Utah first state in 2023 to ban gender-affirming health care of minors

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Utah has become the first state this year to ban gender-affirming health care for transgender youths, part of a wave of anti-LGBTQ legislation brewing in statehouses.

The state’s Republican-dominated Legislature fast-tracked the bill – which prohibits transgender surgery for those under the age of 18 and bars hormone treatments for minors who have not yet been diagnosed with gender dysphoria – two days after its session opened Jan. 17. GOP Gov. Spencer Cox signed the legislation Saturday.

So far this year, at least 10 other states have introduced bills targeting such health care access for transgender and gender-nonconforming people: Kansas, Kentucky, Missouri, Montana, New Hampshire, Oklahoma, South Carolina, Tennessee, Texas and Virginia.

In 2022, at least 15 states restricted access to gender-affirming care or considered laws that would do so, according to the Williams Institute. Some of the bills carried penalties for health care providers and even families.

ADVOCATES SAY BANS ARE ‘CRUEL’ AND ‘DANGEROUS’:Should transgender youths have access to gender-affirming care?

What is gender-affirming care?

Gender-affirming care is a term for medical care that is “highly individualized,” according to Dr. Kellan Baker, executive director of the Whitman-Walker Institute. “There is no set way to go through gender affirmation. Everyone’s needs are different.”

Care can involve social transitions such as a new name, a new haircut, new clothing and different pronouns – none of which are irreversible, he said. Medical care, which can include hormone therapy, can be crucial, he said. Puberty delaying medications, which are reversible, Baker said, allow youths time to explore their identity “free of a ticking clock.”

GENDER-AFFIRMING CARE EXPLAINED:What to know about gender-affirming care for transgender and nonbinary communities

What do backers of these bills say?

Supporters of gender-affirming care bans often claim they are saving young people from regret later in life.

Cox said in a statement that his decision was based on his belief that it was wise to pause “these permanent and life-altering treatments for new patients until more and better research can help determine the long-term consequences.”

“While we understand our words will be of little comfort to those who disagree with us, we sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures,” he said.

But major medical associations – from the American Medical Association to the American Psychiatric Association – disagree, saying this type of health care is needed, and they have lined up in support of gender-affirming care and against bills that criminalize it in recent years.

What is the mental health impact of bans on young people?

Recent polls by The Trevor Project, which provides crisis and suicide prevention services for LGBTQ people under 25, show the damaging toll the bills can have.

• 85% of trans and nonbinary youths say recent debates about state laws restricting their rights have negatively impacted their mental health.

• Proposed bills that would ban doctors from prescribing gender-affirming medical care make 73% of transgender and nonbinary youths feel angry, 57% sad, 47% stressed, and 40% scared.

CARE SAVES LIVES:Gender-affirming care helps save lives, cuts depression risk in transgender and nonbinary youth, study finds

What was the reaction to Utah’s bill?

The ACLU of Utah had urged Cox to veto the the bill. “By cutting off medical treatment supported by every major medical association in the United States, the bill compromises the health and well-being of adolescents with gender dysphoria. It ties the hands of doctors and parents by restricting access to the only evidence-based treatment available for this serious medical condition and impedes their ability to fulfill their professional obligations,” the ACLU said in a letter to the governor.

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