Bill to Ban Gender-Affirming Care Heads to Montana House

After a third lengthy and contentious hearing, Senate Bill 99, introduced by Sen. John Fuller, R-Kalispell, will be considered on the House floor

By Denali Sagner
The state Capitol rotunda. Beacon File Photo

The Montana House Judiciary Committee on Tuesday sent an amended version of Senate Bill 99 — a bill that would ban gender-affirming care for transgender minors in the state of Montana — to the House floor, where, if passed, it will be sent to the Governor’s desk for consideration. In a three-hour-long committee hearing on Monday, the third public hearing on the bill, medical providers, representatives from civil rights organizations, LGBTQ Montanans and parents of transgender children pushed back on the proposed legislation, which garnered support from conservative advocacy groups and individuals who expressed concern over medical procedures they described as “mutilation” and “child abuse.”

The hearing marked a continued battle in Helena over bills pertaining to the LGBTQ community, spotlighting Flathead Valley legislators Sen. John Fuller, R-Kalispell, the sponsor of the bill, and Judiciary Committee members Rep. Amy Regier, R-Kalispell, and Rep. Braxton Mitchell, R-Columbia Falls, who both voted to concur the bill on Tuesday morning.

During public testimony on Monday, proponents of Senate Bill 99 painted a picture of scores of young children being pressured into identifying as transgender, and subsequently receiving irreversible and life-altering surgical and hormonal treatments — treatments that proponents described as “pure evil” and “mutilation.” The vast majority of those who spoke in support of the bill testified as individuals, many as parents and grandparents who saw the bill as a way to protect Montana’s children.

Constance Neumann, chair of the adjudication panel for the State Board of Nursing, who noted that she could not speak on behalf of the board, said, “Slicing up children in the name of inclusiveness is pure evil.”

Other proponents of the bill included Pastor Flynn Ayers of Christ Church Missoula; Joseph Kohm, director of public policy at the Colorado-based Family Policy Alliance; Elizabeth Fedak of the Washington, D.C.-based Women’s Liberation Front; and Matt Sharp of the Arizona-based Alliance Defending Freedom.

During proponent testimony, committee members raised objections over the use of the words “transgenderism” and “mutilation” to describe transgender people and gender-affirming surgeries, respectively, citing the derogatory connotations of the terms.

“Unless we’re going to characterize all surgeries as mutilation, I think the good representative from Missoula’s objection is well taken,” Rep. Tom France, D-Missoula, said in regard to an objection raised by Rep. Zooey Zephyr, D-Missoula. “I’ve had surgeries, they’re painful, they’re hard to recover from, but they’re the best advice of a doctor and I needed them, and I don’t think it’s fair to characterize that as a mutilation.”

Regier, chair of the House Judiciary Committee, allowed for the use of the word “mutilation,” saying that “it’s some people’s opinion as to what’s happening.”

Similar to previous hearings on Senate Bill 99, opponents to the bill included the Montana Chapters of the American Academy of Pediatrics and American College of Emergency Physicians; Montana Hospital Association; Montana Primary Care Association; Montana Nurses Association; American Civil Liberties Union (ACLU) of Montana; Montana Human Rights Network; Montanans Organized for Education; Montana Association of Rabbis; Forward Montana; and Planned Parenthood Advocates of Montana. State clinics and hospitals, including Bozeman Health, Benefis Health System in Great Falls, Bridgercare in Bozeman, and Blue Mountain Clinic in Missoula, also spoke against the bill.

Opponents pushed back on proponents’ characterizations of transgender children and gender-affirming healthcare, emphasizing the long and arduous process minors who want to receive hormonal and surgical treatments undergo, stressing what they described as infringements on parental rights and doctor-patient confidentiality, warning of negative consequences for the state’s healthcare ecosystem should the bill pass, and describing the bill’s contents as unconstitutional and discriminatory.

“I’m not entirely sure that the details of this bill matter anymore at this juncture,” SK Rossi, an attorney and lobbyist with the Montana Human Rights Campaign, said.

Rossi described the historical arc through which lesbian, gay and bisexual Americans have achieved civil rights, a process that was fought through state and federal court battles challenging discriminatory laws — laws like Senate Bill 99, according to Rossi.

“Legislation seeking to prevent us from living outwardly was passed, court decisions overturned that legislation, and eventually, statutory protections recognizing LGB people as people with rights to be who they are, passed. It’s a tale as old as time,” Rossi added. “Eventually, this obsession with trans people and our bodies and forcing us into these rooms to talk about ourselves will do nothing but reveal the cruelty of these bills and this process, and the public will move further towards us. It is an unconstitutional bill. We will fight it in court.”

Kathryn Lowe, a pediatrician at Bozeman Health, attempted to address medical misconceptions about gender-affirming care. Lowe emphasized that there is no medical treatment given to transgender adolescents prior to puberty, and that parental consent is always required for gender-affirming medical procedures. Lowe also described puberty-blockers, a medication that can be prescribed to adolescents to pause puberty for a variety of reasons, including as a way to limit gender dysphoria, as “safe, effective” and “fully-reversible medications.”

“I want you all to understand that. That is the truth, from a medical professional,” Lowe said.

Still, some legislators pushed back against medical testimony offered by board-certified healthcare providers.

In a tense exchange between Rep. Neil Duram, R-Eureka, and Dr. Kathryn Brogan, a psychiatrist at Shodair Children’s Hospital in Helena, Duram asked Brogan, “Is it a fair statement to say that any given blood sample from an adult, a mature adult, you can determine from that blood that that sample comes from a male or a female based on the hormones present?”       

Brogan answered, “I don’t believe that that is a fair statement.”

Duram responded, “I guess I disagree,” prompting unrest in the room, with one attendee shouting, “You’re not a doctor.”

Later in the hearing, Duram posed the same question to Dr. Eric Lowe, emergency medicine physician at Bozeman Health, who said, “I, too, would back up my colleague. I do not know of a hormone level that could identify male or female in a blood sample.”

During the hearing, the spotlight often fell on legislators from the Flathead Valley, who have led the charge this session on bills pertaining to LGBTQ residents of Montana.

Rep. Mitchell discussed his experience “growing up in our public schools just a couple years ago,” and described a climate of “activists, social media influencers, and other groups and organizations pushing that kids should be transgender,” where “the vast majority of these kids are being pressured into this as some sort of social trend,” a description vehemently opposed by transgender Montanans, who explained their experiences with social isolation and harassment after coming out as transgender.

Mitchell, who voted yes on concurring the bill as amended, introduced House Bill 359 earlier this session, which would ban children from attending drag shows in Montana. The proposed legislation, like Senate Bill 99, has seen significant controversy and accusations of discrimination.

The sponsor of Senate Bill 99, Sen. Fuller, introduced a similar bill to ban gender-affirming healthcare in the 2021 legislative session, as well as a bill requiring interscholastic athletes to participate under their sex assigned at birth.

Regier, who also voted yes on Senate Bill 99 on Tuesday, brought House Bill 303 earlier this session, legislation that would allow medical providers to refuse care due to “ethical, moral, or religious beliefs or principles,” and will face a Senate committee hearing next week.Medical providers and civil rights organizations have criticized the bill, saying it would allow providers to discriminate against LGBTQ residents of the state and deny them critical care. 

The House Judiciary Committee concurred Senate Bill 99 on Tuesday, adding one amendment that would allow Montanans to use public fundsto receive out-of-state care at facilities that perform gender-affirming care, so long as that care is not gender-affirming care. Another amendment by the committee struck out a statute that allowed those who received gender-affirming care and claimed injury to sue medical providers up to 25 years after that care was received.

The bill will now head to the House floor for another public hearing.