Five Things to Know About Gender-Affirming Health Care
Across the country, lawmakers have enacted sweeping attacks on transgender people — particularly transgender youth. After initially focusing primarily on restroom restrictions, opponents of trans rights have switched their target to sports. This year, Arkansas went even further, passing a ban on gender-affirming healthcare for transgender youth. Four transgender youth and two doctors joined with the ACLU to sue the state.
Arkansas’s new health care ban, scheduled to go into effect at the end of July, would not only prohibit healthcare professionals from providing or referring transgender youth for medically necessary health care, it would also allow private insurers to refuse to cover gender-affirming care for transgender people of any age. If it is allowed to go into effect, the law will have detrimental effects on the mental, emotional, and physical health of transgender people across the state.
The first court hearing addressing the constitutionality of a ban on gender-affirming care for trans youth will take place on July 21. Here are five things to know about the Arkansas ban on gender-affirming care, taken directly from the personal testimonies and briefs submitted to the court.
Trans youth know what is best for them.
“[After starting hormone therapy,] I now feel a level of confidence I never knew was possible. I can easily and confidently interact with other people, whether I know them or not. My body is finally beginning to match who I am.” — Dylan Brandt
15-year-old Dylan Brandt and the three other transgender youth in our case know who they are.
“Hormone-therapy treatment has been life-changing. Since starting hormone therapy, I have become genuinely happy and confident for the first time since I can remember. I can finally see a future for myself. My depression has subsided. I have not engaged in self -harm. I have become more engaged with my family and community.” — Sabrina Jennen, another transgender youth relying on gender-affirming healthcare.
Parents see what gender-affirming care means to their kids.
“[After accepting Brooke’s new pronouns,] it was as if a cloud lifted and Brooke’s smile came back. We had a happy, bright-eyed child again, and we were relieved to see our child flourishing once more.” — Amanda and Shayne Dennis, parents of 9-year-old Brooke Dennis.
Amanda and Shayne Dennis are just two of the many parents of transgender children who have seen the positive impact that gender-affirming care has had on their children.
“Since starting hormone therapy…she has become more engaged with her family. Treatment has made her happy, confident, and has helped her become the thriving child we love so dearly.” — Aaron and Lacey Jennen, parents of 15-year-old Sabrina.
Many young people who are not trans access gender-affirming health care.
“If House Bill 1570 (the "Health Care Ban") takes effect, I will be prohibited from providing these treatments to my transgender patients because they relate to ‘gender transition’ but I will be able to continue providing the same treatments to my cisgender patients to help bring their bodies into alignment with their gender.” — Dr. Michelle Hutchison, one of the doctors suing the state.
Across pediatric practices, cisgender youth rely on this critical care for a variety of reasons — including to treat precocious puberty and polycystic ovarian syndrome. A Harvard Medical School and Fenway Institute study found that doctors have been using these safe medications for decades for cisgender children who go through puberty too early.
“There is nothing inherently harmful about undergoing hormone treatment to sustain one’s health and it is a common practice in many non-transgender patients for reasons unrelated to treatment of gender dysphoria. I regularly treat cisgender patients with the same hormone therapy that is provided to transgender patients.” — Dr. Deanna Adkins.
Doctors Agree: Gender-Affirming Care is Life-Saving Care
Arkansas has become the first state to pass a bill banning health care for transgender youth and 16 other states have introduced similar legislation.
Source: American Civil Liberties Union
Gender-affirming care saves lives.
“Gender-affirming care, including puberty suppression and hormone therapy, is potentially lifesaving.”
That’s what the Pediatric Endocrine Society made clear in their brief to the court.
“Proper gender-affirming care can mitigate a patient’s clinical distress and lead to significant improvements in the overall well-being of youth and adolescents who are at risk of or have been diagnosed with gender dysphoria … studies show that transgender adults who received appropriate treatment during adolescence had a lower incidence of lifetime suicidal ideation than those who wanted but could not obtain such treatment.” — The American Academy of Pediatrics.
In light of this, it is not surprising that child and adolescent psychiatrists have attested that, should the Health Care Ban take effect, “the lives of some of our patients will be put at risk.”
Laws attacking trans youth will hurt the Arkansas economy.
“If the Health Care Ban takes effect, the backlash — from consumers and businesses alike — is likely to be fierce, causing a decline in economic activity within the state. This will inflict substantial harm on amici, Arkansas businesses, and all Arkansans, because all benefit from a strong economy.” — A group of businesses in a brief to the court.
This is in large part because many of the families who will be affected by the Health Care Ban are considering leaving their homes, their extended families, their communities, and even their jobs to ensure that their children are able to receive gender-affirming care.
The ban could also discourage other LGBTQ individuals and their families from moving to the state altogether, impairing:
“the ability of [Arkansas businesses] to attract and retain a diverse, inclusive, and talented workforce. As a result, it will place Arkansas’ businesses at a competitive disadvantage, both domestically and on the global stage.” — Liveramp Holdings, Inc. and Additional Business Organizations.
Brandt et al v. Rutledge et al
Families of transgender youth and doctors are fighting an Arkansas law that would prevent transgender youth from getting medically necessary care.
Source: American Civil Liberties Union
Learn More About the Issues on This Page
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Press ReleaseDec 2024
LGBTQ Rights
President Biden Must Veto Defense Bill Attacking Military Families with Transgender YouthPresident Biden Must Veto Defense Bill Attacking Military Families with Transgender Youth
WASHINGTON — The U.S. Senate today passed a version of the National Defense Authorization Act that would ban coverage for gender-affirming care for transgender youth whose parents are active-duty military personnel. The American Civil Liberties Union is opposing final passage of the defense bill over the inclusion of this health care ban and calling on President Joe Biden to veto the bill. Section 708 of the NDAA would prohibit insurance coverage for “medical interventions for the treatment of gender dysphoria” such as hormone therapy and puberty-suppressant medications, which Speaker Mike Johnson says would “permanently ban transgender medical treatment for minors.” The same treatments would be covered by TRICARE for any medical purpose other than treating gender dysphoria, the clinical diagnosis for the psychological distress experienced by transgender people related to their gender identity. “By passing this bill, the House and Senate are forcing thousands of active-duty service members to choose between their careers in the military and the future of their transgender children,” said Mike Zamore, national director of policy & government affairs at the ACLU. “This unconscionable and unjustifiable attack on those families stands in direct contrast to President Joe Biden’s legacy of defending the civil rights of transgender Americans — including when few in his own party showed the courage to do so. President Biden should cement his legacy by vetoing this bill and sending it back to Congress to pass without Speaker Johnson’s last minute health care ban for servicemembers’ kids.” If signed by President Biden, this health care ban would be the first new anti-LGBTQ provision enacted by Congress and signed into law by the president since the enactment of the military’s since-repealed “Don’t Ask, Don’t Tell” policy for LGBTQ servicemembers and the since-repealed federal law barring recognition of same-sex marriages known as the Defense of Marriage Act. It is unknown how many transgender youth are currently enrolled in TRICARE or how many of those enrolled are currently receiving coverage for gender-affirming care. In one 2022 analysis, 2,500 minor patients sought care for gender dysphoria through TRICARE Prime insurance at military or civilian treatment facilities in 2017, and 900 received puberty suppressants or gender-affirming hormones. Earlier this month, the Supreme Court heard oral arguments in a landmark case brought by the ACLU, the ACLU of Tennessee, Lambda Legal, and Akin Gump on behalf of three families and a medical provider challenging a Tennessee ban on gender-affirming hormonal therapies for transgender youth on the grounds the ban violates the Equal Protection Clause of the U.S. Constitution. -
Press ReleaseDec 2024
LGBTQ Rights
Montana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's LicensesMontana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's Licenses
HELENA, Mont. – A Montana court has granted a preliminary injunction preventing the state of Montana from enforcing policies that bar transgender people from obtaining accurate sex designations on their birth certificates and driver’s licenses. After a prior restriction on amendments of birth certificates was struck down by the courts, in early 2024 the state of Montana enacted a new rule that categorically bars transgender Montanans from correcting the sex designation on their birth certificates. Around the same time, the Montana Department of Justice adopted a policy similarly restricting amendment of driver’s licenses. The plaintiffs challenged these policies in state district court, arguing that they violate various constitutional provisions, including the right to equal protection of the law. In a recent Montana Supreme Court decision, two justices concluded that discrimination on the basis of transgender status – as the state is engaging in here – is a form of sex discrimination that violates the Montana Constitution’s equal protection clause. The plaintiffs, two transgender women, are represented by the American Civil Liberties Union, the ACLU of Montana, and Nixon Peabody LLP. Plaintiff Jessica Kalarchik, a veteran who served in the United States Army for 31 years, said: “After finally being able to live my life openly as the woman I know myself to be, I am frustrated that my birth state, Montana, wants me to carry around a birth certificate that incorrectly lists my sex as male. I live my life openly as a woman, I am treated as a woman in my daily life, and there is no reason I should be forced to carry a birth certificate that incorrectly identifies me as male. Fortunately, the court agrees that this ridiculous policy should not be in effect.” “Once again the State of Montana chose to adopt a draconian policy that is clearly intended to marginalize transgender Montanans, only for that discriminatory action to be blocked by the courts,” said Akilah Deernose, executive director for the ACLU of Montana. “Here in Montana we treasure our right to privacy and to live our lives free from governmental intrusion. The State of Montana clearly has not learned any lessons from the past few years, where courts have repeatedly struck down unconstitutional laws targeting transgender Montanans.” “Forcing anyone to carry documents that contradict their identity unjustly violates their rights to privacy, equal treatment, and not being compelled to convey a government message about their sex that they disagree with,” said Malita Picasso, staff attorney for the ACLU’s LGBTQ & HIV Project. “Such a policy marks transgender people for further mistreatment and discrimination, essentially requiring them to carry papers that out them as transgender any time they need to provide identity documents. Fortunately, the court has refused to allow the state of Montana to subvert the freedom of transgender Montanans to control their own identity as this case goes forward.” In granting the plaintiffs’ motion for a preliminary injunction, the court held, “[i]f the challenged state actions discriminate against transgender individuals on the basis of their transgender status, they also necessarily discriminate the basis of sex.” The state has the option of appealing the district court’s ruling to the Montana Supreme Court, but the underlying case will proceed in district court. A trial has not yet been scheduled. -
FloridaDec 2024
LGBTQ Rights
Keohane v. DixonKeohane v. Dixon
On September 30, 2024, the Florida Department of Corrections rescinded its policy regarding treatment of gender dysphoria, which allowed for hormone therapy when deemed medically necessary, as well as access to clothing and grooming standards that accord with one’s gender identity. Under this new policy, grooming and clothing accommodations have been stripped away, and hormone therapy is not permitted unless an exception is deemed constitutionally required. The ACLU brought a class action challenging the policy. -
IdahoDec 2024
LGBTQ Rights
Robinson v. LabradorRobinson v. Labrador
Two incarcerated transgender women have sued the state of Idaho alleging that HB 688, a 2024 law barring state funding for gender-affirming medical care for transgender people, denies them access to the health care their doctors have prescribed for them and is a violation of their Eighth Amendment right to be free from cruel and unusual punishment. They represent a class of all incarcerated folks within the state of Idaho who face the loss of hormone therapy due to HB 668.