A wave of legislative attacks on the rights of transgender youths continues to pummel the country, but nowhere is the fight for rights more contentious than in Arkansas. The state recently passed a first-of-its-kind bill that prohibits physicians from offering gender-affirming surgeries to transgender individuals under 18 years of age––a significant setback for transgender rights.
The new state statute bans physicians from prescribing puberty-blocking drugs, hormones and even gender-affirming surgeries to minors, even if they have parental consent. If physicians violate the law, they could lose their state licensure and may be subject to litigation.
The timeline of the bill, The Save Adolescents from Experimentation Act (HB1570), reveals just how controversial it stands. It was initially passed by the Arkansas legislature in March, with a 28-7 vote in the State Senate and a 70-22 vote in the State House. Republican Gov. Asa Hutchinson vetoed the bill, noting it was too extreme even for him.
“If House Bill 1570 becomes law, then we are creating new standards of legislative interference with physicians and parents as they deal with some of the most complex and sensitive matters involving young people,” Hutchinson said of the bill earlier this month. “It is undisputed that the population of minors who struggle with gender incongruity or gender dysphoria is an extreme minority. But while they are a minority, they deserve the guiding hand of their parents and of the healthcare professional that their family has chosen.”
However, Hutchinson is supportive of other anti-trans legislation, even signing into law a bill that prevents transgender athletes from competing in female sports also in March. His veto did not matter in the end, as the Arkansas legislature fired back override votes in both congressional chambers to make the bill law of the land.
The fight reveals that even for some anti-LGTBQ Republicans, taking away health care and criminalizing doctors is a step too far. Unfortunately, Arkansas is not the only state seeking to ban trans youth from sports; Tennessee, Mississippi and Alabama have also passed anti-trans sports legislation.
Anti-LGBTQ Bills on the Rise
Arkansas is one of the first states to affirm these anti-trans laws, but there are others cropping up across the country.
More than half of the states in the country are voting on anti-transgender legislation this year, with much of it is focused on minors, according to the American Civil Liberties Union (ACLU). These states include: Alabama, Georgia, Florida, Kansas, Kentucky, Louisiana, Missouri, Montana, New Hampshire, Oklahoma, South Carolina, Tennessee, Texas and Utah.
Here are a few of the ongoing legislative attacks:
In February, Alabama reintroduced the Vulnerable Child Compassion and Protection Act (SB10), a rule that prohibits gender change therapy for minors and bans withholding of certain related information from parents.
North Carolina introduced the Youth Health Protection Act (SB514), which bans medical professionals from providing gender-affirming services to anyone under 21 years of age. The law also mandates government employees to notify parents or guardians if a minor shows signs of gender nonconformity or gender dysphoria.
In response to the bill, more than 1,500 parents of transgender, non-binary, and gender-expansive youth penned a letter with the Human Rights Campaign to state legislatures condeming the anti-LGTBQ bills across the country.
“Transgender children are children,” HRC President Alphonso David said. “They deserve the ability to play organized sports and have access to medically-necessary care, just like all children. These bills are cruel—and parents are not going to be silent when elected officials attack their children through discriminatory legislation.”
The attacks on trans youth gaining traction are all happening at the state level, which the favored approach by Republicans to attack rights. When it comes to women’s health care, Republican-led legislatures have been very successful at chipping away reproductive rights in several states over the last decade. And the issue is still ongoing, with Texas Gov. Greg Abbott recently attempting to use the Covid-19 pandemic as a means to temporarily take away abortion care altogether. Also this year, South Carolina attempted to ban abortion before many women will even realize they’re pregnant.
So far, there are 192 anti-LGBTQ bills in state legislatures being considered, 101 of which directly target transgender people and 30 that also deny medically-necessary services and gender-affirming care to transgender youth, according to the Human Rights Campaign.
While these types of bills are harmful, they’re also wildly unpopular and cause states that pass them to suffer economic, legal and reputational consequences. For example, North Carolina is expected to lose $3.76 billion over 10 years from a bathroom bill it passed, while Idaho lost support and ability to host NCAA tournaments after passing an anti-transgender sports bill, which eventually was overturned.
“This is the first law of its kind anywhere in the country, and it is immeasurably cruel to the transgender children who already suffer from higher risks of anxiety, depression, body dysphoria, and suicidal ideation and for whom those risks will only increase without medical care,” David said. “This broadly unpopular bill is anti-science and dismisses the medical expertise of a wide range of child welfare advocates.”
Physicians Oppose Anti-LGTBQ Laws
Medical societies are taking note of the growing anti-transgender legislation––and voicing their opposition to state legislatures getting involved with what happens between doctors and patients. In a joint statement, The Endocrine Society and the Pediatric Endocrine Society noted their opposition to legislation that blocks transgender individuals from getting gender-affirming surgeries and treatments, citing a high risk of suicide and other health disparities from these actions.
The American Psychiatric Association (APA) agrees, stating health is a basic human right for all individuals, regardless of gender identity or orientation. Gender-affirming care is part of comprehensive primary care and considered medically necessary, and access to such care can be life or death. Transgender individuals who do not receive the gender-affirming care they need can develop psychological illness, which may turn deadly.
Statistically, the transgender population, as well as the LGTBQ population, faces higher rates of suicide––a 2020 study found that nearly half of gay, lesbian, bisexual, transgender and other gender nonconforming young Americans attempted suicide in the previous 12 months.
In their statement, the APA also opposed efforts by government entities to punish physicians who want to provide gender-affirming care for their patients, which is a key component of the new law in Arkansas.
“Physicians must be able to practice medicine that is informed by their years of medical education, training, experience and the available evidence, freely and without threat of punishment,” the APA said. “Patients and their physicians, not policymakers, should be the ones to make decisions together about what care is best for them.”
A key concern around the implementation of the new Arkansas law is that it does not take into account the minors who are already receiving gender-affirming hormone treatments in the state.
It’s unclear if the law in Arkansas will stand for long. The ACLU is preparing to file suit to support the state’s transgender youth.
“ACLU supporters from around the country spoke out against this bill,” Chase Stangio, deputy director for transgender justice with the ACLU's LGBTQ & HIV Project, said in a statement. “We will always have your back and will be relentless in our defense of your rights.”
Parents are fighting back, too.
“Transgender folks are so tired, tired of fighting for their existence,” the group of parents wrote with HRC in their April 12 letter. “And parents like us are tired of begging you to see our kids and treat them as full and equal members of society.”