The first U.S. trial over a statewide ban on gender-affirming care for children began in Arkansas this week, and its implications are significant for LGBTQ youths in the state and across the country.
A suit, filed by the American Civil Liberties Union of Arkansas on behalf of the families of four transgender youths and two doctors who provide gender-confirming care, is attempting to formally stop a ban on providing gender-confirming treatment – including hormones, puberty blockers or surgery – to anyone under 18 years old.
Arkansas last year became the first state to enact a ban on gender-affirming care. Republicans in the state’s Legislature overrode Gov. Asa Hutchinson’s veto of the legislation. U.S. District Judge Jay Moody temporarily blocked the law last year; that block was upheld by a panel of the 8th U.S. Circuit Court of Appeals in August.
Major medical groups oppose ban on care
The ban has been publicly opposed by the American Medical Association and American Psychological Association, and research has shown that gender-confirming health care is not only safe, but beneficial to the mental health of LGBTQ youths.
Transgender teens have the highest rates of attempted suicide in the country, according to a study conducted by the American Academy of Pediatrics, and gender-confirming hormones and puberty blockers may be associated with lowering depression and suicide risk in transgender and nonbinary youths, according to research in JAMA Pediatrics.
“It’s completely inappropriate for states to regulate medically necessary care that is supported by every major medical association in this country,” Sarah Warbelow, Legal Director at the Human Rights Campaign, told USA TODAY. “This is well-researched care that has been going on for a long time. It’s not something new … we do know what the outcomes are for youth who receive gender affirming care, and that they’re positive outcomes.”
Many state LGBTQ advocacy groups say the ban discriminates against transgender youths and ignores existing medical literature that supports the need for access to gender-affirming care.
“We hope that our elected officials can be guided by the opinion of informed professionals who have put diligent time and effort into seriously researching issues of transgender physical and mental health,” River Valley Equality Center, an Arkansas LGBTQ community building organization, wrote in a statement to USA TODAY. “Many lives depend on getting this right.”
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Bill part of a trend targeting LGBTQ people
Arkansas’ ban is part of a larger trend in legislation targeting the LGBTQ community in the United States. Twenty-six states have either introduced or enacted anti-LGBTQ bills – from classroom censorship to book bans to school sports access to health care restrictions – in 2022, according to the Human Rights Campaign.
In Alabama, part of a new law that made it a felony to prescribe puberty blockers and hormones to transgender youths was blocked by a federal judge in May, and a Texas judge halted the state’s current and future child-abuse probes for children who have received gender- affirming medical care.
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Megan Tullock, director of programs and advocacy for Northwest Arkansas Equality, said the politicization of debates over LGBTQ health care and education is placing an already vulnerable population in a challenging position, especially transgender youths.
“It’s awful for trans kids and trans grown-ups,” Tullock said. “They’re people, and having their lives be political ping pong balls is just awful … when you know what you need, your doctors know what you need, that care is available and your government actively steps between you and that care, it affects all of your waking time.”
Should the ban on the Arkansas law be overturned, doctors who provide gender-confirming care to minors could lose their licenses, face other disciplinary measures and even face lawsuits.
Case could have larger consequences
In either outcome, the Arkansas suit could have repercussions for those beyond trans and nonbinary youth, according to Warbelow. Should the ban go into effect, other states that have considered similar bans may expedite bills in the next legislative session, while if the ban is struck down, it could serve as a deterrent to those politicians, she said.
Advocates for the law have argued the ban is within the state’s authority to regulate medical practices and will prevent those under 18 from making “life-altering, permanent decisions,” according to Republican Attorney General Leslie Rutledge.
But many options for gender-affirming care for youth are not irreversible, and misrepresentation of medical literature has led to misinformation – and disinformation – on the facts of gender-affirming care, according to Warbelow.
“Especially when we’re looking at puberty blockers, this is a pause button. It is designed essentially to give young people time to grow and reflect on their their gender identity,” she said. “It’s important that the courts, when they’re looking at these matters, really are taking into account what is accurate in the medical literature.”
The trial is expected to last two weeks, and Moody began hearing testimony and evidence in the case on Monday.
Contributing: The Associated Press
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