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States line up to protect youth from transgender wave

Lawmakers introduce limits on harmful treatments for minors

Rep. Bruce D. Skaug, R-Nampa, (standing) sponsor of a bill protecting minors from transgender medical procedures in Idaho Associated Press/Photo by Darin Oswald/Idaho Statesman

States line up to protect youth from transgender wave

While a teenager, Luka Hein told a therapist in her outpatient mental health program in Nebraska that she thought she might be transgender. She had learned about the concept online.

“I was a young teenager who had a lot going on in life. I had several comorbidities—anxiety, depression, and just general poor mental health,” she said. “I ended up kind of spiraling into this hatred of myself and my body, and feeling almost like I want to escape my body.”

After that conversation, Hein said her treatment plan shifted almost instantly from managing anxiety and depression to changing her body to look more male.

At 16, she had a double mastectomy and began taking testosterone with a prescription. By the time she turned 20, Hein stopped taking cross-sex hormones and joined a growing number of people who detransition, or stop identifying as the opposite sex. People who receive transgender surgery or medication often face irreversible damage even if they choose to detransition.

“I don’t think it’s right for a child that doesn’t even have the mental capacity to fully understand the long-term impacts of that to be able to have their parents sign off for them to be sterilized and cut up,” Hein said.

More than 20 states across the country are considering bills that would protect minors from hormone treatments and transgender surgeries, which can cause irreversible damage. Now 21, Hein has testified before lawmakers about how she felt rushed into a gender transition process she later came to regret.

In 2021, Arkansas became the first state to pass a law barring medical professionals from prescribing cross-sex hormones or conducting gender reassignment surgeries on minors. Arizona and Alabama passed similar legislation last year. Federal judges in Alabama and Arkansas have blocked all or part of the measures.

In January, Utah’s governor signed a bill prohibiting physicians from performing transgender surgeries on children who were not already diagnosed with gender dysphoria before the law went into effect. Last week, South Dakota adopted the Help Not Harm bill, protecting children under 18 from surgery or other medical intervention to identify as the opposite sex. Tennessee’s legislature passed a similar bill this week.

In Nebraska, state Sen. Kathleen Kauth introduced the Let Them Grow Act in January. Under her proposal, medical providers who perform these surgeries or prescribe hormones for youth who identify as transgender risk losing their licenses. “We very deliberately didn’t make this a criminal issue. I know in some states, the parents and the doctors have been criminalized,” she said. “What I want is to have the most number of kids not be experimented on,” Kauth said. She wants to see parents and physicians refocus on psychological treatments instead of rushing to offer medical interventions.

Advocates for so-called “gender-affirming” care claim laws that ban such treatments for children violate parental rights. Matt Sharp, director of the Center for Legislative Advocacy at Alliance Defending Freedom, said parental rights do not supersede state regulations on things that have been deemed unethical, harmful, or unlawful.

“Parental rights focuses on the government coming in and telling me how I can and cannot raise my child, consistent with my beliefs, my values,” he said.

Sharp added that states have the right to regulate medical practices in the same way they regulate alcohol sales, wearing seatbelts, and obtaining a driver’s license. “It’s the government regulating a profession within the state, making sure that they’re not doing something that is harmful and especially when you have vulnerable minors that can’t comprehend and consent to the long term consequences that this has,” he said.

Major U.S. medical organizations, including the American Medical Association and the American Academy of Pediatrics, say that “gender-affirming” approaches are the standard of care for youth who identify as the opposite sex.

But Jennifer Bauwens, director of the Center for Family Studies at the Family Research Council, said there are not enough long-term studies on the effectiveness of these procedures and medications. Bauwens has decades of experience treating children and adults with psychological trauma. She said that while most mental illnesses have multiple treatment options that can be customized to the patient’s needs, medical providers are told that the only way to treat gender dysphoria is through affirmation and gender reassignment.

“If we were going to treat them correctly, the first thing we will do is have a proper assessment. Look at their trauma history and look at those things that we know are contributing factors to gender dysphoria,” she said. “Anytime the transgender idea is mentioned, it’s like everything else falls by the wayside.”

In a 2021 survey of 100 detransitioners, the Institute for Comprehensive Gender Dysphoria Research found that a majority of respondents did not receive an adequate mental health evaluation before beginning medical interventions.

Medical professionals in Sweden, Finland, and other European countries, which Bauwens said were at the forefront of offering medical interventions for gender dysphoria, have issued new guidelines that prioritize psychological treatment over surgeries or hormones. In the United States, Bauwens said many healthcare providers are discouraged from questioning treatments’ negative side effects and lack of scientific support. “You have a lot of social pressures and professional pressures that demand that affirmation is given,” she said.

But some practitioners have spoken out. Jamie Reed worked at the Washington University Transgender Center at St. Louis Children’s Hospital for four years. In an essay for The Free Press, Reed voiced concerns that not only are transgender medical treatments ineffective but families are also often pressured into agreeing to them. Providers frequently refer to the treatments as life-saving care preventing a child who is experiencing gender dysphoria from committing suicide.

While some studies show improved mental well-being in young patients shortly after receiving transgender medical interventions, Bauwens said there is not enough long-term data to understand the true effects. She added that healthcare providers and parents, especially Christians, should continue to advocate for the protection of children.

“This whole issue is about identity,” Bauwens said. “Christians, of all people, have the best answers about identity and who we are in Christ. And that’s what we want to affirm.”

Hein said her doctors told her parents that she was highly likely to take her own life if she did not receive physical interventions despite her never having suicidal ideation. “They brought up the suicide statistics to kind of scare my parents into affirming. And from there, we weren’t really given any other option,” she said. “It really is on the level of emotional blackmail to continue to tell parents that their kid is going to kill themselves.”

Hein said she and others like her plan to continue sharing their stories. “It really is important when you have someone who’s been harmed by a practice, that you listen to what they have to say because they could be like the canary in the coal mine to go no, there’s something wrong here,” she said.

Lauren Canterberry

Lauren Canterberry is a reporter for WORLD. She graduated from the World Journalism Institute and the University of Georgia with a degree in journalism, both in 2017. She worked as a local reporter in Texas and now lives in Georgia with her husband.

Thank you for your careful research and interesting presentations. —Clarke

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