Republican state lawmakers have filed a wave of bills that would ban medical professionals from treating transgender teens with hormones and sex reassignment surgery, reigniting a polarizing national debate over the rights of transgender youths and the government’s reach into doctors’ offices.
More than half a dozen statehouses are considering bills that would penalize medical professionals — and, in at least one case, parents — who give young people access to puberty-blocking medicines and other treatments. Conservative lawmakers argue that they are protecting vulnerable children who may be experimenting with their identity from making life-altering changes to their bodies, a characterization that advocates for transgender youths call misinformed and dangerous.
South Dakota on Wednesday became the first state to take action, with a House committee passing a bill that would punish doctors who provide such treatments to people under 16 with a maximum one year in jail and a fine of up to $2,000.
State Rep. Fred Deutsch (R) said he introduced the bill because the solution for “children’s identification with the opposite sex isn’t to poison their bodies with megadoses of the wrong hormones, to chemically or surgically castrate and sterilize them, or to remove healthy breasts and reproductive organs.”
Similar bills have been introduced in recent weeks in South Carolina, Colorado, Florida, Oklahoma and Missouri. State lawmakers in Kentucky, Georgia and Texas have announced plans to file bills that limit transgender youths’ medical options.
Missouri’s bill would report parents who consent to such treatment to child welfare officials for child abuse. Doctors also would have their licenses revoked if they perform gender-reassignment treatments.
The speed and number of state bills has mobilized transgender activists, suicide prevention groups and civil rights organizations that say conservative lawmakers are gravely misinformed about medical interventions for transgender youths and are sensationalizing the issue.
They say the legislative restrictions are unnecessary because the process of transitioning is methodical and rarely includes surgery before age 18. Transgender children typically transition socially first, advocates say, changing their names, pronouns and dress to match their gender identities.
Sam Brinton, head of government affairs at the Trevor Project, a suicide prevention service that focuses on LGBTQ youths, compared the legislation to the controversial bathroom bills that prohibited transgender people from using locker rooms, public restrooms and other sex-segregated facilities that matched their gender identity.
“These bans on medical care are just the bathroom bills 2.0. It’s fearmongering. Same old transphobia, different bill,” Brinton said. “And they are preying on some the weakest and most vulnerable in our community.”
In 2018, the American Academy of Pediatrics released a policy statement that recommended giving youths “access to comprehensive gender-affirming and developmentally appropriate health care,” while noting the benefits and risks of using hormones that delay puberty.
But some worry that such medical intervention is being used on youths too young to understand the potential consequences. A bill under consideration in Florida would make it a felony for doctors to provide certain hormones or gender reassignment surgery to minors, even with parental consent.
“A great majority of Americans and Floridians agree that a 12-year-old should not change their body in such a permanent way,” said Florida state Rep. Anthony Sabatini (R), who introduced the bill.
Sabatini said he was inspired to file the legislation after learning about a divorce custody case in Texas in which a father objected to his 7-year-old child socially transitioning, which the mother encouraged. Donald Trump Jr. tweeted about the case in October, calling it “child abuse.”
Some Republican lawmakers have been more hesitant. Utah state Rep. Brad Daw (R) drafted a bill that would restrict puberty blockers and hormone treatments for youths, believing that such decisions were irreversible. But then he did further research, met with advocates and spoke with families who described puberty blockers as “a lifesaver” that prevented young people from committing suicide.
“You can’t just ignore that,” Daw said.
He also learned that puberty restarts when youths stop taking the blockers, and said he is reconsidering what kind of bill would make the most sense.
“I’m not certain of anything right now,” Daw said. “What I’m certain about is this topic is a lot more complex and lot more nuanced than I would have believed. It may not be an all or nothing.”
Advocates have called the anti-LGBTQ state bills submitted this legislative session “a slate of hate,” including a Florida statehouse bill to repeal ordinances that prohibit “conversion therapy” for LGBTQ youths. Legislation restricting transgender students’ sports participation is pending in Alabama, Georgia, Indiana, Missouri, New Hampshire, Tennessee and Washington state, according to the American Civil Liberties Union.
The bills are being used as an election year “scare tactic, lightning rod issue” to bring conservatives and swing voters out, said Taylor Brown, an attorney with Lambda Legal, an LGBT civil rights group. Brown worries transgender children will suffer as debates over the legislation fan the flames of the country’s bitter culture war.
Transgender advocates say that people supporting limitations on medical intervention for transgender youths are spreading medical inaccuracies, citing right-wing websites that accuse parents of allowing young children to undergo double mastectomies or castration as young as age 10.
South Dakota state Rep. Linda K. Duba (D) called Deutsch’s bill “cruel and just totally unconstitutional,” saying that transgender medical treatments should be a private matter between youths, their parents and their doctors.
“We all need to learn more about what we don’t know or understand. I do have friends who are trans as well as friends who have trans children,” Duba said. “No one would voluntarily choose to go through this pain and discrimination. Unfortunately, I live in a state where religion and fear of the unknown drive decisions.”
South Dakota’s legislature is often used as a testing ground for conservative bills, because Republicans hold a supermajority in the statehouse and there’s a low cost for lobbying in the state. It was one of the first states to pass a law restricting transgender students’ bathroom use. That 2016 law was ultimately vetoed by the governor, but it helped build momentum for a flurry of “bathroom bills” across the country.
Deutsch said he began considering the bill last spring, after he met people on Twitter who said they were formerly transgender and were “hurting and suffering” as a result of the treatments.
He has framed the bill as “homegrown,” but said he consulted with conservative groups such as the Liberty Counsel and Kelsey Coalition as he was drafting it. In October, Deutsch attended the Summit for Protecting Children from Sexualization in the District hosted by the right-wing Heritage Foundation, which discussed similar efforts criminalizing transgender care in other states, he said.
A website promoting Deutsch’s bill includes videos from the Heritage Foundation and a “parent resource guide” from the Minnesota Family Council, a Christian organization aligned with the Family Research Council. The website also includes quotes from people who say they regret gender transitioning.
Some advocates and physicians framed the bill as a solution looking for a problem. Fewer than four physicians in South Dakota offer puberty blockers and hormone therapies, and it is unclear if any perform surgeries for transgender patients, advocates and doctors say.
Quinn Parke, of Sioux Falls, S.D., began taking hormone blockers at 16, after struggling with depression and suicidal thoughts so severe Parke was admitted to a hospital.
Parke, who identifies as non-binary and uses they and them pronouns, said it took more than a year of appointments with doctors and psychologists to get the prescription to temporarily stop hormonal changes and mood swings that were worsening the teenager’s gender dysphoria. Parke testified at Wednesday’s hearing in Pierre, S.D.
“It wasn’t just like one person making the decision. It was dozens of people,” said Parke of the choice to take puberty blockers.
Quinn Parke’s mother, Kim Parke, said the puberty blockers have drastically improved the teenager’s self-esteem and mood, but she doesn’t think lawmakers realize the months of consultations that preceded the prescription.
“It’s frustrating because . . . it wasn’t an easy thing to get there, and it wasn’t an easy decision,” Kim Parke said. “We did a lot of thinking on it.”
While the South Dakota bill wouldn’t take away existing prescriptions, Quinn Parke worries about friends who are younger and just beginning to look into puberty blockers.
“I’ve been in their shoes and I know what it’s like to not have this when you need it,” Quinn Parke said. To politicians who want to further restrict access, the teen says, “You keep saying you want to protect us, but everything you’re doing is just making our lives worse.”