Republican lawmakers across the country, including several from Utah, are bringing anti-transgender bills to their state legislatures. Some target medical procedures and healthcare for those under 18 years of age and others seek to ban transgender people from participating in sports. Some go as far as to press “child abuse” charges against parents who support their transgender children.
Conservative anti-LGBTQ organizations are spearheading the efforts behind the scenes, as was shown in Utah last year as a group of Utah legislators hijacked a bill seeking to end so-called conversion therapy on minors in the state. It turned out that Family Watch International leaders flew into the state as the state legislature considered the bill. Family Watch International was designated a hate group by the Southern Poverty Law Center.
HB92: Transgender youth healthcare
The first bill in Utah that has been released is HB92 with the ambiguous title, “Medical Practice Amendments.” The bill’s intent is to prohibit a doctor from performing any transgender-related procedure on a minor.
The bill is sponsored by financial advisor Rep. Rex Shipp, R-Cedar City, in the House, and CPA Sen. Curt Bramble in the Senate. Bramble has long been a “traditional marriage” supporter and is considered one of the most conservative legislators on the Hill.
The bill has a long list of medical definitions and adds several procedures to the “unprofessional conduct” statute, including “unnecessary puberty inhibitions” or “sex characteristic-altering procedure” for those under 18 years old.
Sex characteristic-altering procedures would include and typical gender correction surgeries, facial feminization surgeries, administration of testosterone or estrogen, or “removing any otherwise healthy or non-diseased body part or tissue.”
Exceptions to the restrictions would be surgeries or procedures performed of sexually ambiguous or with certain chromosomal variations.
Alliance Defending Freedom
The Alliance Defending Freedom is a Christian Right-based group that develops “religious liberty” legislation and case law in the United States and around the world. The group seeks to recriminalize sexual acts between consenting LGBTQ adults, has defended state-sanctioned sterilization of transgender people abroad, contends that LGBTQ people are more likely to engage in pedophilia, and says the “homosexual agenda” will destroy Christianity and society.
On transgender issues, the group refers to trans women as men, saying, “Allowing males to compete in the female category isn’t fair and destroys girls’ athletic opportunities. Males will always have inherent physical advantages over comparably talented and trained girls — that’s the reason we have girls’ sports in the first place. And a male’s belief about his gender doesn’t eliminate those advantages.”
“Men who self-identify as women are still biological men. Sure, they can take synthetic hormones to make themselves appear more feminine, style their hair, and wear makeup (or not). But being a woman is more than a physical appearance or a feeling—it is a biological reality. And no amount of wishing or desire will ever change the fact that a feminized man will never truly experience what it is to be a woman,” wrote ADF senior writer Marissa Mayer on the ADF website.
The group has a media reference guide where they encourage the media to use such terms as “homosexual agenda” for the lesbian and gay civil rights movement; “cross-dressing,” and “sexually confused” rather than the term transgender; “gender-identity confusion/gender confusion” for gender identity; “(leftist) sexual indoctrination programs” for sexual education programs and health education; “sexual preference/choice” for sexual orientation; “sexually mutilated male/female, self-proclaimed male/female, biological male/female” for intersex person/male/female; “special legal protections, privileged class” for equal rights, equal protection, and protected class; and using quotation marks around the word marriage when referring to same-sex couples and around the word hate when referring to hate crimes.
The group is now “peddling” drafted bills as first volleys against the transgender movement, both “for the children.”
Troy Williams, executive director of Equality Utah, says the legislature shouldn’t intrude in the decisions between a parent and physicians.
“We don’t need more government intrusion in the lives of our families. Parents should make decisions about the healthcare for transgender youth in accordance with evidence-based medical best practices, which are well established,” Williams said. “Guidelines for transgender health have been clearly affirmed by the American Academy of Pediatrics, the American Psychological Association, the American Medical Association, and many more.”
“Our state leaders should be finding ways to manage the pandemic and pull us together, rather than entertaining legislation designed to harm transgender youth,” he said.
Transgender and intersex activist Sue Robbins points to Alliance Defending Freedom, also on the list of Southern Poverty Law Center’s designated hate groups, as being a fringe group trying to push their agenda on more conservative states.
“HB92 is another of the bills that are originating from the Alliance Defending Freedom and being shopped to many states. Transgender healthcare has evidence-based science behind it, and these hate bills are perpetuated by taking fringe stances and using fear for our youth’s well-being to generate early support,” Robbins said. “This is pretty much the same as the bill we saw from Rep. Brad Daw last year. As he learned more about the community, he kept removing restrictions from the bill until it became only a study and was easily defeated in a House vote. We will do as we have before and educate the bill sponsors to create an understanding of the reality of the positive impact and needs of Transgender healthcare for our youth and work to defeat it once again. Utah is better than this.”
Trans activist and ACLU staff attorney Chase Strangio questions why these groups and legislators want to interfere with the medical care of trans youth.
“These anti-science bills cannot be understood as motivated by concerns about children or their ability to consent to medical treatment. Rather, they’re motivated by some adults’ need to police young people’s bodies and to make them align with those adults’ expectations of how young male and female bodies should look,” Strangio said. “These bills run counter to every prevailing norm of medical science in the United States and have been condemned by the American Academy of Pediatrics, the American Medical Association, and the Endocrine Society, among others, because they would cut off young transgender people from treatment known to save their lives.”
“Together, all of these legislative efforts — like other anti-trans legislative efforts before them — attempt to weaponize the current distorted, pseudoscientific public discourse about transgender people, both for larger political aims of right-wing lawmakers and as part of a larger project to stop people from being transgender at all,” Strangio continued.
“But the reality that these lawmakers and other anti-trans forces will eventually have to face is that when transgender young people are able to access health care, play sports, go to the restroom without fear and use pronouns that affirm who they are, nothing bad happens to anyone,” Strangio concluded.
What science says
Medical researchers and doctors say intrusion into the medical care of transgender youth can be harmful.
“Several studies demonstrate the clear mental health benefit of
gender-affirming medical treatment, including puberty blockers. Withholding such treatment is harmful and carries potential life-long social, psychological, and medical consequences,” the World Professional Association for Transgender Health and a coalition of other world-wide health organizations said in a statement last year.
“Treatment of transgender adolescents involving gender-affirming medical interventions (puberty suppression and subsequent gender-affirming hormones) is the most widely accepted and preferred clinical approach in health services for transgender people around the world,” the statement continues. “The aim of puberty suppression is to prevent the psychological suffering which stems from undesired physical changes that occur during puberty and to allow the adolescent time to carefully consider whether or not to pursue further transition when they are eligible.”
The group says that earlier commencement of the treatment has greater effectiveness than later. The interventions, they write, are “stepped up” as time progresses, from reversible treatments to, eventually, irreversible ones.
Withholding such treatment until later in a teen’s life, they say, means they will experience complete puberty incongruent with their gender identity, which has potential life-long harmful consequences such as stigmatization, personal physical discomfort, difficulty with sexual function, and social integration.
The American Medical Association estimates that 1.4 million adults and 150,000 youth ages 13 to 17 in the United States identify as transgender. Over a third, they say, suffer a major depressive episode in their lifetimes. At least one study showed that 20 percent were diagnosed with suicidality in the past 30 days.
“The increased prevalence of these mental health conditions is widely thought to be a consequence of minority stress, the chronic stress from coping with societal stigma and discrimination because of one’s gender identity and expression. Indeed, gender-based discrimination affecting access to services is a strong predictor of suicide risk among transgender persons. Lack of access to gender-affirming care may directly contribute to poor mental health: individuals with gender dysphoria who have undergone no gender confirmation treatment are twice as likely to experience moderate to severe depression and four times more likely to experience anxiety than their surgically-affirmed peers.”
“Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population,” the group said.
The American Psychiatric Association also says that it is important for youth to have access to supportive treatment.
“The APA supports access to affirming and supportive treatment for trans and gender diverse youth and their families, including appropriate mental health services and, when indicated, puberty suppression and medical transition support,” the APA said in a statement. “The APA opposes all legislative and other governmental attempts to limit access to these services for trans and gender diverse youth or to sanction or criminalize the actions of physicians and other clinicians who provide them.”
Transgender Education Advocates of Utah Executive Director Candice Metzler is saddened the bills are basically a religious test.
“I have spent many, many years working with transgender youth and I hate to see their lives and medical decisions politicized in this way. It’s unacceptable, really,” Metzler said. “H.B. 92 demonstrates how power and authority can be used to stigmatize and degrade vulnerable groups of people.”
“One only needs to examine the language in the bill to understand that it is about bias towards people whose gender identity and/or body do not conform to social expectations,” Metzler continued.
Metzler said that what legislators are calling “transgender procedures” are routinely used in many situations not related to transgender care.
“For example, puberty blockers are often used for treating precocious, or early onset, puberty, which can have long-lasting health implications if not treated early,” Metzler explained.
Metzler calls the bill a “purity test.”
“This bill is an attempt to establish what a ‘proper human body’ should look like and act like,” Metzler said.
Similar bills that restrict medical treatments for transgender youth are being run so far in Missouri, Indiana, Alabama, and New Hampshire.
Upcoming bill: Transgender athletes in sports
While a bill expected by Rep. Kera Birkeland, R-Morgan, is still in the process of being drafted. It will be under the title, “Student Athletics Participation Amendments,” and is expected to require student athletes to participate under the sex assigned at birth.
Legislatures in Montana and New Hampshire are already debating similar bills.
Montana’s bill is modeled closely to the Idaho bill that passed last year. Also titled the “Save Women’s Sports Act,” the bill would require public school athletic teams be based on “biological sex.”
A federal judge ruled in August 2020 that Idaho’s law was likely unconstitutional and passed strictly due to animus against transgender people, prompting him to grant a preliminary injunction that stalled HB500’s implementation.
Metzler believes this bill will provide an opportuntiy to “have the conversation” about transgender exclusion.
“The time for transgender exclusion is coming to an end,” Metzler said. “It is a mirror of what is going on — denying the reality that humans are diverse.”
“In the history of the international Olympics, they realize this diversity is a lot more complex than they originally thought. Right now they test on testosterone and estrogen levels, saying that certain levels ‘shouldn’t’ compete in the women’s category. But they only scrutinize people they suspect are transgender.”
“If you tested all individuals assigned female at birth you’d find extreme differences in levels. We only test people when they are breaking records and people start complaining,” Metzler concluded.
The Utah Legislative session began January 19 and will adjourn on March 5.