Bill limiting medical care for transgender youth passes committee again

Opponents say the bill is unnecessary, harmful to trans youth community

Illlustration by Getty Images.

Before the House Judiciary Committee again passed a bill limiting medical care to transgender youth, Shawn Reagor told legislators House Bill 427 would have life or death consequences.

Reagor said he spent hours in the emergency room’s parking lot last week waiting to learn the fate of a 19-year-old transgender woman who attempted suicide.

The emotional story came during Reagor’s testimony Monday on behalf of the Montana Human Rights Network in opposition to HB427. Reagor said he was told by the woman’s roommate that when the woman found out the bill restricting the type of care doctors can provide to trans gender youth had resurfaced in the legislature, it caused her to “completely lose hope.”

“The actions that you take today and the vote that you take today will have life and death effects. We got lucky this time,” Reagor said.

The bill passed committee on an 11-8 vote with Rep. Mallerie Stromswold, R-Billings, once again the lone dissenting Republican. HB427 is the revival of HB113 and will go on to be heard on the House floor.

After HB113 failed twice on the house floor in January, Whitefish Republican Rep. John Fuller introduced HB427. HB427 is nearly identical but would only bar doctors from performing certain gender-affirming surgeries and not from using puberty blockers and other hormones to treat minors experiencing gender dysphoria as HB113 did.

Four people showed up to testify on behalf of the bill Monday. In contrast, more than a dozen people, including multiple medical professionals, members of the trans community and civil rights groups, testified against it.

Among other things, opponents argued the bill would negatively impact the mental health of trans youth and make it harder to recruit pediatricians to the state. They also said that the legislature should let expert medical providers determine how to best treat their patients.

Medical professionals have said the bill is unnecessary because genital gender-affirming surgery on minors goes against best-practice medical guidelines. In rare cases, top surgery is performed on minors 16-years-old and older.

Those who testified for it said it is meant to protect children from making medical decisions they may regret later in life.

One proponent who testified denied the reality that trans people exist — a point S.K. Rossi, a lobbyist for the cities of Bozeman and Missoula, strongly rejected.

“The problem with that is that we do exist … as your neighbors, probably as your family members who are too scared to tell you, and they exist in this building,” Rossi said.

Rossi, who frequently testifies on behalf of LGBTQ rights, said they are tired of it. “We come to you during every single one of these hearings and ask you to just leave us alone … the intent of this bill, as far as I can tell from the supporters, is to push trans people out of the state. We’re not going anywhere, and we’d appreciate it if you’d leave us alone.”

Testifying on behalf of Montana’s Pride Foundation, Quinn Leighton said if the legislature wants to pass bills like HB427, they should at least consult the people most affected.

“I think it’s always best that not only are they consulted, but they’re at the table, helping to inform those decisions,” Leighton said. “I’m afraid that bills like this are moving forward are being made on behalf of their livelihood and their lives without actually talking to them.”

Because the bill would deny transgender youth access to surgeries that would remain available for their cisgender peers, the bill would create equal protection problems, said Laurel Hesse, a legislative program manager for Montana’s American Civil Liberties Union.

“This bill is not at all about protecting kids, but instead is driven by invidious purpose and bear desire to harm transgender people,” she said.

The loosely defined medical conditions and procedures in the bill combined with the litigation it allows would make Montana an unattractive place for pediatric specialists to practice, said Dr. Erin Grantham, the state’s only pediatric urologist. A healthcare professional shortage already exists in the state.

“The incentive to litigate makes it professionally unsafe for us to do medically necessary surgeries in Montana … surgeries which have nothing to do with gender identity,” she said.  Additionally, she said, words like “normal” and phrases like “medically verifiable” used in the bill are open to broad interpretation and invite litigation.

“Trying to legislate medical care in an area as complicated as this can be a little bit dangerous,” she said. “I’m asking you to allow trained physicians and other medical providers to continue to make good medical decisions with family members and not work against a Boogeyman that doesn’t exist in Montana.”

Some opponents also said the bill would harm the care provided to children outside the context of treating gender dysphoria.

“The bill has language to allow for surgery for intersex children. However, an unintended consequence of this bill is that it does not include all of the reasons why some intersex children require surgery,” said Dr. Lauren Wilson, vice president of Montana’s Chapter of the American Academy of Pediatrics.