On Monday, the Arkansas Senate passed a bill that would criminalize doctors who prescribe gender-affirming health care treatments to transgender minors.
Under the so-called “Arkansas Save Adolescents From Experimentation Act,” doctors would be threatened with disciplinary action or the loss of their license if they recommend puberty blockers, hormones, or surgery to transgender-identifying youth.
The bill would allow minors who were prescribed treatments for gender dysphoria to sue physicians for up to 20 years afterwards — which, along with the aforementioned threats of loss of licensure or disciplinary action, will effectively force doctors to refuse to treat transgender youth to protect themselves from liability.
The bill also prohibits public funds, including Medicare and Medicaid, from being used to cover the costs of transition-related care, prevents private insurance from covering treatments for gender dysphoria for patients under the age of 18, and allows health care plans to refuse to cover transition-related treatments or procedures.
Gov. Asa Hutchinson is expected to sign the bill, given his previous endorsement of at least two other bills targeting the LGBTQ community for discrimination. Should he do so, Arkansas will become the first state to ban gender-affirming care for transgender youth.
Similar bills are currently being considered in Alabama, where the Senate passed a law making prescribing gender-affirming treatments to minors a felony; and Tennessee, where a House committee has approved a bill under which doctors would be charged with misdemeanors for recommending such treatments.
Speaking during a press conference on Monday, Chase Strangio, the deputy director for transgender justice at the American Civil Liberties Union, called the Arkansas bill “the single most extreme anti-trans law to ever pass through a state legislature.”
“This bill puts physicians in a position of having to either meet their ethical obligations as physicians to their patients, or to violate state law, which could compromise their medical license altogether,” Strangio said. “When we look at the impulse behind these bills, one of them is to stop people from being trans and to eradicate trans-ness — which is never going to happen.
“The other motivation we’re seeing in the context of anti-abortion laws and restrictions on access to reproductive health care, is a desire on the part of the government to restrict bodily autonomy and control people’s bodies.”
Rumba Yambú, director of the Arkansas-based transgender advocacy organization inTRANSitive, said it was “painful” to see lawmakers targeting transgender individuals, specifically youth with various bills seeking to erode their rights and challenge their humanity.
“Every trans Arkansan I know is hurting because of these bills,” Yambú said. “We need our trans siblings and our trans allies outside of Arkansas to help shine a light here. We need you all to help us elevate our voice, and put pressure on Governor Asa Hutchinson” in hopes he will veto the measure.
“We want every trans kid in Arkansas and every trans adult to know that we’re working and strategizing around the clock to fight these bills. We’ve been here before this legislative session, and we will be here for you after,” Yambú added. “To every trans kid, know that it is a fact that you were born blessed. Being trans is a blessing and it’s a blessing that scares people who were born without it, because we break every binary they’ve constructed in order to hold on to power.”
Opponents of the bill alleged that the bill, and others like it, are being pushed by out-of-state organizations, including anti-LGBTQ groups like the Family Research Council and Alliance Defending Freedom.
“These bills are not constituent-driven pieces of legislation,” Strangio said, referring to the efforts by outside groups as an attempt to “eradicate trans lives.”
“These bills are not drafted in Arkansas. They were not originated in Arkansas,” he added. “And ultimately, we have to bring all of the resources to bear, to fight what is an incredibly well-funded global movement to attack us.”
Opponents have also balked at the idea that lawmakers — most of whom don’t possess degrees or specialized training — would intervene into private and family medical decisions. Several parents of transgender youth have expressed disgust at lawmakers’ assumptions that they are making an impulsive decision without sufficient information when they decide to allow their children to transition.
Joanna Brandt, the mother of a 15-year-old trans son, said she had to make “tough decisions” in her child’s best interests over the years, noting that she had carefully weighed and considered all options before deciding to allow her son to receive gender-affirming medical care, in consultation with his personal physician.
“I didn’t make that choice lightly…. I sought the advice and expertise of medical professionals,” Brandt said. “The idea of consulting lawmakers never occurred to me because they should not have a part in these decisions. I did my research. I educated myself on our options and thought long and hard on what I felt was in his best interest.
“Today, after two years of therapy, doctor’s visits and almost 18 months of gender-affirming hormone therapy, Dylan is happy, healthy, confident and hopeful for his future,” she said. “My son will be devastated if he is forced to stop his hormone treatment. All of the progress that he has made, all the plans to be able to graduate from high school and go off to college, presenting outwardly in the full expression of how he feels on the inside, would come to a screeching halt.”
Transgender actress Laverne Cox said it was “exhausting” for transgender people and youth to be dealing with attacks against them in addition to the problems they face due to discrimination or lack of resources.
Cox said the Arkansas bill — as well as a similar one in her home state of Alabama — have to be viewed as a continuation of ongoing attempts to stigmatize or marginalize transgender people, beginning with the spate of “bathroom bills” introduced in various legislatures just a few years ago.
“It seems so insane, but what I see in the media are efforts to dehumanize and stigmatize trans folk, to objectify reduce us to our bodies and medical procedures. And I have to say, I’ve been reticent to speak out about this, honestly, because I’m tired and I don’t want to have conversations with and about trans people that dehumanize us,” Cox said. “I’ve met so many young people who’ve said that access to health care has saved their lives. And when we deny that access to health care to trans youth, we know that there are higher rates of suicide, higher rates of depression.
“Trans is beautiful. The humanity of trans people is beautiful and should be celebrated,” she added. “The conversations I’ve seen happening around young trans young people are just deplorable. Can we just remember that these are human beings, that they are people and that any decisions about the health care of trans youth should be made between that transgender young person, their parent and their doctor? The government has no place in these decisions.”
LGBTQ advocates have also noted that most reputable medical and mental health associations oppose efforts to block transgender youth from accessing transition-related care, including the American Medical Association, the American Academy of Child & Adolescent Psychiatry, the American Academy of Pediatrics, the World Professional Association of Transgender Health, and the Endocrine Society. They also contest the idea, promulgated by conservative lawmakers, that transition-related care, which has been around for decades is somehow “experimental” or harmful to children.
The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for LGBTQ youth, expressed well-founded fears that the Arkansas bill would simply increase the rates of suicide, suicidal ideation, or self-harm among trans youth. The organization has supported over 850 crisis contacts — in other words, youth who reached out because of feelings of depression, despondency, or suicidal ideation — in Arkansas over the past year, and believes that number will increase if trans youth are barred from transitioning.
“The evidence is clear: gender-affirming care produces positive mental health outcomes and reduces suicide risk. That’s why it’s considered best-practice, embraced by doctors across the country, and endorsed by every major medical association,” Sam Brinton, the vice president of advocacy and government affairs for The Trevor Project, said in a statement. “Governor Hutchinson should listen to the experts — and transgender young people in Arkansas — and veto this cruel bill. It’s a matter of life and death.”
An Arizona Republican lawmaker has proposed a bill that would criminalize doctors who prescribe medical interventions, such as puberty blockers or hormones, to transgender children suffering with gender dysphoria.
State Sen. Wendy Rogers (R-Flagstaff) has proposed Senate Bill 1045, which would make doctors who prescribe gender-affirming medical treatments, including gender confirmation surgery, to those under 18 guilty of a Class 4 felony, punishable by one to three years in prison.
Advocates argue that gender confirmation surgery is rarely recommended or prescribed for youth under 18 in the United States, noting that many physicians treating transgender patients abide by guidelines established by the World Professional Association for Transgender Health, which require a patient to have reached the age of majority and received at least 12 continuous months of hormone therapy before surgery can be considered an option.
In 2021, more than 268 anti-LGBTQ bills, and, specifically, 147 anti-transgender bills, were introduced in more than three dozen state legislatures, with 26 anti-LGBTQ measures eventually being enacted into law in 10 states. But even though it's only two weeks into 2022, Republican lawmakers, in particular, seem determined to continue the push for anti-LGBTQ measures as they seek to stir up conservative voters ahead of this year's midterm elections.
Thus far, Republicans in seven different states have introduced at least nine measures targeting transgender and nonbinary youth, including bills to restrict transgender athletes from participating on sports teams matching their gender identity, prohibit them from receiving gender-affirming medical care such as hormones or puberty blockers, or bar them from gender-specific facilities that don't match their assigned sex at birth.
Insurance companies in California will now be required to cover the costs of at-home test kits for sexually-transmitted infections, including HIV, syphilis, and chlamydia.
Under a bill that went into effect earlier this month -- the first of its kind in the nation -- not only will insurance be required to cover the cost of the at-home tests, but the number of health care providers that can offer STI tests will be increased, and providers will be required to provide "expedited partner therapy," or prescribe antibiotics or treatments to the sexual partners of those who test positive for STIs.
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