House to consider a total ban on gender-affirming care for adolescents

The West Virginia House of Delegates will consider a total ban on gender-affirming care that would leave children diagnosed with gender dysphoria who are at risk of harming themselves with no in-state medical care options. The bill comes less than a year after Gov. Jim Justice signed a ban on gender-affirming care for minors in the state.

In a brief meeting on Friday afternoon, the House Committee on Health and Human Resources overwhelmingly passed House Bill 5297. It’s the second consecutive year that lawmakers in that committee have approved language policing gender-affirming care without inviting testimony from physicians who provide it or patients who receive it.

The proposed bill would overturn the current law that allows children diagnosed with severe gender dysphoria to access pubertal modulating and hormonal therapy.

No member of the committee spoke in favor of the bill or offered an explanation for why it was on the agenda at this point in the session.

After the vote, bill sponsor Del. Geoff Foster, R-Putnam, who is not on the committee, expressed unhappiness with the version Justice signed off on last year. The bill is personally important to him, he said.

Foster does not believe that providing these medications to children with gender dysphoria would prevent suicide.

“I ran the bill last year and as it passed the House, I believed it was a better piece of legislation,” he said.

Every major medical organization, including the American Medical Association, the World Health Organization, the American Academy of Pediatrics and the American Psychiatric Association, among more than a dozen others, supports gender-affirming care for youth.

Children diagnosed with gender dysphoria are at higher risk for self-harm and suicide, which Del. Anitra Hamilton, D-Monongalia, pointed out to lawmakers as she spoke against the measure.

“That’s a call for help that we as a Legislature should answer,” she said.

A 2020 study by the Williams Institute at UCLA found that there are around 10,000 children in West Virginia who identify as LGBTQ. A 2017 study by the same group reported that West Virginia had the highest per capita rate of trans youth in the nation.

According to the Trevor Project, a nonprofit organization focused on suicide prevention for LGBTQ youth, more than 50% of LGBTQ kids in West Virginia seriously considered suicide in 2021. About 14% of those kids attempted suicide. Among the LGBTQ community, suicide and suicidal ideation rates — as well as rates of anxiety and depression — are highest in the state and the nation for  trans youth, per the report.

Del. Mike Pushkin, D-Kanawha, attempted to amend the legislation during Friday’s committee meeting to allow minors who are already undergoing gender-affirming care, including medications and therapies, to continue doing so until July. Pushkin said not adopting the amendment — which was voted down 8-11 by members of the committee —  was “inhumane.”

He argued that the government shouldn’t come between decisions made by doctors, parents and their children.

“I think this is a very important amendment — if someone is participating in [these treatments] it would allow for the government to come in and kick somebody off of this, to come between them and a physician and their parents and say, ‘we know best, this is not for you,’ it would be incredibly detrimental,” Pushkin said. “Gender dysphoria is a real, diagnosed condition … I’m not going to begin to try to understand it, I don’t, but I think it’s inhumane to kick someone off their medicine, kick them out of therapy they’re getting.”

State law currently requires the minor seeking gender-affirming care to be diagnosed as suffering from “severe” gender dysphoria by no fewer than two medical or mental health providers. One of the health providers has to be trained in the treatment of severe gender dysphoria in adolescents.

“This type of treatment is reversible. What isn’t reversible is suicide,” Pushkin said. “Without this amendment, you will see teen suicides and child suicides.”

In an email, Fairness West Virginia, an LGBTQ civil rights nonprofit, said that the group’s request for a public hearing over the bill was denied before it was taken up by committee on Friday.

Legislative rules largely prevent public hearings after day 43 of the legislative session. The bill was put on agenda on day 45.

Foster said he had hoped the bill would have run sooner in the health committee.

Andrew Schneider, executive director for Fairness West Virginia, said in response, “Republicans continue to strip West Virginians of their bodily autonomy — the freedom to decide for ourselves what health we need. And now, they want us to sit down and quietly accept these attacks. Well that’s not going to happen. We won’t be quiet about a bill that bans evidence-based suicide prevention.”

Should the bill pass the House of Delegates, Foster felt confident that it has a chance to pass the Senate.

Last year, Sen. Tom Takubo, R-Kanawha, who is a doctor, led efforts in the Senate to insert the limited exemption for children diagnosed with severe gender dysphoria into the proposed gender-affirming care ban.

Takubo told lawmakers that the medications would be used in “very specific situations,” and he cited concerns for children who would be at heightened risk of self harm.

“Patients with severe gender dysphoria, which is an extreme psychological illness, these kids struggle, they have incredible difficulties,” he said last March.