Gender Affirming Care is safe. Why do Kentucky legislators want to ban it?

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Jaime Lazich


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Kentucky lawmakers are really digging their heels in on their gross anti-trans agenda. Alongside fast-moving sports bans HB 23 and SB 83, this year legislators have introduced bills HB 253 and SB 84. The new wave of legislation aims to ban healthcare practitioners from providing gender affirming care for trans minors, and even giving a referral for the care. 

The bills’ name, “Kentucky’s Children Deserve Help Not Harm Act”, signals that gender affirming care is dangerous. A wealth of research shows the opposite: this care is not only safe, it’s life-saving. The bills’ rescission of gender affirming care would withhold vital treatments, causing grave harm to the trans youth it claims to protect.

But a lot of groundwork has already been laid to ensure that these bills easily pass into law. The media drumbeat of delegitimization about gender affirming care has shaped public opinion. News coverage amplifies ideas that care is too easy to access, administered irresponsibly, is unsafe or experimental. If you’re unfamiliar with what gender affirming care entails, it can be easy to jump on board with these spurious takes. The reality of this care bears little resemblance to anti-trans rhetoric. Let’s break down what accessing care really looks like.

Accessing gender affirming care is difficult

There are a multitude of barriers that stand in the way of securing this care, for trans minors and adults. If you are under 18, your parents need to be on board – not only with your transness, but your receiving care. It’s likely sadly obvious, but parent-approval can be hard to come by for trans youth: in a recent survey of trans folks it was found that 18% of those surveyed lacked support from their family. Eight percent of those surveyed were kicked out of their home for their trans identity. 

Then, you’ll need to find out if your insurance covers gender affirming care. Many insurance plans do not. Hell, you might not be able to afford it even if it is covered: sky-rocketing premiums and deductibles in health insurance plans can make even covered care inaccessible. 

Next is the Doctor Hunt. Is there one near you that administers gender affirming care? If you live in a rural place, as is the case in much of KY, chances are slim. Access is easier with the new ubiquity of telehealth, but some people still drive hours to reach a qualified doctor. 

OK, you found a doctor. Are they taking new patients? Are they covered by your insurance? Fingers crossed that the only place where you can access care in your state doesn’t suddenly close.

Gender affirming surgery is non-existent for trans children

Disinformation about gender affirming care flourishes through conflation of the care that’s received by trans adults with the care that’s administered to trans minors. These are not one and the same. Language in the bills like “genital or nongenital gender reassignment surgery” leads you to believe that every trans young person is getting surgery. Use of this terminology is a scare tactic, and has little to do with the nature of care that trans youth actually receive. 

No trans young person is getting gential surgery; it’s not even included in the World Professional Association for Transgender Health Standards of Care for children and adolescents. The WPATH is basically the bible of what medical treatments and interventions trans people have access to. It is relied upon by doctors, attorneys and insurance companies. Some older trans adolescents may receive chest surgery, but it’s rare. 

The care that trans minors really receive

What gender affirming care for trans youth really looks like is puberty blockers and hormone replacement therapy. Puberty blockers are administered around age 8 or 9, when the onset of puberty begins. They are not experimental or dangerous. They have been safely used for over 30 years. Cis people use blockers all the time: for treating precocious puberty, endometriosis and cancer

Puberty blockers are totally reversible, unlike the physical changes that occur with endogenous puberty. Puberty suppression can be truly life-saving for trans and nonbinary youth. The pause allows them more time to expore their gender nonconformity, and prevents the development of potentially dysphoric sex characteristics that can become difficult or impossible to reverse. This care can prevent the need for surgical intervention later in life.

Trans and gender diverse youth typically start hormone replacement therapy around ages 15 or 16. HRT has an even longer history of use than puberty blockers, making its debut in the 1940s. And yes, cis people use HRT too.

This care is safe and life-saving

Gender affirming care for trans youth has the backing of every major medical association in the U.S. Last year, in response to legislation that would ban the care, many of these orgs offered a joint statement testifying to the simple truth that, “Patients and their physicians, not policymakers, should be the ones to make decisions together about what care is best for them.”

The medical consensus supporting gender affirming care is reinforced not only by ideals, but also by fact. Trans and nonbinary youth who have access to gender affirming care display improved mental health outcomes. There have been 15 studies looking into the effects of this care on trans young people that point to lowered rates of depression, anxiety, body dissatisfaction, self-harm, suicidal ideation and suicide attempts. To put it plainly: this healthcare is necessary. It is saving the lives of young people. 

The consequences of banning care

Banning gender affirming care for trans youth and forcing them into endogenous puberty is not an impartial act. The WPATH makes this evident: “As the level of gender-related abuse is strongly associated with the degree of psychiatric distress during adolescence (Nuttbrock et al., 2010), withholding puberty suppression and subsequent feminizing or masculinizing hormone therapy is not a neutral option for adolescents.” Far from the professed goal of preventing harm to trans minors, HB 253 and SB 84 actively impose it.

Put a stop to this nonsense

Contact legislators who want to ban this life-saving care to tell them to put a stop to these bills. You can find HB 253 and SB 84’s sponsors’ emails, phone numbers and twitter handles at the links below. If you live in the district that they represent, please reach out! Even if your legislators aren’t a sponsor of these bills, find their contact information at openstates.org, and let them know that you oppose anti-trans legislation.

Senate Bill 84 Sponsors

Senator Robby Mills for District 4 (Henderson, Hopkins, Union, Webster counties)

Senator Mike Wilson for District 32 (Logan, Simpson, Todd, Warren counties)

Senator Rick Girdler for District 15 (Clinton, Cumberland, Pulaski, Russell, Wayne counties)

Senator Adrienne Southworth for District 7 (Jefferson, Shelby, Henry, Anderson counties)

Senator Phillip Wheeler for District 31 (Pike, Elliott, Johnson, Lawrence, Martin counties)

House Bill 253 Sponsors

Rep Savannah Maddox for District 61 (Boone, Grant, Kenton, Scott counties) 

Rep Shane Baker for District 85 (Laurel and Pulaski counties)

Rep Josh Calloway for District 10 (Breckenridge, Hancock, Hardin counties)

Rep Melinda Gibbons Prunty for District 15 (Hopkins and Muhlenburg counties)

Rep Scott Sharp for District 100 (Boyd county)

Rep Nancy Tate for District 27 (Hardin and Meade counties)

Rep Walker Thomas for District 8 (Christian and Trig counties)

If you have funds available please donate to the ACLU of KY Foundation, who will be fighting tooth and nail to block any anti-trans legislation in the state.

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