More than 200 medical professionals in the South have signed an open letter opposing a bevy of state bills targeting health care treatment for transgender minors.
In at least eight states, Republican lawmakers have introduced proposals that would punish — and in some cases jail — doctors and other medical professionals who provide puberty-suppressing drugs, cross-sex hormones and transition-related surgery to adolescents. Bills being debated in Missouri and New Hampshire would classify this gender-affirming care as “child abuse.”
"Enacting this disturbing anti-transgender legislation would prohibit me and other medical providers from doing our jobs, forcing us to violate existing standards of medical care for transgender patients."
Dr. Michael Guyton-Nunley
“These bills run counter to the growing consensus in the medical community that improving access to gender-affirming care is a central means of improving health outcomes for transgender people,” stated the letter, which was coordinated by the advocacy group Campaign for Southern Equality.
“Many credible studies of trans youth populations have demonstrated that gender-affirming care is linked to significantly reduced rates of depression, anxiety, substance abuse and suicide attempts,” the letter continued. “Gender-affirming care reduces reliance on self-prescribed and self-administered hormone use, which can be dangerous without the oversight of a physician. To put it plainly, gender-affirming care saves lives and allows trans young people to thrive.”
The letter was signed by a wide variety of health care professionals, including mental health counselors, pharmacists, nurse practitioners, surgeons, speech pathologists and dentists. Dr. Michael Guyton-Nunley, one of the signatories and a physician practicing in Greenville, South Carolina, said denying medically necessary medication or surgery to trans youth would “cause long-term harm.”
“Enacting this disturbing anti-transgender legislation would prohibit me and other medical providers from doing our jobs, forcing us to violate existing standards of medical care for transgender patients,” he said. “I join so many of my colleagues across the South in urging lawmakers to reject these dangerous and discriminatory bills.”
Proponents of these bills believe they are necessary to prevent young people from making decisions about their bodies before they are old enough to understand the consequences. South Dakota state Rep. Fred Deutsch, a Republican co-sponsor, argued that the answer to “children’s identification with the opposite sex isn’t to poison their bodies with megadoses of the wrong hormones, to chemically or surgically castrate and sterilize them, or to remove healthy breasts and reproductive organs.”
After passing the state House on Jan. 29, Deutsch’s legislation could be up for a vote in the South Dakota Senate as soon as next week.
Jasmine Beach-Ferrara, executive director of the Campaign for Southern Equality, an LGBTQ advocacy group, said publishing the open letter was of particular importance, as a handful of the bills targeting transgender health care have been introduced in several Southern states. Legislation proposed in South Carolina, for instance, would subject doctors to losing their license for offering gender-affirming care to trans minors, while a bill under consideration in Kentucky would make it a felony.
“Unfortunately, the South has long been the testing ground for some of this insidious legislation,” Beach-Ferrara told NBC News. “When far-right think tanks generate these bills, the South is one of the first places they tend to go.”
The South has, indeed, weathered its share of bills targeting lesbian, gay, bisexual, transgender and queer people in recent years. Mississippi is home to the nation’s strictest “religious liberty” law, which allows businesses to refuse service to customers based on their sexual orientation and gender identity. Some critics of the bill, HB 1523, claimed it could even allow women to be fired from their jobs for wearing pants.
More recently, Tennessee passed a law allowing taxpayer-funded foster care and adoption agencies to refuse to work with LGBTQ prospective parents and others if doing so would conflict with their religious beliefs. More than 100 businesses — including Amazon, Hilton and Nike — condemned the measure, which activists call a “license to discriminate.”
Advocates believe there is reason for hope in the South, however. A bill in Florida that would have — like Kentucky’s legislation — subjected doctors to a felony charge for providing transgender care to minors was effectively killed on Monday.
“A very brave group of trans youth, their families and providers testified at the hearing and were present there,” Beach-Ferrara said. “We see what happens when people get to hear the actual stories of real people and understand what's at stake.”
The Campaign for Southern Equality hopes the open letter will serve as a reminder that while some conservatives support these measures, the medical community does not. In addition to support for gender-affirming care for trans youth from groups like the American Medical Association and the American Academy of Family Medicine, a study published in January in the journal Pediatrics found that having access to treatments like puberty blockers significantly decreases suicidal thoughts in transgender people.
Beach-Ferrara said amplifying the voices of medical professionals is particularly critical because of how much is on the line — especially when research shows that 41 percent of trans people have attempted suicide at some point in their lives.
“We’re doggedly optimistic that when people learn exactly how extreme these laws are, they will understand that these bills need to be dead on arrival,” she said.