Legislation to limit gender-affirming care to trans youth may reappear

A similar bill failed in the Montana Legislature

By: - February 15, 2021 7:31 pm

Detail of the stained glass at the Montana state capitol in Helena. The capitol was completed in 1899 and then an addition was completed in 1911. (By Eric Seidle for the Daily Montanan.)

Despite socially conservative legislation mostly flying through a GOP-controlled House, liberal opponents were able to twice squash an effort to bar doctors from providing gender-affirming care to transgender youth.

But Manhattan Republican Rep. Jennifer Carlson is not giving up.

On Monday, a bill drafted by Carlson similar to the failed House Bill 113, albeit less restrictive, was one step away from being formally introduced to the Montana Legislature.

Both bills aim to restrict the type of care that medical providers can use to treat minors experiencing gender dysphoria.

However, Carlson’s bill would only ban surgical procedures and not puberty blockers or other hormonal remedies when treating gender dysphoria.

Puberty blockers are common and follow best-practice medical guidelines for treating minors experiencing gender dysphoria, while surgeries are rare, according to Dr. Lauren Wilson, vice president of the Montana Chapter of the American Academy of Pediatrics.

Carlson’s bill would also prevent doctors from referring patients to health care providers for gender transition surgeries.

Health care providers found violating the prohibitions in such bills could result in their medical licenses being revoked.

The bill draft could change before it is formally introduced.

Rep. John Fuller, R-Whitefish, who carried HB113, said he has not looked at Carlson’s newly drafted version yet. He said he does not believe that puberty blockers should be used in treating gender dysphoria but said he would consider supporting a bill that only banned surgeries if that’s what it took for it to pass in the House.

Carlson did not respond to emails, calls or texts for comment. Dylan Klapmeier, spokesman for the House GOP, said leadership had no comment on the matter.

Proponents of the legislation, including Carlson and Fuller, have argued it is necessary to protect children from making a medical decision they may come to regret later in life.


Wilson criticized the legislature for inserting itself into private medical decisions.

“We don’t have laws about appendectomies or cancer procedures for kids, so I don’t know why we would legislate medical care in this scenario when there are already clear guidelines,” she said.

SJ Howell, on behalf of the Free and Fair Coalition — a group of more than a dozen Montana organizations that oppose anti-transgender legislation — said the coalition believes the changes in Carlson’s bill are designed to get back some of the votes lost on HB113 and will make it more likely to pass the House.

Despite the changes, Howell said the coalition’s message remains the same: “This is still interfering in private medical decisions that families are making with their doctors, and it is harmful and discriminatory and sends the wrong message about Montana.”

House Minority Leader Rep. Kim Abbott, D-Helena, said she wished that Republicans would move on from the issue.

“Our colleagues remain fixated on moving legislation designed to intimidate Montana kids,” Abbott said. “I’m sure that all Montanans would like them to get to work on issues that matter.”

Abbott also said she is hoping House members will listen to the same voices that opposed HB113 and convinced the majority to reject the bill.

“We’re hopeful we can continue to hold the line,” she said.

Opponents of Carlson’s newly drafted bill and HB113 said the legislation is unnecessary and further marginalizes the trans youth community, which already experience higher rates of depression and suicide.

A study published by the American Academy of Pediatrics said providing appropriate gender-affirming care to youth can lead to fewer mental health problems.

Wilson said she is not aware of any instances that the gender reassignment surgery described in the bill was performed on a minor in Montana.

“I don’t think there are any surgeons in Montana that even do those surgeries,” she said. “I just find it strange that the legislators are going out of their way to make this stand about something that is not an issue, and it seems they are out to make transgender youth feel like they deserve to be marginalized by society.”

When it comes to treating gender dysphoria, she said puberty blockers and hormones are the mainstays of best-practice care for trans youth.

The House Judiciary Committee first heard testimony on Rep. Fuller’s HB113 on Jan. 18, along with another bill he sponsored, HB112, that would ban K-16 trans athletes from participating on sports teams that align with their gender.

Both bills passed out of committee on an 11-8 vote with Rep. Mallerie Stromswold, R-Billings, the lone Republican to vote no. Unlike HB113, HB112 passed out of the House and moved onto the Senate.

Howell said, like HB113, Carlson’s bill is an overstep by the legislature.

“The truth is that trans youth already face harassment and bullying and discrimination, and having the state get involved in private medical decisions seems like a harmful overstep,” Howell said.

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Keith Schubert
Keith Schubert

Keith Schubert is a reporter for the Daily Montanan. Keith was born and raised in Wisconsin and graduated from the University of Minnesota in 2019. He has worked at the St.Paul Pioneer Press, Milwaukee Journal Sentinel and most recently, the Asbury Park Press, covering everything from local craft fairs to crime and courts to municipal government to the Minnesota state legislature. In his free time, he enjoys cheering on Wisconsin sports teams and exploring small businesses. He can be reached by text or call at 406-475-2954 .