Bill Approved to Limit Treatment for Transgender Youth

A bill sent to the Senate in South Dakota would penalize physicians who provide treatments for transgender youth.  Lawmakers from other states are considering similar bills as advocacy groups stand in opposition. Read on to learn about the debate around House Bill 1057. Nurses Headlines News

Bill Approved to Limit Treatment for Transgender Youth

South Dakota’s House of Representatives approved a bill, on February 29th, that would criminalize physicians who treat transgender children with hormones and sex reassignment surgeries. The Vulnerable Child Protection Act will now be sent to the state’s Senate for a committee hearing. Rep. Fred Deutsch, the bill’s primary sponsor, explains the legislation will protect vulnerable children who “are being chemically castrated, sterilized and surgical mutilated.

South Dakota’s House of Representatives is the first state to pass a bill to restrict medical treatment for trangender teens. However, more than half a dozen state houses are considering similar bills.

House Bill 1057

Under the bill, it would be a Class 1 misdemeanor for a physician to prescribe hormone replacement therapy or perform sex reassignment surgery to youth under the age of 16. This includes:

Performing a mastectomy

  • Gender affirming surgery (vasectomy, penectomy, vaginoplasty and others)
  • Prescribing, dispensing or administering puberty blocking medication, supraphysiologic doses of testosterone to females and supraphysiologic doses of estrogen to males
  • Removing any healthy or non-diseased body part or tissue.

The penalty would be a maximum of 1 year in jail and a fine of $2,000. Nurses would be exempt from prosecution.

The Debate

Republicans and Democrats debate represent a larger culture war with conflicting values, beliefs and practices. The debate is bigger than just the medical issues and extends into parenting and the role of physicians.

Opposition to the Bill

Parents, many members of the medical community and advocates of transgender youths make the following arguments (although there are many more) in opposition to House Bill 1057:

  • The bill is a form of discrimination that would withhold life saving treatment
  • The bill is unconstitutional and the decision about gender expression should be between the youth, parent and doctor.
  • Sex assignment surgeries and are rarely performed on youth
  • Puberty blockers, requiring parental consent and extensive counseling, are reversible

Libby Skarin, policy director for the American Civil Liberties Union of South Dakota, issued a statement after the vote, stating “By blocking medical care supported by every major medical association, the legislature is compromising the health of trans youth in dangerous and potentially life-threatening ways.”

A conservative Christian organization, Liberty Counsel, has offered legal counsel to defend bill, at no cost to state taxpayers.

Proponents of the Bill

Lawmakers supporting the bill make debate these points (among others):

  • Need to protect youth from making life altering changes until they are old enough to consider all available options
  • Too young to understand the potential consequences
  • Sex-reassigment surgery and administration in youth are harmful, abusive and criminal acts

The website https://hb1057.com/, promotes Deutsch’s bill and features resources and videos from the Heritage Foundation, the Minnesota Family Council, a Christian organization.

For Thought

In 2018, the American Nurses Association released a position statement, Nursing Advocacy for LGBTQ+ Populations and applied the nursing code of ethics to this population.

Quote

“..nurses must advocate for patient centered treatment, equal access, equal services, and equal resources for all populations that may be adversely affected by bias or prejudice. Nurses have an ethical duty to honor and respect the identities, beliefs, values, and decisions of all patients.”

ANA Position Statement: Nursing Advocacy for LGBTQ+ Populations

How do you think this ethical duty of nursing fits into the debate around limiting transgender healthcare for youth?

Let us hear from you!

References

South Dakota House Passes Bill Restricting Medical Treatments for Transgender Youth

https://www.washingtonpost.com/national/south-dakota-house-passes-bill-restricting-medical-treatments-for-transgender-youth/2020/01/29/8578b550-413d-11ea-b503-2b077c436617_story.html
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J.Adderton

About J.Adderton, BSN, MSN

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J. Adderton MSN has over 20 years experience in clinical leadership, staff development, project management and nursing education.

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Specializes in Ortho, CMSRN.

Being a child/teenager is all about finding who you are. Sometimes, once you grow up, you aren't who you thought you were becoming. If they really want to transition, they can make the choice once they're an adult. I think prescribing drugs to inhibit puberty or performing plastic surgery on a child is nothing short of child abuse. I realize that others on the other side of the debate feel just as strongly because of the high risk of suicide of transgender children. The risk is high whether you allow them to transition or you don't. I've read articles of transgenders who were appalled that they went through with the modifications and wanted to take it back. Let them grow up, give them time to think about it, and when they're grown, they can make a decision.

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Specializes in Stroke Care - Med/Surg.

Personally, I think the government needs to butt out. These decisions should be left up to parents, providers (including psych/social work), and ultimately the patients themselves. As the article stated, these surgical procedures are so rarely done on young patients. Hormone regimens are reversible and could be an effective treatment for gender dysphoria, provided it's considered safe (psychologically and physiologically). Calling it child abuse is extreme, in my opinion: parents already consent to growth treatments, ADHD medications and other invasive therapies.

Of course, teens shouldn't be allowed free reign for these issues, but they're not allowed that for really any medical decision. Even something as common as birth control requires counseling, education and a prescription from a provider.

** as a note: the proper terminology is "transgender person/people", NOT "Transgenders". It's a descriptor; not a noun.

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Specializes in School Nursing.
6 hours ago, ClaraRedheart said:

Being a child/teenager is all about finding who you are. Sometimes, once you grow up, you aren't who you thought you were becoming. If they really want to transition, they can make the choice once they're an adult. I think prescribing drugs to inhibit puberty or performing plastic surgery on a child is nothing short of child abuse. I realize that others on the other side of the debate feel just as strongly because of the high risk of suicide of transgender children. The risk is high whether you allow them to transition or you don't. I've read articles of transgenders who were appalled that they went through with the modifications and wanted to take it back. Let them grow up, give them time to think about it, and when they're grown, they can make a decision.

I totally agree with you. I see students in my school waver back and forth between sexes, not sure about what they are, and experimenting to as you say, "find themselves" This is why I think that waiting until they are adults is the best thing for them. Allow them the time to grow, develop, and be able to make wise and well thought out decisions that will have an impact on the rest of their lives.

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Dear Nurses, you would be subject to arrest, imprisonment and loss of your nursing licenses should this bill and the other 7 that were filled pass.

The SD House State Affairs Committee amended HB 1057, changing the potential penalty from a Class 4 felony to a Class 1 misdemeanor and the lowering of the age of the targeted minors from 18 to 16.

As amended, any physician, surgeon, physician assistant, clinical nurse specialist, or nurse practitioner found guilty of “attempting to change or affirm the minor’s perception of the minor’s sex” including prescribing hormones blockers would be subject to conviction of a Class 1 misdemeanor with potential punishments of up to one-year imprisonment and up to $2,000 in fines.

The bills to 'protect vulnerable children' are a coordinated attack against healthcare providers after the Heritage Foundation failed to pass bathroom bills, which they also authored, the last few sessions.

You are being targeted by the Heritage Foundation and other far-right groups because you are, as we have seen from the lack of outrage expressed here, the most compliant, and therefore a target of opportunity.

I am not a medical professional but I am transgender and have been writing about our people since 2007.

Kelli Anne Busey
Editor
Planet Transgender
https://planettransgender.com

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Specializes in Surgical Specialty Clinic - Ambulatory Care.

I really don’t think treatments to change or enhance one’s appearance should be allowed to be offered to persons under 18. Only caveat is disfigurement r/t accidents or congenital malformations.

I think they should be encouraged to use external body modification devices (fake boobs, corsets, weaves, make up etc.) to express how they feel who they are and what they wished they looked like, as any teen with body dysmorphic disorder should. But not even piercings except for ear rings for both genders until adulthood.

Permanent decisions are not for teen minds.

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Specializes in Psych, Addictions, SOL (Student of Life).
58 minutes ago, KalipsoRed21 said:

I really don’t think treatments to change or enhance one’s appearance should be allowed to be offered to persons under 18. Only caveat is disfigurement r/t accidents or congenital malformations.

I think they should be encouraged to use external body modification devices (fake boobs, corsets, weaves, make up etc.) to express how they feel who they are and what they wished they looked like, as any teen with body dysmorphic disorder should. But not even piercings except for ear rings for both genders until adulthood.

Permanent decisions are not for teen minds.

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Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

The government needs to get out of people's personal lives. This one size fits all bill is wrong.

There may, at times, be extreme circumstances present and this bill would not take that into account. You can't legislate for every variable that may occur and everyone is different.

Unless it's your child, it's none of your business.

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9 hours ago, KalipsoRed21 said:

I really don’t think treatments to change or enhance one’s appearance should be allowed to be offered to persons under 18. Only caveat is disfigurement r/t accidents or congenital malformations.

I think they should be encouraged to use external body modification devices (fake boobs, corsets, weaves, make up etc.) to express how they feel who they are and what they wished they looked like, as any teen with body dysmorphic disorder should. But not even piercings except for ear rings for both genders until adulthood.

Permanent decisions are not for teen minds.

Fake “boobs” really? Can’t we sound at least a little bit professional?

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Specializes in med-surg, IMC, school nursing, NICU.
10 hours ago, KalipsoRed21 said:

I really don’t think treatments to change or enhance one’s appearance should be allowed to be offered to persons under 18.

Using the term “enhance one’s appearance” implies these are cosmetic procedures which they are not. They are gender reaffirming procedures, not plastic surgery. Two different things. Individuals seeking these procedures aren’t simply dissatisfied with the shape or size of a part of their anatomy, they instead feel profoundly uncomfortable and “wrong” in their bodies.

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Specializes in Psych, Addictions, SOL (Student of Life).
1 hour ago, jobellestarr said:

Fake “boobs” really? Can’t we sound at least a little bit professional?

I prefer the term Breast enhancement

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Maybe even anterosuperior enhancement.

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