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.
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.”
Not mature enough to vote, smoke, drink alcohol, sometimes drive with unrestricted licenses, or sometimes engage in sexual conduct but mature enough to make major life changing medical decisions?
I am not saying one way or the other but sheesh, can we decide how old is old enough?
Specializes in Surgical Specialty Clinic - Ambulatory Care.
On 2/10/2020 at 1:38 AM, LalaRN9000 said:
The government should not be able to dictate or penalize how medical professionals think or practice. They decide what is the appropriate plan of care for their patient, not the state.
SD is a conservative state with politicians who are uncomfortable or outright want to discriminate against the lgbtq community. I don’t think it protects these kids at all. LGBTQ youth are are much more likely to commit suicide than their heterosexual peers. This kind of legislation sends a message to these kids that undermines their self worth, indicates that there is something inherently wrong with them and dehumanizes these kids. They get enough judgment already.
I can see why people want to delay any type of gender affirming surgery at a young age, to avoid these situations of regret but it’s none of the government business. Why would a kid choose to be trans if they didn’t truly have gender dysphoria.
We have a duty to treat all patients with dignity and respect, regardless of there gender identity. We must advocate for their needs and well being. This includes supporting trans patients and families.
If the government didn’t dictate how we practice, you wouldn’t have to have a license to be a nurse. You could just out of the blue decide you were some professional and start calling yourself as such. The respect our profession has is due to the standards that regulate it, annoying and sometimes stupid as they are. We do have a duty to treat all patients with dignity and respect, regardless of what they choose in life. But treating one with dignity and respect doesn’t mean giving them what they want. Advocating for their needs and well being doesn’t mean going against the most basic rule of medicine. “First do no harm.” I have a patient right now who is super fragile. Bad COPD, lung cancer that has not progressed, but still is present, on oxygen, not eating enough, kidney issues, cardiac issues....bad. During radiation treatment her vocal cords were damaged and she can barely talk. It causes her a great deal of distress and she and her daughter both want her to have vocal cord implants to fix this....but no doctor will do it because she is so fragile. The patient and daughter feel that it is their decision if she wishes to take the risk....but it’s not because the first rule of medicine is to do no harm. The law that has passed does nothing more than create a clear line of something that we all know to be true. It goes against the health of youth to have surgeries for non medical reasons. If this law said no doctor could ever preform a sex change surgery, that would be something to get up in arms about. If it said medical professionals can’t treat transgender youths as the sex they desire to be, that would be worth get mad. But to say that no doctor can give you medically unnecessary medications or surgeries before the age of adulthood (18 years old) is not a bad law. It’s a great law because it prevents litigation (children medical law suits statues of limitations is WAY longer than adults.)
It's similar to saying "a black" vs "a black man" -- it's unnecessarily dehumanizing, and considered offensive by many who hold that identity. And since transgender is an adjective, it's also just plain bad grammar. https://www.merriam-webster.com/dictionary/transgender
As a black man, I reject this analogy for more than one reason. If you are looking at statistics for instance, it is perfectly okay to say for instance, blacks have been disproportionately been represented in healthcare studies or preventative care.
As a black man, I reject this analogy for more than one reason. If you are looking at statistics for instance, it is perfectly okay to say for instance, blacks have been disproportionately been represented in healthcare studies or preventative care.
As a white, I concur. Except whites have been over-represented in healthcare studies as a percentage of the population.
As a black man, I reject this analogy for more than one reason. If you are looking at statistics for instance, it is perfectly okay to say for instance, blacks have been disproportionately been represented in healthcare studies or preventative care.
Fair point. However, as a member of the LGBTQ community, with many trans friends and someone who has worked with trans patients, I can tell you that many of these folks would find these terms offensive. Some may not care, true. But I'd rather do my utmost to use language that is inclusive, non-offensive, and person-centered, and to advocate that others in this field do the same. I want patients of all genders to feel safe and understood by their healthcare teams.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
16 hours ago, Bloop41 said:
Fair point. However, as a member of the LGBTQ community, with many trans friends and someone who has worked with trans patients, I can tell you that many of these folks would find these terms offensive. Some may not care, true. But I'd rather do my utmost to use language that is inclusive, non-offensive, and person-centered, and to advocate that others in this field do the same. I want patients of all genders to feel safe and understood by their healthcare teams.
As a member of humanity it is ridiculous that we sit around getting offended by petty issues such as labeling. I have been called white had have been offended by it because of how the person used the term. I have been called honky and gringo and not been so offended because the people who were using them made it clear they were being cynical. The context of the label should be considered when chastising people for using them. At most I would say, “We prefer transgendered person and not a transgender.” But when you start the correction out as an accusation of offensive language by the person trying to have a sincere conversation, then it is you who cuts off the conversation. Hopefully more of us than not wish to be inclusive of others, but this crazy issue where we get hung up on terms instead of substance is nuts.
Why is race always conflated with LGBTQ? What about the people who are both, LGBTQ and non-white? They are separate issues and should be discussed as such. I hate when people throw race in sex related conversations. Just my pet peeve because the next step is to conflate civil rights issues with LGBTQ rights issues which are not the same either, because again, what if you have both issues at play?
Ask anyone in the LBGT community when they knew and 99% of us/them will say they knew in their childhood and definitely when we were teens. They don't make it to adulthood and suddenly decide they were born the wrong gender.
I agree with the person that it should be a case by case basis. Pretty much 99% of parents aren't going to go along with it anyway. But if someone is real sure they are transgender, has supportive and understanding parents, then the government should not tell them they can't be until they are "mature enough to make that decision". The same way they can't tell a cisgendered teen male "you can't decide that you like girls until you're mature enough to know for sure you're heterosexual".
Also about the person that stated that some kids go back and forth between genders, then obviously they aren't real sure and any good practitioner would not allow them to transition. These people might actually be nonbinary and grow up into someone that doesn't identify with a gender and that should be supported as well.
Transgendered persons don't go back and forth and make a decision. They are born that way and the only decision is how and when they can be their true identity, but society has other ideas.
Why is race always conflated with LGBTQ? What about the people who are both, LGBTQ and non-white? They are separate issues and should be discussed as such. I hate when people throw race in sex related conversations. Just my pet peeve because the next step is to conflate civil rights issues with LGBTQ rights issues which are not the same either, because again, what if you have both issues at play?
Just my $0.02. Carry on.
Thank you. It grinds my gears, especially equating the plight of the black community with the LGBTQ+ issues. It undermines the former. These are very distinct issues and there is a gaping chasm as wide as the grand canyon between the history of racial oppression and current gender issues. It is not only improper and foolish, but a gross act of negligence to draw parallel comparisons between the two societal classifications.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
13 hours ago, Tweety said:
Ask anyone in the LBGT community when they knew and 99% of us/them will say they knew in their childhood and definitely when we were teens. They don't make it to adulthood and suddenly decide they were born the wrong gender.
I agree with the person that it should be a case by case basis. Pretty much 99% of parents aren't going to go along with it anyway. But if someone is real sure they are transgender, has supportive and understanding parents, then the government should not tell them they can't be until they are "mature enough to make that decision". The same way they can't tell a cisgendered teen male "you can't decide that you like girls until you're mature enough to know for sure you're heterosexual".
Also about the person that stated that some kids go back and forth between genders, then obviously they aren't real sure and any good practitioner would not allow them to transition. These people might actually be nonbinary and grow up into someone that doesn't identify with a gender and that should be supported as well.
Transgendered persons don't go back and forth and make a decision. They are born that way and the only decision is how and when they can be their true identity, but society has other ideas.
I agree that sexuality and gender are solidified in adolescence. I still do not agree, even with the most sure of adolescence, that any healthy pediatric patient should be allowed to under go complex medical procedures for the sake of their appearance. And the excuse that they feel ‘wrong’ in their body and it is ‘more than’ their appearance are still emotional issues more than physiological ones.
Cleft palet, for example, is a deformity that prevents proper nutrition for an infant or child. For the physical health of the child it needs to be fixed. Otherwise I would say that it shouldn’t be fixed until the kid is 18 and can make that decision as an adult. Anything that doesn’t need to be done for the physical health of a child should not be allowed until they are 18.
Specializes in Nursing Education, Public Health, Medical Policy.
On 2/8/2020 at 12:14 AM, dream'n said:
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.
Unless the surgery/meds/procedures are being done with taxpayer sponsored insurance ( e.g.Medicaid), then it is the business of more than just the parents.
What's concerning is the trend of people mistaking gender stereotypes for a person's sex. Not every woman is submissive, loved barbie dolls as a child, or loves makeup and long hair. There are far too many people claiming they must be transgender because they're male yet they simply want to be feminine and preferred toys geared towards girls when growing up. Dysphoria with one's primary and secondary sex characteristics is one thing, but until this is differentiated from gendered preferences, it seems unwise to allow a child to make life-altering decisions potentially based on stereotypes.
.thumb.png.25dc111ae613e658de4a048da55b3337.png){kind=small}
Asystole RN
2,352 Posts
Not mature enough to vote, smoke, drink alcohol, sometimes drive with unrestricted licenses, or sometimes engage in sexual conduct but mature enough to make major life changing medical decisions?
I am not saying one way or the other but sheesh, can we decide how old is old enough?