A bill to ban gender-affirming treatment for Kentucky minors would worsen the state’s health-care workforce shortage and chill family health providers who often are the first to provide mental health care for children, the chair of the House health committee said as the bill went to the Senate on a 75-22 vote Thursday.
“This proposal undermines everything that we're doing to increase our health-care workforce,” Rep. Kim Moser, a Republican from Taylor Mill, told her colleagues. She told Kentucky Health News, “I just don’t think that we should be in the business of legislating medical treatment.”
Moser was one of three Republicans opposing House Bill 470, sponsored by Rep. Jennifer Decker (R-Shelby County). The other opponents were Kim Banta of Fort Mitchell and Stephanie Dietz of Edgewood, also in Northern Kentucky.
Moser, a nurse by profession, warned against the bill’s greatly extended 30-year window for lawsuits against a health-care provider who provides any gender-affirming care to a minor, including treatments that support gender transition. Currently, malpractice suits must be filed within one year.
“I just think that we’re sending the wrong message in saying that on one hand, we value our health-care workers and we’re working on legislation to improve our health-care workers situation, but on the other hand, we’re imposing a 30-year statute of limitations,” she said. “That sends a huge message to our health-care workers that we are going to micromanage you, we are going to insert government into the practice of medicine, and we are going to punish you if you step out of line.”
A bit earlier, as the House Judiciary Committee approved the bill 14-7, Moser said she appreciated that its latest version removed a defined list of mental-health providers from the list of providers who couldn’t treat youth seeking gender-affirming care, but she said the reality is that initial mental health care often falls to a physician, physician assistant, or advanced practice registered nurse, and this bill restricts what they can talk about with transgender youth.
“Eighty percent of what family practitioners and many other physicians do in their practice is address mental health,” she told the House. “It’s not only counselors who address mental health of their patients. Patients come in with a wide variety of situations, and their physicians need to be those trusted individuals with whom they can have a confidential conversation. ... I think this goes too far. I think it’s discriminatory. I think it eliminates parents’ rights.”
Dr. Craig Losekamp, a Bowling Green physician, told the committee that the bill would impair his practice, because much of his transgender care involves non-transgender-related subjects. He said his patients come from as far as 120 miles away to seek care from him.
“If this bill goes through, I won’t be able to take care of those kids, talking about those subjects that are very important to them,” he said. “It doesn’t even involve hormones, it means me acknowledging them and their gender identity and treating them as a compassionate human being.”
Losekamp said 10 percent of children who come out to their family suffer physical violence from the family, about 8% are kicked out of their home, 10% run away, and the suicide-attempt rate for transgender people is 40%.
“These people need care. They need their respect. They need to be treated like human beings,” he said.
Later, the committee heard from a trans person who said they were “severely harmed” by a transition guided by their parents. Losekamp said regret happens with all surgeries, but the regret rate for transgender surgery is 1% while the overall rate for all surgeries is one in seven, or 14%.
“If you are going to make a bill pass that will protect that small percentage at the expense of the overwhelming majority, you are not managing harm; you are creating more harm,” he said. The bill says it “may be cited as the Do No Harm Act,” parroting the most-often cited part of the Hippocratic Oath.
Moser told Kentucky Health News that some have argued that if health-care providers don’t break this law, it won’t affect them, but she said the bill will cause a “chilling effect” in how they care for their patients, and “I don't think that it gives health-care workers who are looking to relocate or stay in Kentucky and practice medicine any comfort.”
Asked why a bill dealing with a health issue wasn’t assigned to her committee, Moser said she wasn’t consulted about that.
In her closing remarks on the floor, she said, “I’d like to say to the rest of the world who’s watching Kentucky, we are not complete Neanderthals; we are generally very thoughtful people.”
Asked later what she meant by that, she said, “I think that we should be a little more responsible in how we are treating children and families and health-care workers. ... I think that there are [other] ways to address the problem they are trying to solve.”
She suggested that the bill be simplified to say that children under the age of 18 could not have transgender surgery, and to limit hormone therapy to those who have had extensive counseling.
Dr. Chris Bowling, a pediatrician from Northern Kentucky representing the Kentucky Medical Association and the American Academy of Pediatrics, told the committee that gender-affirming care is also supported by: the American College of Obstetrics and Gynecology, the Society for Adolescent Health and Medicine, the Pediatric Endocrine Society, the National Adult Endocrine Society, the American College of Physicians, the World Professional Association for Transgender Health, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry.
“These are not things that should be decided on the basis of feelings; they should be decided on the basis of facts,” Rebecca Blankenship, executive director of Ban Conversion Therapy Kentucky, told the committee.
The panel then heard from supporters of the bill, including three physicians, two who spoke remotely. Two said that left alone, 80% to 90% of these youth will return to their biological gender after the onset of puberty, another cited a long-term study from Sweden that showed damage to children’s mental health, and the third noted that a person’s brain is not fully developed until the age of 25.
Luka Hein, 21, who transitioned from female to male as a teenager, but has since detransitioned, said the medical system was not interested in treating the underlying cause of her distress, but instead, she got drugs and surgery and was put in “the pipeline that is the gender-affirming care industry,” which is “experimental.”
Rep. Pamela Stevenson of Louisville asked Decker why the government was trying to become the parent to all of these children. Decker replied, “I have great compassion for the children, parents and their families who are in this situation. However, ultimately, it is our obligation to protect children from irreparable harm. ... We do not allow parents to give their children alcohol until the age of 18,” nor cigarettes.
Stevenson, the Democrat running for attorney general, said, “It’s not for irreparable harm; it’s because they're not like you.”
A new Mason-Dixon poll released by the Fairness Campaign, a pro-LGBTQ rights advocacy group, showed that 71% of respondents oppose laws letting state leaders overrule parents’ wishes for gender-affirming care for their child. The Louisville Courier Journal reports that the poll surveyed 625 people with an error margin of plus or minus 4 percentage points.
Written by Melissa Patrick. Cross-posted from KY Health News.