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House Lawmakers Clash Over Gender-Affirming Care in Youth

— Republicans say it causes long-term medical complications, Democrats say it's safe and effective

MedpageToday
A screenshot of Mike Johnson speaking during this hearing.

Lawmakers clashed over the safety of gender-affirming care in minors on Thursday, during a of the House Judiciary Subcommittee on the Constitution and Limited Government.

Republicans condemned the practice, which they characterized as "mutilation," while Democrats argued such care is safe and effective, citing the support of multiple medical groups.

Subcommittee Chairman Rep. Mike Johnson (R-La.) kicked off the contentious hearing with a video clip of a surgeon describing performing vaginoplasties and phalloplasties. "This is the mutilation of children, and it should be prohibited by our law," Johnson said.

Rep. Harriet Hageman (R-Wyo.) likened gender-affirming care to the Tuskegee experiment, adding that "it causes irreversible sterilization and serious long-term medical complications and long-term reliance on pharmaceuticals."

Rep. Mary Gay Scanlon (D-Pa.), ranking member of the subcommittee, countered Republican arguments by stating that gender-affirming care is "safe and effective" and "essential to the mental health and well-being of trans youth."

"The idea that politicians are more qualified to judge the medical value or necessity of gender-affirming care than every major medical organization is absurd," she said, noting that such care is supported by the American Academy of Child and Adolescent Psychiatry, the American Medical Association, and the American Academy of Pediatrics.

Scanlon also chastised Republicans for "repeating right-wing talking points to de-legitimize critical healthcare."

"Words matter," she added, pointing out that the language Republicans use is helping to drive discrimination and violence against trans children and their families.

Jerrold Nadler (D-N.Y.), ranking member of the full Judiciary Committee, also voiced concerns about the vulnerability of these children and families, with transgender youth experiencing higher rates of depression, anxiety, and suicidal thoughts than cisgender youth, according to a mental health survey from the Trevor Project.

"It can't help that they are under siege by Republican-dominated state legislatures," he added.

At last count, 76 anti-transgender bills have been signed into law. And yet, every single federal court judge asked to consider the constitutionality of these laws has found that they "violate parents' constitutional rights," he said.

During the hearing, the subcommittee heard testimony from both the parent of a transgender child and a "detransitioner" -- an adult who transitioned from her sex at birth to male and then back to female.

Two Lives, Two Stories

Myriam Reynolds, a licensed professional counselor, first realized her son was transgender when he was 11 years old.

While she mourned the loss of her "little girl," Reynolds put her child's needs first, and she and her husband found a comprehensive program at a nearby hospital in Colorado where they connected with a multi-disciplinary care team consisting of physicians, social workers, psychologists, and other clinicians.

After moving to Texas, Reynolds found a similar care team and her son, Cameron, was given puberty blockers and hormone therapies. She said she does not support surgery for her son at this stage.

However, she added, "I have no doubt that the healthcare my son accessed was life-saving."

Asked what it feels like to have the government fight against gender-affirming care, Reynolds said, "It's extremely stressful. It's extremely distracting, and it produces all kinds of fear."

If it were financially feasible, Reynolds said she and her family would have left Texas.

"We have no choice but to at least try to tell our story," she said, in the hopes that at least some people will understand.

Chloe Cole, a "detransitioner" and advocate, took the opposite view.

At age 12, Cole told her parents she was transgender and her parents sought help from medical professionals. Cole said she was "fast-tracked onto puberty blockers and then testosterone."

The testosterone injection caused changes to her voice, her nose, and her jawline, and made her Adam's apple more prominent. At 15, Cole had a double mastectomy. Cole said her transition from female to male caused "lifelong irreversible harm ... I look in the mirror sometimes, and I feel like a monster."

Looking back, Cole said, "When I told my parents that I felt like a boy, in retrospect, all I meant was that I hated puberty, that I wanted this newfound sexual attention to go away."

Shannon Minter, legal director for the National Center for Lesbian Rights, said Cole's story represents "the exception and not the rule."

The "vast majority of young people who receive these treatments are getting them after careful assessment and because they really need them," Minter said, noting that 98% of young people who receive treatment continue to receive them into their adult years.

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    Shannon Firth has been reporting on health policy as MedPage Today's Washington correspondent since 2014. She is also a member of the site's Enterprise & Investigative Reporting team.