Washington (AFP) - Leo is 14 years old and has been taking testosterone for about six months.

"It definitely helps me. It makes me feel more confident," the teenager from rural Pennsylvania told AFP. "I feel more in tune with my gender identity."

Leo is worried, however, about laws adopted in a number of conservative US states that ban hormone treatments for minors like him, who do not identify with the gender they were assigned at birth.

"I just want to be able to take my shot every week," Leo said, adding that he feels "less depressed" thanks to the testosterone that blocks his menstrual periods and stimulates muscle and hair growth.

Leo said he is one of just a few "queer kids" in the coal country region of Pennsylvania where he lives.

For the moment, local lawmakers have not proposed any legislation that targets trans youth and, for his own mental health, Leo hopes it stays that way.

Before receiving the hormone treatments, "I hurt myself because of being queer," he said.

More than half of trans youth had seriously considered suicide and nearly one in five made a suicide attempt during the past year, according to 2021 survey by the Trevor Project, a nonprofit engaged in suicide prevention efforts among LGBTQ+ youth.

They are more likely to suffer from depression, anxiety, eating disorders, risky behavior and self mutilation than other adolescents.

'More comfortable'

Jack Drescher, a professor of psychiatry at Columbia University, said studies show that kids "feel more comfortable being allowed to express the gender that they feel themselves to be."

Nevertheless, citing the irreversible effects of some treatments, lawmakers in a dozen Republican-ruled states have adopted laws restricting or prohibiting gender-affirming care for minors.

"There may be some children who are confused and may think they're transgender," Drescher said. "And therefore you don't want to do something that they might regret later on.

"But they're trying to protect those children at the expense of children who will benefit from treatment," he said.

In addition to banning medical intervention, Republican-led states have passed a raft of laws determining what trans students can or cannot do -- from which school bathrooms they can use, to which sports teams they play on.

Pushing back against trans rights has become a rallying cry for the current generation of US conservatives, and advocates fear children are increasingly being caught in the middle.

Rachel Smith, 47, a trans woman who works as a behavioral health therapist with trans youth in Baltimore, said "a lot of kids are very depressed, not hopeful about the future" because of the anti-trans bills.

"There is a high level of anxiety," Smith said.

According to the Trevor Project, 86 percent of trans or nonbinary youth say the legislative frenzy has a negative impact on their mental health.

'I fear for my kids'

Smith and Leo recently attended an event in Washington called the "Transgender Day of Visibility" during which an artist dressed in white was covered in fake blood to draw attention to the suicide risks in the community.

Also attending was Jaclynn, a 44-year-old mother of four children -- "one trans, one queer" -- wearing a T-shirt bearing the words "Proud Mom" underneath a rainbow.

"I fear for my kids," said Jaclynn, who lives in a small town in North Carolina she described as being in the heart of the "Bible belt."

"Both are in therapy," Jaclynn said, fighting back tears, and one had attempted suicide.

"That's part of why we are here," she said. "I came with my kids. I think it's very important that they see that I support them and that the rest of these people support them."

Leo was accompanied by his stepfather who said it "feels good being here."

"There is a good turnout," his stepfather said. "There don't seem to be any folks shouting at us."

That was not the case the following day when there was an altercation between trans activists holding signs reading "Protect Trans Youth" and a handful of right-wing demonstrators outside the Supreme Court.

Police rapidly intervened and no one was injured.