Medical treatment

Missouri bill punishes medical treatment of transgender children

“In the transgender population, there is a 40% lifetime suicide attempt rate, with a majority of such attempts before the age of 19.”

JEFFERSON CITY, Mo. — For hours Thursday, Missouri lawmakers debated a bill that would punish doctors and health care providers if they provided procedures and treatments to transgender children.

Representative Suzie Pollock is the sponsor of HB 2649.

The law project

She calls it the “Missouri Save Adolescents from Experimentation (SAFE) Act”.

It prohibits any physician or other healthcare professional from providing gender transition procedures to a child under the age of 18 or from referring the child to a healthcare professional for such procedures.

The bill also prohibits any health insurance company or health benefit plan from reimbursing gender transition procedures for children under 18.

Rep. Peter Merideth, who represents the city of St. Louis, was one of the committee members to hear testimony for and against the bill.

“This bill would deprive doctors of tools such as puberty blockers or hormone treatments,” he said.

The hearing

Pollock told the committee that she believed this treatment could cause harm.

“These drugs can sterilize children and never allow them to have an orgasm. Do you want to do this to a child, do you want to strip them of this? If they go all the way, they are never happy. People who are fully trans, they don’t have normal sexual function. You’re stealing that from the kids,” she said. “My main goal is to protect the kids.”

Pollock said there were no first-hand accounts from witnesses because they wanted to protect their children.

“They don’t want to drag them here and expose them to the public, they won’t bring them here and testify because they don’t want to bring any more drama into their child’s life,” Pollock explained.

Proponents of the bill have said these procedures have risks and potential outcomes.

Pollock said constituents told him it was on their second visit when they were referred to a gender clinic.

But several testimonies against the bill discuss that the convoluted process is not on a whim and it is in-depth discussions that can take time.

The argument has also been made that children may not know what is best for them.

Those against the bill are organizations like PROMO. They think it would cause more harm than good and there is nothing safe about this bill.

Katy Erker-Lynch is the Executive Director of PROMO, which tackles systemic inequalities to free the entire LGBTQ+ community from discrimination and oppression.

“It has been well documented that when we don’t give trans youth access to gender-affirming health care, it can contribute to feelings of depression, social isolation, internalized trans phobia, or self-hatred, risk of self-harm and suicidal behavior,” Erker-Lynch said. mentioned.

Shira Berkowitz is Senior Director of Public Policy and Advocacy at PROMO and fights for accessibility to healthcare. They share their own story of being a triplet and knowing they felt out of place in their own skin.

“I felt like a stranger in my body,” they shared.

They also have a message for other children.

“We are you, we see you and we care deeply about you and we will not stop fighting this legislation on your behalf,” Berkowitz added.

Medical experts

Dr. Laurie Haynes testified in support of the bill. She is a psychologist and board member of the International Federation for Therapeutic Choice and Counseling. She said she has written research on gender dysphoria.

“Studies show that this mismatch resolves naturally for children if they don’t receive body-harming interventions,” she said.

She said it would require lifelong medical treatment.

“This child abuse must stop,” Dr Haynes said.

In a cross-talk, Dr. Haynes was asked if she was in favor of conversion therapy. She replied that she was in favor of it for those who want to voluntarily explore to moderate their changes.

Those opposing the bill were two doctors from the University of Washington. They described the work they do at the Transgender Center at St. Louis Children’s Hospital.

Dr. Sarah Garwood is an adolescent medicine specialist and co-director of the centre.

“Providing gender-affirming care literally saves lives,” she shared. “In the transgender population, there is a 40% lifetime suicide attempt rate with a majority of such attempts before the age of 19.”

Dr Garwood said that with medical intervention, there is evidence of improvement in this statistic.

She pointed out that even if the treatment was banned, gender exploration would not stop.

“Transgender medical care is evidence-based and guided by the American Academy of Pediatric Standards of Care and Support. This bill is contrary to what I have in the good fortune of my training and contrary to national standards “, notes Dr. Garwood.

Dr Garwood said that at their center for children who have not yet reached puberty, the emphasis is on psychological social support and family education. After the onset of puberty, other options become available, such as puberty blockers and hormone therapy.

“They mostly consult with mental health professionals, talk about ways to feel more comfortable in their bodies, and when indicated, we talk about gender-affirming hormones. Not all teens have need to start hormones or puberty blockers before age 18. But let me be clear to those who do, hormones save lives,” she said.

She also emphasizes that medical interventions are done with a multidisciplinary team approach. A mental health assessment and consent must be made by the child and their guardians.

Surgeries under the age of 18 are not recommended.

Dr. Christopher Lewis is the other co-director and pediatric endocrinologist.

“Most of the studies looking at the impact of these therapies show a decrease in negative life outcomes, substance use, suicide and depression,” Dr. Lewis said.

They shared that around 1-3% of people have de-transitioned and there are several reasons why this happens.

Both sides discussed the importance of mental health and reducing suicide rates. However, the goal to get there seemed different.

And after?

There are three weeks left in the Missouri legislative session, which means there may not be enough time to vote on this bill.

But lawmakers could see a bill like this come back next year.

Related stories