At the end of last year, Leelah Alcorn, a transgender Ohioan in a family who aggressively and abusively denied her gender identity, committed suicide. Shortly after her death, a post published to her Tumblr blog explicitly stated that she took her own life due to this abuse and her inability to be allowed to transition.

While there have been many reactions to Leelah’s story — including a proposed national law to ban the abusive conversion therapy that her parents inflicted on her — not many have talked about why she couldn’t transition. However, it is one of the most vital elements of the entire issue.

Alcorn was under the age of 18 and still needed her parents’ permission to start transitioning, according to the World Professional Association for Transgender Health’s “official” standards of care; though, the parental consent laws vary from state to state. It’s a convoluted system of laws, and that turns out to be a problem for transgender minors’ access to transition-related health care.

Transitioning is not the quick, single surgery one sees on television. It’s a long procedure involving hormones, multiple surgeries and navigating a labyrinthine gatekeeping process. For example, the aforementioned WPATH standards require patients seeking hormones or surgeries to live as visibly trans for six months, subjecting transgender folk to what writer Mina Carpenter calls “a hazing period of vulnerability, violence and discrimination,” especially considering the shocking statistics about anti-trans violence and hate crimes.

Transgender people are 150 percent more likely to be victimized than other members of the LGBTQ community.

Also consider that gender transitioning requires a referral from two doctors. For comparison’s sake, partial lobotomies and electroshock therapy also require two doctors to sign off on the procedure. 

Totally elective cosmetic surgery, on the other hand, has no such requirement.

It goes on and on and gets worse for minors, such as Leelah. It’s obvious that laws mandating parental consent to transition could easily be abused in a transphobic household.

But it’s one face of the same dodecadonal, dung-beetle ball that is anti-transgender gatekeeping — enforced by a pathologizing list of “standards” from the WPATH, which promote misinformation amongst the “progressive” health care workers who rigidly abide by it. Though the WPATH is trying to update its standards, it is still far behind the times.

The push for Leelah’s Law is important, but her tragedy must also be a rallying cry for improving access to transgender health care, whether in allowing one to change their gender identity on their state ID without “bottom” surgery, making insurance companies stop discriminating against transgender individuals and transitioning procedures, or allowing minors to transition without parental permission.

We know what needs to be done. If we don’t act on these changes, we will be responsible for even more Leelahs

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Tom Johnson is a film & television studies junior. Follow him on Twitter.