Gender-affirming care ban for transgender minors has second hearing

A bill to ban gender-affirming care for transgender minors received nearly three hours of testimony Monday in its designated House committee, the first major action on the legislation since it passed out of the Senate in early February.

Senate Bill 99 — part of a national wave of bills seeking to curb transgender health care and, more broadly, LGBTQ expression and public accommodations — would prohibit health care providers in Montana from providing puberty blockers and cross-sex hormones to anyone under age 18. The bill also bans a list of surgical procedures, such as mastectomies, which medical experts have testified are rarely or never practiced on teens in Montana.

Other parts of SB 99, sponsored by Sen. John Fuller, R-Kalispell, prohibit public funds such as Medicaid from directly or indirectly paying for the list of banned medical procedures. The bill also generally bars state employees and facilities from “knowingly” providing gender-affirming medical care or being used to “promote or advocate the use of social transitioning,” such as using pronouns or clothing that affirms a minor’s gender identity.

Proponents and opponents clashed during testimony before the House Judiciary Committee, echoing arguments presented to the Senate in January. Opponents, who outnumbered proponents in both hearings, blasted the bill as unconstitutional, discriminatory, and an infringement on medical choice and parental rights. Supporters of SB 99, including national conservative policy groups supporting similar bills in other states, generally decried gender-affirming medical care for minors, with some going as far as to equate the interventions to child abuse.

In his opening remarks to lawmakers Monday, Fuller framed the bill as a way to protect impressionable children from medical decisions and social pressures they can’t fully comprehend.

“Health professionals take an oath to do no harm, and altering the physical appearance of a child without their majority consent is unconscionable,” Fuller said. “… The state of Montana has the responsibility and the right to protect children from such tactics, and I urge a do-pass.”

Transgender teens, parents and medical professionals blasted that characterization, instead portraying a gradual process with many layers: social transitioning, puberty blockers to temporarily delay pubertal onset, and potentially hormone therapies to address longstanding gender dysphoria.

“It is typically a long, slow process with many professional evaluations over months and sometimes years to determine which medical options are best for each individual adolescent,” said Dr. Kathryn Lowe, a Bozeman pediatrician representing the state chapter of the American Academy of Pediatrics. “These medications cannot be prescribed without both parents consenting.”

Another member of the pediatrician group presented lawmakers on the committee with a list of 20 state medical organizations and hospitals that are also opposed to the bill, including the Montana Medical Association, the Montana Psychological Association and the Montana Association of Pediatric Psychiatrists.

Other of the roughly 40 opponents with personal experience of gender-affirming care expressed frustration and anger at lawmakers for considering a bill that would risk destabilizing the medical care that their families have come to rely on.

Phoebe Cross, a 15-year-old from Bozeman, said they were part of the “target demographic” for SB 99. They recounted being severely depressed when they hit puberty but eventually started taking testosterone, an intervention they said has helped them be able “to look in the mirror and smile.”

“This bill is going to be taking away my right to health care and essential medical care,” Cross said. “I have gone through so many medical professionals to go on testosterone. I have the approval of multiple therapists, gender-affirming care specialists and general physicians, all of them in strong support of me going on testosterone as it has saved my life.”

Parents of transgender children testified to the Republican majority committee about similar themes. Some described conducting painstaking research and seeking myriad medical opinions after their children expressed gender nonconformity or dysphoria. Others pointed out that, if the bill becomes law, breast reductions or enhancements and other significant surgeries would still be accessible to families with cisgender children, while such procedures for transgender kids would be illegal.

“Let’s face it, we are here today because some of you are uncomfortable looking at transgender people. So you are trying to make it harder for them to exist,” said Jessica Vangarderen Weingarten, a Belgrade mother with a transgender daughter. “If you vote for this bill, you will be taking away the only treatment we have found that has offered any sort of relief for my daughter. I cannot believe you would even consider that. You’re not even offering any other options.”

Fuller was backed by roughly 30 proponents, including Montana parents and grandparents who expressed fear and outrage about the availability of gender-affirming treatments for minors, regardless of parental consent.

“As my daughter was growing up, she couldn’t even decide what she wanted on her sandwich or what she was going to wear to school,” said Helena resident Ruth Rater. “… I would just ask that you consider, if you can’t go to an R-rated movie until you’re 17, that you should not have this type of surgical procedure pushed upon a minor that has difficulty making decisions on who they are.”

Democratic lawmakers on the committee, including Rep. Zooey Zephyr, D-Missoula, repeatedly objected when proponents testified that transgender minors were being “mutilated” by gender-affirming care. Zephyr said the procedures some proponents talked about where services she herself had obtained. Committee chair Amy Regier, R-Kalispell, said the objections were noted but did not prohibit the use of the phrase in testimony, saying opponents were expressing their opinions.

Lawmakers may decide to amend SB 99 to weed out some of the controversial provisions. Rep. Casey Knudsen, R-Malta, drafted two such changes that he told Montana Free Press on Monday are aimed at clarifying how the law would impact medical providers who accept public insurance and create a smaller window for when patients can sue over alleged harm.

The committee did not debate or vote on the bill after the hearing. Regier said a decision could happen as soon as this week, depending on other amendments committee members may be considering.

SK Rossi, one of the lobbyists opposing the bill on behalf of the Human Rights Campaign, suggested they would not be surprised if SB 99 passed out of committee and eventually proceeded to Gov. Greg Gianforte’s desk. In that way, they said, SB 99 is one chapter of a long history in LGBTQ people working to advance civil rights.

“Eventually, we’re going to win,” Rossi said. “… Eventually, this obsession with trans people and our bodies and forcing us into these rooms to talk about ourselves will do nothing but reveal the cruelty of these bills and this process, and the public will move further towards us. It is an unconstitutional bill. We will fight it in court, and there is no way to fix it because the central tenet of it is unequal treatment for transgender people.”

Reporter Mara Silvers can be reached at msilvers@montanafreepress.org. The Montana Free Press is a Helena-based nonprofit newsroom. To read the article as originally published, click here.