The Georgia Legislature has joined the surge of GOP-controlled states to seek to restrict doctors’ ability to provide gender-affirming care to transgender minors, even with parental permission.
A bill filed Thursday by Gwinnett Republican Sen. Clint Dixon would restrict health care providers from prescribing puberty blocking drugs or sex hormones or performing surgery or procedures that “remove any healthy or non-diseased body part or tissue.”
The bill contains exceptions for people born with ambiguous sex characteristics, people seeking to reverse gender-affirming operations and people who would die from a physical ailment if not for the treatment.
Another provision in the bill seeks to prevent school personnel from encouraging a minor to tell their parents they feel like they are a different gender.
“It’s a pretty comprehensive attack on transgender young people,” said David Brown, legal director for the Transgender Legal Defense and Education Fund. “It seems to contain both a prohibition on providing medically necessary healthcare for transgender young people and also an element tacked on at the end that requires schools to treat transgender students worse than other students, so it is quite comprehensive in that sense, and that’s unfortunate.”
The fund is suing Georgia over its refusal to provide gender-affirming care to state workers under its benefit plan.
Dixon said the bill is necessary to protect Georgia children.
“The state has a compelling interest to protect all young Georgians from harm,” he said in a statement. “Allowing Georgians who cannot legally vote, smoke, or purchase a firearm to make a high stakes decision with irreparable consequences is dangerous and must be addressed immediately by the Georgia General Assembly. It’s time to stand on the right side of history and protect our children from reckless medicine and a lifetime of regret.”
Medical professionals and transgender advocates say using words like “dangerous” and “reckless” to describe gender-affirming care is misleading.
According to a 2018 American Academy of Pediatrics policy statement, gender affirmation encompasses a range of treatments from social affirmation – things like adopting a new name or hairstyle – to gender-affirming surgery, which is irreversible.
The AAP describes puberty blockers as reversible, but notes that the effect of sustained puberty suppression on fertility is unknown. Hormone therapy – estrogen for people assigned male at birth or testosterone for people assigned female at birth – is partially reversible, but some features like Adam’s apple protrusions, voice changes, male pattern baldness and development of breasts are considered irreversible once developed.
The report says surgical intervention is typically reserved for adults, but can be offered to adolescents “on a case-by-case basis with the adolescent and the family along with input from medical, mental health, and surgical providers.”
In practice, providers say performing irreversible gender-affirming surgery on a minor is extremely rare.
The report notes that being transgender is not a mental disorder, but transgender adolescents and adults experience high rates of depression, anxiety, eating disorders, self-harm and suicide, due in large part to stigma and isolation. Gender-affirming care can reduce gender dysphoria, feelings of dissonance between a patient’s gender identity and sex at birth.
“Gender affirmation among adolescents with gender dysphoria often reduces the emphasis on gender in their lives, allowing them to attend to other developmental tasks, such as academic success, relationship building, and future-oriented planning,” according to the report.
According to the American Civil Liberties Union, state legislatures have filed 287 anti-LGBTQ bills so far this year, including 90 aimed at health care. Utah became the fifth state to pass a transgender health care ban late last month following Tennessee, Arizona, Arkansas and Alabama. Arkansas and Alabama’s laws have been put on hold as they face court challenges.
In none of these cases have lawmakers presented examples of children whose lives have been ruined by gender-affirming care, said Carl Charles, senior attorney with Lambda Legal, an LGBTQ+ legal advocacy group.
“The states who are passing these bills are not doing so as of yet with evidence of any minor in their state who has been harmed by gender-affirming care,” he said. “In fact, to the opposite, these legislators have been presented time and time again, going as far back as 2020 when these bills started to appear, state legislators have have been presented with a great deal of anecdotal evidence to the contrary, by trans youth, their families, trans adults, to say this care is supportive, this care is helpful, this care saves people’s lives.”
Frontline Policy Action, a conservative lobbying group, celebrated the bill in a press release. President Cole Muzio said the group “looks forward to working with Sen. Dixon, the Georgia General Assembly and Gov. Brian Kemp to ensure this legislation becomes law.”
A spokesman for Kemp’s office did not respond when asked whether Kemp supports Dixon’s bill. A bill that resulted in a ban on transgender girls playing on school sports teams squeaked through last year’s session after Kemp made a last-day push.
This year, Kemp’s public comments have revolved mostly about the state’s economy, echoing his messaging from his successful re-election campaign. That was a departure from Georgia’s 2022 legislative session when “culture wars” issues made their way into the state code.
“He ran very successfully on a platform of economic growth for the state, doing things that are going to economically benefit the people of Georgia, and I got to tell you, this is not it,” Charles said.
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