and the GOP would enable child abuse across America.

I am the daughter of two nurses. Like them, I took the Nightingale Pledge when I graduated, pledging “to abstain from whatever is harmful”. And Project 2025 is beyond harmful. It will ruin the lives of people you care about, it will hurt the patients I care for. It will jeopardize the mental health and safety of innocent kids across America.

My patients regularly suffer from anxiety and depression. Even in progressive states and cities, trans teenagers face bullying from peers. We must not turn the American government into the ultimate bully.

The health of a child is a fragile and precious thing, it should be handled by families and, where necessary, competent medical staff. It should not be handled by religious extremists who equate the existence of queer people with pornography. It’s up to all of us to make our voices heard in November. Together, we can prevent child abuse, and protect trans kids.

Bio: Lucia Osler BSN, RN is an adolescent psych nurse in the Denver metro area. She is an advocate for LGBTQIA+ rights and a volunteer supporting Democrats up and down the ballot as part of Nurses for America.