Bill to Ban Medical Care for Transgender Minors gets Hearing

HELENA – A Montana lawmaker is proposing a bill to effectively deny gender-affirming care to young transgender people by threatening health care providers with the loss of their license for a year if they use puberty blockers, hormones or surgery to treat transgender minor.

The bill by Republican Sen. John Fuller also would ban mental health providers at psychiatric hospitals that receive taxpayer funding from promoting or advocating using hormones or surgery as a treatment for gender dysphoria — a violation of which would also lead to a one-year license suspension.

The proposal would make physicians “choose between doing what’s best for the patient and keeping their license,” Dr. Lauren Wilson, president of the Montana Chapter of the American Academy of Pediatrics, said Thursday.

Fuller and supporters of the bill said the effort to ban gender-affirming care for minors is meant to protect children from decisions that will affect them for the rest of their lives.

Montana is one of at least 18 states with bills targeting health care for young transgender people being brought before legislatures this year. Some bills seek to ban treatment until the person is in their 20s. The bills have drawn strong opposition.

Bans on gender-affirming care have passed in Arkansas and Alabama but are being challenged in court.

Fuller’s bill, which is the subject of a committee hearing Friday, would end Montana Medicaid payments for medication or surgery to treat gender dysphoria, which is defined as the distress caused by a person’s gender assigned at birth not matching the gender with which they identify.

Montana’s Medicaid program began covering medication treatment for gender dysphoria for minors in 2015, the health department said, and has spent nearly $1.4 million — an average of $173,000 a year. The department did not immediately respond to a question asking how many children had received treatment.

The bill would also deny public funding to individuals and organizations that provide medication or surgery as a treatment for gender dysphoria — however the bill does not define public funds. Opponents believe it means hospitals would lose Medicare or Medicaid reimbursement entirely if they provide such services. Fuller said Thursday that is not his intention.

State facilities — which Fuller said includes schools — and state employees who work with children could not encourage transgender minors to change names, clothing or pronouns to match their gender, under the proposal.

Also under the bill, physicians who provide hormone or surgical treatment would be vulnerable to lawsuits for at least 25 years if the after-effects of the treatment cause physical, psychological, emotional or physiological harm. It would also ban providers from having a liability insurance policy to cover such claims.

Fuller brought a bill in 2021 that would have banned gender-affirming surgery for transgender minors, but it faced significant opposition from medical experts, human rights advocates and the transgender community, who argued gender-affirming surgery is rarely undertaken by minors and that medical decisions should be left up to families. It passed the House but eventually failed in the state Senate.