Ban on healthcare for trans youth one step away from final legislative approval

Oct 01, 2023

A transgender Pride flag is covered with the words "Hands Off Trans Youth." Hundreds of people gathered Friday, March 31, 2023, at Washington Square Park in New Orleans for a march to mark Transgender Day of Visibility. (Greg LaRose/Louisiana Illuminator)

The Louisiana Senate has approved a ban on gender-affirming healthcare for transgender youth that had previously been killed in the Senate Health and Welfare Committee.

The Senate passed House Bill 648 by Rep. Gabe Firment, R-Pollock, on a 29-10 vote Monday. Sen. Fred Mills, R-Parks, the Senate Health and Welfare Committee chairman who was the deciding vote to kill the bill when he came before his committee, was the sole Republican to oppose the bill. Three Democrats — Sens. Katrina Jackson of Monroe, Gregory Tarver of Shreveport and Gary Smith of Norco — bucked their party to support the bill.

Firment's bill is similar to proposals filed in at least 17 other states, including every other state on the Gulf Coast. An Associated Press analysis found most of these bills have strong similarities to model legislation right-wing organizations have put forward.

After Mills’ committee vote, the controversial bill seemed dead, but ultra-conservative lawmakers quickly coalesced to revive the bill. Lawmakers told reporters the next day they would either recommit the bill to another committee or attach the ban's provisions to a bill in the House.

On June 1, the first day of Pride month, the Senate recommitted the bill to the Senate Judiciary A Committee, which passed the bill in a hurried six-minute hearing the next day.

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The bill was carried on the Senate floor by Sen. Jay Morris, R-Monroe, who raised concerns about minors receiving irreversible gender-affirming surgeries and that children are being left sterile.

In reality, gender-affirming procedures, such as top surgery, which adds or removes breast tissue, or bottom surgery, which constructs a vagina or penis are not recommended for minors, according to Dr. Kathryn Lowe, a pediatrician who represents the American Academy of Pediatrics Section on LGBT health and wellness.

Gender-affirming care is a catch-all term for medical treatments given to people to align their physical bodies with their identified gender. Gender-affirming care is used by transgender people, who identify as a gender different from their sex assigned at birth, as well as cisgender people, who identify as their assigned sex.

Treatments are individualized to the patient. Some young patients will be prescribed fully reversible puberty blockers, giving the patient time to consider their options.

Later, a patient may be given hormone treatments that can help young people go through puberty in a way that allows their body to change in ways that align with their gender identity. These treatments are partially reversible.

Mills gave a floor speech Monday in opposition to the bill, dispelling some of the misinformation about gender-affirming healthcare that has been spread as the bill worked its way through the legislative process.

It's a privilege to fight for the little man

– Sen. Fred Mills, R-Parks

He said he opposes the bill because the facts are against it, referencing a Louisiana Department of Health report about minors on Medicaid who have received gender-affirming healthcare. The report indicates that although around 40% of children in Louisiana are on Medicaid, just a few hundred have been diagnosed with gender dysphoria, and none of them have received gender-affirming surgery since the agency began collecting data in 2017.

"What's really troubling about this bill is basically it says that if you’re presently stabilized on this treatment that you have to be weaned off… Have you ever seen legislation where we’ve taken people off medication that's FDA approved?" Mills asked his colleagues.

Firment's bill requires any youth currently receiving gender-affirming healthcare be taken off the course of treatment by the end of 2024. Providers who specialize in gender-affirming healthcare say that there is no length of time that would make discontinuing care safe, pointing to the risk of suicide.

Studies approximate 80% of transgender youth have considered suicide, and 40% report at least one suicide attempt. Research also indicates gender-affirming healthcare leads to improved mental health outcomes.

Mills read letters to the Senate that he said he received from people in Louisiana thanking him for his vote, including some who said Mills’ vote would save lives and reduce suicides.

"It's a privilege to fight for the little man," Mills said.

Sen. Jay Luneau, who was on both committees that heard the bill, also opposed Firment's legislation.

"This bill creates a standard of care in medicine. That's what doctors are supposed to do," Luneau said, adding that the bill also limits parental rights.

House Bill 648 is part of an unprecedented nationwide barrage of state-level proposals that target the LGBTQ+ community. While anti-LGBTQ+ legislation has been introduced in Louisiana in the past, these measures have gotten much further this year than last year when Firment's proposal did not even receive a committee hearing.

The bill will next go back to the House for concurrence on Senate amendments.

Louisiana Gov. John Bel Edwards has not announced whether he will veto the bill, but last month said the recent onslaught of anti-LGBTQ+ legislation would have a negative impact on the already high suicide rate for transgender Louisianians.

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by Piper Hutchinson, Louisiana Illuminator June 5, 2023

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Piper Hutchinson is a reporter for the Louisiana Illuminator. She has covered the Legislature and state government extensively for the LSU Manship News Service and The Reveille, where she was named editor in chief for summer 2022.