GOP lawmakers pass ban on gender-affirming care for minors

DES MOINES — A proposed ban on gender-affirming care for minors in Iowa is on its way to Gov. Kim Reynolds’ desk.

Republican state lawmakers passed the ban and other LGBTQ bills over the past two days, putting them en route to Reynolds on Wednesday.

Reynolds’ office did not immediately respond Wednesday when asked whether she plans to sign the bill into law once it reaches her.

Thousands of Iowans have publicly protested this bill and others that have been moving through the Iowa Legislature over the past week. Students at dozens of schools across the state walked out of classes, and hundreds attended two rallies at the Iowa Capitol this past week, on Sunday and again on Wednesday.

If the bill is signed into law, it likely will be at least temporarily halted by a legal challenge. Similar bills in other states are being challenged in the courts, including in Arkansas, Alabama, Tennessee and Texas.

Republican legislators who proposed and advanced the ban on gender-affirming care say it is necessary to protect children from medical care and treatments when the science is not settled, even though all major medical groups in the U.S. say the treatments are safe and the vast majority of studies show that the care leads to better mental health outcomes.

Studies cited

During debate Wednesday, Rep. Steve Holt, R-Denison, who oversaw the bill’s movement in the Iowa House, pointed to studies in Europe, including one that says more study is needed on the long-term effects of gender-affirming care.

The study says there is some evidence that individuals who have sex reassignment have “considerably higher risks for mortality, suicidal behavior and psychiatric morbidity than the general population.”

“Our children deserve the time to grow into themselves, to find themselves, to go through phases without medical interventions that are unproven in their efficacy,” Holt said. “It is for these reasons that I believe we should wait on these life-altering procedures and therapies for children until they are adults.”

During debate in the Iowa Senate on Tuesday, Sen. Jeff Edler, R-State Center, who oversaw the bill’s movement in that chamber, pointed to a study that he said illustrates his concern for the long-term impacts of hormonal treatment.

The 2018 study, which can be found on the American Academy of Pediatrics website, says the long-term side effects of hormonal treatment could include bone density loss and also says more research is needed on those long-term impacts. However, it also concludes the treatments benefit the patients and are generally safe.

Republican Rep. Jeff Shipley pointed to the guidance from the World Professional Association for Transgender Health, which says the “number of studies is still low, and there are few outcome studies that follow youth into adulthood.”

Still, those guidelines recommend puberty blockers and hormone treatment in adolescents with gender dysphoria who meet certain conditions, and the organization “vehemently” opposes bills like the one passed by Iowa Republicans.

Rep. Austin Baeth, D-Des Moines, who is a physician, noted the preponderance of evidence continues to show that while the treatments sometimes come with side effects, that they are safe, and that studies and physicians that cast doubt on the treatment’s safety are outliers.

“It takes lots of physicians … to come together, looking at all the studies, not cherry-picking them to support an agenda,” Baeth said. “But looking at the mountain of evidence, the preponderance of evidence, and deciding, what is the most likely answer to this question.”

What bill does

The bill would ban doctors in the state from providing puberty blockers, hormones and surgeries to minors under age 18 to treat gender dysphoria.

Doctors who violate the bill would be subject to discipline from a state licensing board, and individuals could bring lawsuits against doctors who perform gender-affirming care.

Minors who are receiving medical treatment now would have 180 days to discontinue that care.

Parental choice

Brian Lohse, R-Bondurant who was one of five House Republicans voting against the bill, said the bill runs counter to the “parental choice” mantra Republicans frequently champion.

The doctors who testified to lawmakers in February said puberty blockers — medications that stop the onset of puberty — are reversible, while the effects of hormone treatment are mostly reversible. Surgery, which generally means breast reduction, is not reversible.

Doctors also told lawmakers that gender-affirming care is a practice that occurs after months of careful evaluation from multiple doctors, and that parental consent is always involved.

Democrats said the bill is a rash reaction to concerns over the efficacy of the care, noting all major medical organizations in the U.S. support interventions for youth with persistent gender dysphoria. The American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association all include gender-affirming care for youth in their guidelines.

Protest

As lawmakers deliberated the bills, a couple of hundred people gathered in the Capitol’s first-floor rotunda to protest the measures they said would harm LGBTQ youth and strip them of their rights.

Jo Allen, a photographer from Des Moines who is nonbinary, said it is difficult to live in Iowa, given the legislation under consideration. A few speakers at the rally said they are considering leaving the state over the proposals.

“Anti-trans bills have nothing to do about privacy but (are) focused on expelling trans folks from public life,” Allen said. “We are not going anywhere and, despite the bills that you put out against us, we will continue to be our most authentic, trans selves.”

Just north of Iowa on Wednesday, Minnesota Gov. Tim Walz, a Democrat, signed an executive order that protects trans people, families and care providers from a range of legal repercussions for traveling to Minnesota for gender-affirming care, the Associated Press reported.

Walz announced his signing on social media, saying in the post, “My message is clear: Here in Minnesota, our LGBTQ+ neighbors will not be denied or punished for seeking life-affirming and lifesaving medical care.”

Other bills

The Senate late Tuesday also passed a bill that would prohibit transgender students from using school bathrooms that correspond with their gender identity.

Senate Republicans described the proposal as common sense and a way to ensure the privacy and safety of all Iowa students.

Data overwhelmingly shows that incidents of sexual assault in school bathrooms are rare, and that transgender individuals are far more likely to be victims of sexual assault than non-transgender people, including at schools with prescriptive bathroom policies.

House Republicans on Wednesday also passed a bill, largely along party lines, that bans instruction on gender identity and sexual orientation in kindergarten through sixth grade.

Republican Rep. Skyler Wheeler, the chair of the House Education Committee and the bill’s floor manager, said the bill prevents teaching about topics that he thinks should be left to parents, saying students should learn about classic school subjects and not social issues.

“They do not go to school to learn about woke, radical, gender ideology,” he said. “Put simply, parents should parent, and teachers should teach.”

The legislation mirrors provisions in a more expansive bill proposed by Reynolds, which also includes restrictions on library books and parental consent for children to transition their gender at school. It has drawn comparisons to Florida’s so-called “don’t say gay” law.

Democrats said the bill would bar teachers from answering questions from their students.

“If you can’t talk about the real world, and the real people in it, who sometimes happen to be from the LGBTQ+ community, then what’s the use of being there?” said Rep. Ruth Ann Gaines of Des Moines, a former K-12 teacher and current community college professor. “Teaching and learning involves more than books.”

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