Utah Latest State To Ban Gender-Affirming Care For Trans Minors: Here’s Where It’s Restricted— And May Be Soon

Topline

Gov. Spencer Cox (R-Utah) signed new legislation Saturday tightening restrictions on transgender healthcare and stopping trans minors from receiving gender-affirming hormones and surgeries, joining several states with some restrictions and foreshadowing a wave of similar legislation expected from many others.

Key Facts

Under the new law, minors who have already been diagnosed with and treated for gender dysphoria for at least six months may continue hormonal therapy if their healthcare providers certify other treatments, like behavioral therapy, won’t work.

The law went into effect when the governor signed it on Saturday, which means minors diagnosed with gender dysphoria after that won’t have access to gender-affirming hormones or surgery.

Hormone therapy and surgeries for minors are only banned for those wanting to change their biological sex–they are still available to treat conditions like endometriosis, menstrual, ovarian and uterine disorders, and sex-hormone stimulated cancer.

The law includes exceptions for intersex minors, which allow them to receive hormone and surgical therapy as prescribed.

The law charges several state health organizations with researching the long-term effects of gender-affirming hormone therapy on minors, the findings of which will determine if the ban on hormone treatments can be lifted.

The law codifies new rules for physicians, requiring a separate certification to treat trans youth and a comprehensive audit of treatment plans for trans minors already taking hormones.

Minors who were harmed by hormone treatments are now allowed to disaffirm consent and sue physicians until they are 25 years old.

Key Background

Tennessee, Florida and Arizona both have laws on the books restricting surgery for minors. Tennessee also bans hormone treatments for prepubescent kids, while Florida bans them for minors altogether. Texas, Alabama and Arkansas passed laws restricting surgery and hormones for trans minors, but all are embattled in federal lawsuits questioning their constitutionality and aren’t in full effect. Missouri, Virginia, Oklahoma, and South Carolina pre-filed similar bills to Utah’s for this year, though NPR reports at least 18 states are considering limiting care for transgender youth.

The Specifics

The law mandates physicians who treat trans youth get a new transgender treatment certificate, which requires 40 hours of education on transgender care for minors. Doctors have until January 1, 2024 to get certified or cease treating trans teens. Physicians already prescribing hormones to gender-dysphoric minors now have to certify that hormones will provide the best long-term outcomes as opposed to other physical and behavioral therapies. More stringent disclosure rules also require physicians to inform the minor and their guardian of specific risks associated with hormone treatments, including diminished bone density with the use of puberty blockers, and coronary artery disease for cross-sex hormones.

Contra

Gov. Cox says the bill responds to a lack of long-term research on the effects of hormonal and surgical care for trans youth. Some people who advocate for gender-affirming care also decry the lack of substantive research, particularly in the United States. The ACLU of Utah counters that the law violates the constitutional rights of transgender youth, echoing major medical organizations like the American Medical Association, which argues government intrusion into healthcare negatively affects health outcomes. Gender-affirming treatment for minors is vehemently defended by the American Medical Association, the American Psychiatric Association and the American Academy of Pediatrics, among others, citing studies that it can reduce instances of suicide and depression in gender-dysphoric teens.

Surprising Fact

Care for people with varied sexual identities is at least a century old, according to Scientific American. In 1919, Magnus Hirschfeld founded the Institute for Sexual Research in Berlin, where he provided teaching and support for transgender, non-binary and homosexual people ostracized by German society. The Institute’s meticulously curated library–20,000 books on sexual identity and wellness–was burned by the Nazi party in 1933 and Hirschfeld, a Jewish, gay man, was forced to flee the country.

Further Reading

The Forgotten History of the World’s First Trans Clinic (Scientific American)

G.O.P. State Lawmakers Push a Growing Wave of Anti-Transgender Bills (New York Times)

They Paused Puberty, but Is There A Cost? (New York Times)

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