UPDATE: Senate Judiciary Committee Passes Bill to Ban Gender-Affirming Medical Care for Minors

The Montana Senate Judiciary Committee on Jan. 31 passed Senate Bill 99, a proposal by Sen. John Fuller, R-Kalispell, that would effectively ban gender-affirming care for transgender minors. The passage of the bill by the judiciary committee comes after the committee on Jan. 27 heard more than five hours of testimony on the proposed legislation, the majority in opposition. The bill passed the committee on a party-line vote, with seven Republican senators voting yes, and four Democratic senators voting no, and will now face a full vote in the Senate.

“The bill is basically saying, ‘Wait ‘till you’re 18,” Judiciary Committee Chair Sen. Keith Regier (R-Kalispell) said after the committee passed the bill. “We have several prohibitions for minors on various things from alcohol to tobacco, and this is just adding to that. Wait till you’re 18, if you’re still so inclined, go for it.”

While Fuller has positioned the bill as a means to protect Montana’s children, its opponents, who far outnumbered proponents during the Jan. 27 hearing, testified that the legislation would interfere with important medical processes, would drive doctors out of the state and would harm transgender children. Senate Bill 99 is one of dozens of anti-LGBTQ bills being introduced in state legislatures across the country, including many that specifically target medical care for transgender individuals.

Senate Bill 99 includes an array of prohibitions surrounding the treatment of transgender children, the most notable being a ban on all surgical and hormonal gender-affirming care for transgender youth. The bill also blocks any individual or entity who provides gender-affirming care from receiving state funding, blocks the use of Medicaid for gender-affirming procedures, and bans healthcare professionals employed by state, county or local governments from providing medication, social transitioning, or surgery as options to address gender dysphoria in transgender children.

Gender-affirming care includes a range of medical, psychological and social interventions for transgender people, ranging from selecting a new name or haircut to hormone therapy or surgery. According to the Association of American Medical Colleges, children seeking gender-affirming care are often provided with counseling, resources to change their physical appearance, or hormone therapy, while surgery is rarely offered as an option to minors. One route often provided to transgender children is puberty blockers — medication that temporarily suppresses the release of sex hormones for those who have not completed puberty, a measure that medical professionals during the hearing emphasized is reversible, temporary, and widely tested by doctors.

“Senate Bill 99 is designed to protect children from the imposition of chemical and surgical procedures for the purpose of causing the child to physically appear more like a person of the opposite sex, and less like his or her own sex,” Fuller said as he opened the Jan. 27 hearing. “The real issue is that subjecting children to irreversible cosmetic and life-changing surgery before they are an adult and responsible for their own future is what the opponents are advocating. The state of Montana has the responsibility and the right to protect children from such abuse.”

Alongside Fuller, proponents of the bill painted a picture of young, impressionable children being pushed toward irreversible surgeries by medical professionals across the state of Montana, and suffering from regret and mental illness afterwards.

Jeff Laszloffy, president of the Montana Family Foundation, a lobbying group affiliated with Colorado-based right-wing policy organization Focus on the Family, discussed school counselors “grooming” children and pushing them toward gender-affirming care, a popular anti-LGBTQ trope that has seen a reemergence recently.

Joseph Kohm, director of public policy at the Family Policy Alliance, the lobbying arm of Focus on the Family, said children are being pushed to “reject their god-given bodies,” and that gender-affirming care is a “one way, experimental path that leads only to lifelong drug dependency, perhaps the removal of healthy body parts they can never recover.”

Kohm and others also testified that the vast majority of people who transition in their youth regret their decision and attempt to transition back, a characterization that has been disproved by multiple peer-reviewed medical studies.

Recent studies have shown that gender-affirming medical interventions are associated with lower levels of depression and suicide in adolescents and fewer instances of severe psychological distress, smoking and suicidal ideation in transgender adults. Surveyed populations of transgender adults have also shown that nearly all people who began gender-affirming care in their adolescence chose to continue it into adulthood.

Opponents to Senate Bill 99, including medical professionals, parents, legislators and transgender Montanans, drew on the documented effectiveness of gender-affirming care and emphasized the impact the bill would have on Montana’s medical community.

Rep. Zooey Zephyr, D-Missoula, the first transgender member of the Montana legislature, said in the Jan. 27 hearing that she takes “issue with the comments that transitioning is a travesty.”

“Trans people after transition live lives full of joy. My life is one full of joy,” Zephyr said. “I come into this building every day excited to work with you, excited to work for the people of Montana. That joy that I carry with me would not have been possible had I not transitioned.”

Lauren Wilson, pediatric hospitalist and president of the Montana chapter of the American Academy of Pediatrics, clarified that children who express an “insistent, consistent and persistent” desire to undergo gender-affirming procedures “can choose to learn about medical therapy,” pushing back against the narrative that numerous children are being pressured to undergo life-altering surgeries without adequate consultation. Wilson discussed the process that precedes a child receiving hormonal or surgical care, which involves conversations with parents, doctors, psychologists and psychiatrists.

Eric Lowe, chair of emergency medicine at Bozeman Health, shared a letter from over 350 Montana healthcare providers standing in opposition to the bill.

Reading from the letter, Lowe said, “This bill would interfere in the doctor-patient relationship by legislating medical care, ultimately harming patients. This would also negatively affect our ability to recruit healthcare providers to our state if medical care is legislated and providers are penalized for providing healthcare that is standard of care.”

Lowe emphasized that specialists who care for transgender children would likely flee the state to practice elsewhere if Senate Bill 99 passes, ultimately weakening medical care not just for transgender minors, but for all of Montana’s children.

The Montana chapter of the American Academy of Pediatrics, the Montana Medical Association, the Montana Primary Care Association, the American Civil Liberties Union (ACLU) of Montana and the Montana Federation of Public Employees, the largest public employee union in the state, have publicly opposed the bill.

After the committee passed the bill, Sen. Susan Webber (D-Browning), said, “There was tons of opposition. First of all, I just have to applaud all of the young people, all of the people that came in opposition, that they came and stood. It’s a hard thing to do and I applaud their courage.”

As Senate Bill 99 continues to move through the legislative process, opponents have tied it to a wave of anti-LGBTQ bills being introduced in state legislatures throughout the United States. According to the ACLU, 185 anti-LGBTQ bills have been introduced in state legislatures in 2023, regarding issues such as healthcare, education, public accommodations and IDs and records. In addition to Senate Bill 99, the ACLU listed House Bill 359, a bill draft by Rep. Braxton Mitchell, R-Columbia Falls, that would prohibit minors from attending drag shows, as anti-LGBTQ legislation moving through Montana’s legislature.

Utah on Jan. 28 became the first state to ban gender-affirming care for minors, a step many medical professionals and LGBTQ advocates have characterized as a sign of more bans to come in other states.

More information on the 68^th legislature can be found at www.leg.mt.gov.