These States Could Outlaw Transgender Teens’ Access to Health Care and Sports

On Monday, Montana legislators are set to debate whether the state should discriminate against its young trans population.

If passed into law, HB 112 would prevent interscholastic athletes from participating in athletic activities consistent with their gender identity, while HB 113 would enshrine an effective ban on physical and mental health care for trans youth, including banning the use of puberty blockers, while punishing and fining doctors who treat young trans people.

Both bills were introduced by Rep. John Fuller, who has not returned The Daily Beast’s requests for comment. “Fuller says he finds it wrong for young people to go through these types of medical procedures, some of which are irreversible, when they’re so young,” Montana Public Radio reported.

Montana is not alone; 12 other states (so far) have recently crafted similar bills to be debated and perhaps passed into law, specifically targeting young trans people’s access to health care and playing sports.

More than 150 Montana businesses have so far signed on to a letter protesting against the proposed laws.

“As business leaders in Montana, we value full inclusion of the LGBTQ community, and the rights LBGTQ people deserve as students, employees, patrons, and visitors in our great state,” the letter reads.

“HB 112 and HB 113, supported by anti-equality legislators, single out young members of our thriving communities simply for who they are and are deeply damaging to our state. HB 112—based on unfounded claims and fears surrounding youth participation in sports—seeks to ban transgender youth from participating in sports.

“Team sports teach all children valuable life skills, including teamwork, leadership, and self-confidence. We should not deprive transgender youth of the opportunity to develop these skills. HB 113 singles out young transgender members of our thriving communities in being able to access medically necessary care and fines health care providers for giving the standard of care.”

The signatories also make clear their belief that the passage of the legislation would negatively affect business, commerce, and the recruitment of medical professionals in Montana. “The safety, security, and well-being of LGBTQ Montanans directly impacts the growth and prosperity of our business, the productivity and retention of our employees, and the economic development of our state,” they write.

Elsewhere in the U.S., in Alabama, HB1—the “Alabama Vulnerable Child Compassion and Protection Act”—would outlaw therapy for trans minors, and allow for schools to invade their privacy to divulge information about them to their parents.

The administration of puberty blockers, say the drafters of the legislation, “constitutes dangerous and uncontrolled human medical experimentation that may result in grave and irreversible consequences to their physical and mental health.” According to the bill’s proponents, puberty blockers foreclose “the possibility of a natural recovery from this condition”—characterizing being trans as some kind of illness.

Also in Alabama, SB10 would outlaw the provision of puberty blockers to trans teens. Senate Bill 224 in Indiana seeks to broadly do the same.

Guidelines published by organizations including the Endocrine Society, the American Academy of Pediatrics, and the World Professional Association for Transgender Health state that trans teens should be offered medical treatments, including blockers.

Adolescents who wanted and received puberty blockers were 60 percent less likely to have considered suicide within the past year and 30 percent less likely to consider suicide throughout life, according to findings published in the February 2020 issue of Pediatrics. A second study of young Canadian trans people—published in September also by Pediatricsechoed the February study findings.

Young people who received gender-affirming care, “namely, hormone blockers and/or gender-affirming hormones, experience a decrease in emotional and behavioral problems and an improvement in overall psychological functioning,” the Canadian study found.

In Texas, HB 68 proposes that a medical professional supplying puberty blockers, or affirming trans kids, is guilty of “child abuse.” In Missouri, HB 33 would prohibit transition care for trans teenagers under the age of 18. In Utah, HB92 would prohibit “a physician or surgeon from performing a transgender procedure on a minor.”

In Mississippi, the so-called “Transgender 21 Act” (Senate Bill No. 2171) would prohibit transition-related care until a person is 21. Parents of trans teens in the state “have an absolute right to control all aspects of the child’s care,” the proposed legislation reads. Trans teens’ privacy could be legally intruded upon “by schools and other institutions.”

In Tennessee, HB 3 would constitute an absolute ban on trans kids taking part in athletics. A child’s gender, say the drafters of that bill, is their “sex at the time of the student’s birth, as indicated on the student’s original birth certificate.”

In Oklahoma, the “Save Women’s Sports Act,” in relation to athletics teams, sees a student’s gender identity as “defined by biological sex,” which is also echoed in South Carolina’s H. 3477 bill, which lays out in emphatic upper case: “PUBLIC AND PRIVATE MIDDLE SCHOOL-LEVEL AND HIGH SCHOOL-LEVEL TEAMS AND SPORTS MUST BE DESIGNATED BASED ON BIOLOGICAL SEX… TEAMS OR SPORTS DESIGNATED FOR FEMALES MAY BE RESTRICTED TO STUDENTS OF THE FEMALE SEX…”

In North Dakota, the proposed bill HB1298 decrees the same, effectively barring young trans athletes from competition. The Grand Forks Herald reported, “The bill would outlaw any state-owned athletic facility from hosting a competition in which an athlete competes against anyone outside of the gender they were assigned at birth.”

Its lead sponsor, Rep. Ben Koppelman, told the Grand Forks Herald that the legislation “has nothing to do with transgender athletes… I kind of dismiss the idea that it should be about trans, because it’s not about trans—it’s about fair competition… What it’s based on is science that says, ‘Here are the physiological differences between people when they are born.’ And these are irreversible things.”

Make no mistake: these bills target and attack trans youth and will cause them serious and lasting harm

Caitlin Borgmann

In New Hampshire, HB 198 would see high school and postsecondary athletic teams and sports designated for females, women, or girls “based upon biological birth.” Those sports “shall not be open to students of biological male birth gender. Single sex athletics is rooted in the reality of biological differences between the sexes and is rooted in objective biological fact and fairness.” Meanwhile, New Hampshire’s HB 68 defines health care for young trans people as “child abuse.”

“Make no mistake: these bills target and attack trans youth and will cause them serious and lasting harm,” Caitlin Borgmann, executive director of the ACLU of Montana, said of the proposed bills in that state. “We cannot let fearmongering and lies about what it means to be transgender result in laws that would stigmatize trans youth, harm families and communities, and drive businesses away from Montana. Trans youth deserve respect and dignity for everything they are. These anti-trans bills are not welcome in Montana.”

Miha, who oversees public education for Transvisible Montana (and who declined to give a surname), said they were not surprised by the bills and hoped they would fail. “We’re used to being bullied by legislators. We’re just doing the best we can to make connections with our community, and keep them informed so they can talk to their representatives. I think our opposition has seen this legislation work in other places like our neighbor Idaho, so they’re thinking, ‘Let’s try it here.’

“They also know that people get afraid of what will happen to children, so they come up with these hyped-up bills playing on those fears, without knowing all the information, and without thinking about their fellow citizens, who include transgender, non-binary, and two-spirit people.”

Chase Strangio, deputy director for transgender justice at the American Civil Liberties Union’s LGBT & HIV Project, told The Daily Beast the various bills’ presence was part of a coordinated attempt to undermine trans rights by right-wing activist and judicial organizations including the Alliance Defending Freedom (ADF), which has been designated by the Southern Poverty Law Center as an anti-LGBTQ hate group.

“In 2016, the bills were all about bathroom access. What we’re seeing is a shift in target—from the restroom to the playing field and health care provider,” Strangio said, adding the bills could be a backlash against last year’s totemic “Bostock” Supreme Court ruling that Title VII of the 1964 Civil Rights Act does protect LGBTQ people from discrimination.

We’re talking about cutting young people off from the health care they are relying on or they’ve been anticipating…

Chase Strangio

“If these were to pass, my whole body tenses up in terms of the drastic physical and emotional harm that would result instantaneously,” Strangio said. “We’re talking about cutting young people off from the health care they are relying on or they’ve been anticipating, forcing kids into experiencing catastrophic dysphoria, and undoing the treatment people have been receiving. We know from studies not having access to care in the first instance is catastrophic. We don’t know yet the devastating consequences of actually withdrawing care, because that would be so far outside the scope of any medical protocol. Kids are going to die, and probably quickly.

“I am not being hyperbolic. Essentially, what these bills do is make it a crime to be trans and under 18—or under 21 in some cases. If these bills pass, the very real questions become, how do people survive, how do we keep people alive, how do we support people, and how do we fight back?”

The ACLU, said Strangio, would work to stop the bills going into effect, especially after a recent British high court ruling—as reported in The Daily Beast—resulted in trans kids having their care abruptly withdrawn.

“As ever, people with the means and resources will find a way, while those who will suffer most will be poor and without access to health care, and they are going to be in a serious situation,” Strangio said.

The new bills follow Idaho’s federal court blocking an effort to prevent transgender people born in the state from changing the gender marker on their birth certificates to match their gender identity.

A federal judge in the state also blocked the enactment of another law, HB 500, which would have banned transgender students who identify as female from playing on female teams sponsored by public schools, colleges, and universities. (The ban does not apply to men’s teams.) The legal battle over reaffirming or striking down the Idaho athletics ban continues.

HB 500 and the other anti-trans sports bills in legislatures fly in the face of the current National Collegiate Athletic Association (NCAA)’s inclusive policies. Billie Jean King and Megan Rapinoe were among 200 elite female athletes who signed an amicus brief against HB 500, writing, “This bill flies in the face of bedrock principles of equality and diversity in sports.”

NBC News reported earlier this month on a British Journal of Sports Medicine study which showed that trans female athletes maintained an athletic edge over cisgender competitors after a year of hormone therapy.

However, some of the methodology behind the research has been questioned, and its lead author, Dr. Timothy Roberts, made clear to NBC News that he did not support those who cited the research to argue that trans women be excluded from playing sports.

For one, Roberts’ research focuses on adults, rather than the teen athletes who are the focus of the current wave of anti-trans bills. A transgender woman who transitions before or at puberty “doesn’t really have any advantage” when it comes to athletic performance, Roberts told NBC News. “So that young lady should be allowed to compete with all the other people who are born women.”

I’m optimistic. We are encouraging folks to get in touch with their representatives to vote ‘no’ on the two bills.

Andy Nelson

Andy Nelson, operations administrator at The Center, Western Montana’s LGBTQ+ Community Center, told The Daily Beast, “It’s a disheartening feeling for sure, seeing these two bills. They’re very detrimental. When the Montana legislature meets, these kinds of bills tend to be brought up by Republican legislators. Typically they get shut down, but this time all branches of the state government are Republican-controlled, and so it feels a little more pressing. But I’m optimistic. We are encouraging folks to get in touch with their representatives to vote ‘no’ on the two bills.”

The proposed sports bills also undermine trans teens’ medical care, said Strangio. “If you have to participate according to the sex assigned to you at birth, or be excluded from critical parts of education peers have access to, that’s incredibly stigmatizing. It undermines people’s sense of inclusion.”

The conversations to date about trans participation in sports—around safety, and perceived advantage—“have been so mean-spirited they have led to trans people not wanting to take part in sports,” said Strangio, with trans kids unable to access “the benefits that flowed from taking part in youth sports.”

“It’s emotionally devastating for young trans people who have found joy and connection in athletics to have that taken away, and it undermines medical protocols to treat trans youth,” Strangio said. “Treat them as who they are, consistent with their gender identity—and that means in all aspects of their lives. You can’t be a boy 60 percent of the day, then have the state try to force you to be a girl on the soccer field. That just doesn’t work.”

There was “no evidence” that trans people so dominate in athletics as to present any kind of threat, said Strangio—and trans athletes featured as many variations in their strength and speed as cisgender athletes.

Strangio mentioned the headline-making example of trans wrestler Mack Beggs, who was forced to compete against girls because of Texas athletic rules, when all he wanted to do was to “be allowed to compete against other boys.”

“There are shifting justifications for these sorts of rules and laws,” said Strangio. “But they are not about protecting anyone. They are about hurting trans people. I think there is a serious risk of these laws passing in many states. We and other groups will fight with everything we have to support trans people to stop them from passing. The introduction of the bills is harmful enough. The passage of the bills is absolutely devastating.”

The community response is very much ‘We respect you, we value you, and you should have your rights.’ These two bills are just upper-level bullying.

Miha, Transvisible Montana

Transvisible Montana’s Miha is hopeful that the state’s bills will fail, because of the success LGBTQ campaigners had had to date in campaigning for anti-discrimination ordinances in different Montana cities. “The community response is very much ‘We respect you, we value you, and you should have your rights.’ These two bills are just upper-level bullying. I am concerned, but remain hopeful that the better in people shines through, or that the folks behind the bills realize they’re wrong and have a turnaround on it.”

Strangio takes some hope from the imminence of a Biden administration, and Democrat control in the House and Senate. “They will hopefully not allow for discrimination against trans people in education. All these states are going to risk their federal funding if they treat trans people in these ways, and there will be blood on their hands if they systematically cut off health care for trans people. I hope they come to their senses before it’s too late.”

As well as the significance of the “Bostock” ruling, a Democrat-controlled Senate may also pass the Equality Act, enshrining LGBTQ protections in federal law. Strangio also hopes the Biden administration enforces the anti-discrimination protections under Title IX with regard to trans students, as the Obama administration had done—and as the Trump administration, under Education Secretary Betsy DeVos, had sought to undermine.

Andy Nelson told The Daily Beast he had lived all his life in Montana. “My feeling about the state is that it has a general ‘live and let live’ feeling. We don’t see a lot of the strong hatefulness you see in other parts of the country. Some people, especially those with religious views, may not agree with LGBTQ people, but they also think LGBTQ people should just be let be.

“The folks who bring these kinds of bills up tend to come from rural parts of the state. They are ignorant of the LGBTQ community, and may not have met a trans person—or may have done but not realized it. They are jumping on the anti-trans bandwagon, having seen what our neighbor Idaho did with its anti-trans bill.”

We are in the middle of a pandemic. Shouldn’t states be focusing on other things rather than harming people and pursuing discriminatory policies, especially when they affect kids?

Chase Strangio

“I can’t say how misguided and dangerous these proposed laws are,” said Strangio. “If the states disrupt the ability of doctors to administer care during a pandemic, they are going to have a hard time recruiting medical professionals in their state when they need them most. Undermining their ethical and professional obligations is not a good message to send to those wanting to practice medicine in those states.

“Also, we are in the middle of a pandemic. Shouldn’t states be focusing on other things rather than harming people and pursuing discriminatory policies, especially when they affect kids? The idea at this time that these states want to mistreat young trans people is something completely outside the bounds of anything I could have imagined, and is a sad commentary on our entire country.”

“There are so many studies out there that show—and we know as people living this experience—that our access to health care is life-saving,” said Miha from Transvisible Montana. “We are a really great, strong community of people who no matter what happens will support each other, find ways to uplift each other, and get the care that we need.”