Bill limiting access to gender-affirming care in Kentucky gets approval from House
An ostensibly distilled version of a bill that would radically limit access to gender-affirming health care for LGBTQ youth in Kentucky won approval from a legislative committee and the House of Representatives Thursday.
House Bill 470, from Rep. Jennifer Decker, R-Shelbyville, restricts how health care providers across specialties treat their underage transgender patients by outlawing “gender-affirming care” and “gender transition services.” The version of the bill approved 14-7 by the House Judiciary Committee Thursday afternoon, revised from an initial draft, defines gender-affirming care as “treatments by health care providers that support a gender transition.”
According to the bill, those treatments include the prescription of puberty-blocking hormones, gender re-assignment surgery, and inpatient and outpatient hospital services.
An earlier version of the bill included “mental health providers” in that definition and explicitly barred providers’ use of minor patient names and pronouns if they don’t correspond with their gender assigned at birth. The draft that won approval from Thursday’s committee did not include that reference. But its definition of “health care providers,” as defined by Kentucky State Statutes includes “mental health services.”
It’s the latest measure among a raft of others this session aimed at regulating the treatment of LGBTQ youth in Kentucky. Opponents, including doctors, said the bill will have grave impacts on an already marginalized population. Throngs of people descended on the Capitol Annex Thursday to speak in opposition to the bill. Clad in Pride flags, some carrying signs, they filled the committee room and an additional overflow room, where they watched the meeting remotely.
Before Decker won support from Republicans in the House for her bill, 75-22, she explained to the committee that her bill, “seeks to protect Kentucky’s children from irreparable damage.” Her bill, which now goes before the Senate, deems the provision of gender-affirming care by health care providers “unethical and unprofessional,” and “unfit to perform the duties and discharge the responsibilities of his or her position or occupation.”
This directly contracted testimony from three doctors, two of whom spoke on behalf of the Kentucky Medical Association and the Kentucky Psychological Association.
Pediatric doctors, a psychologist and a social worker who addressed the committee Thursday begged lawmakers not to pass this measure, which they say is antithetical to the “standard of care” that is scientific, evidence-based and backed by major medical associations including the American Academy of Pediatrics and the American Psychological Association.
Dr. Laurie Mount Grimes, speaking on behalf of the Kentucky Psychological Association, said KPA has “grave concerns about the toxic effect on the mental health of trans kids.”
At the “root of this legislation is a belief that trans is not a real thing,” Mount Grimes said. “Trans identity cannot be legislated away, and laws should not be enacted that directly increase their sense of isolation,” she said, echoing what three separate family medicine health care providers told the Herald-Leader in a report published earlier on Thursday. They fear a “mental health crisis” among LGBTQ youth will result from such measures passing into law.
Miles Joiner, a social worker, said this bill “asks me to go against the American Medical Association, the American Psychiatric Association and the American Medical Association. How can you ask professionals to do that?”
Joiner, who is a trans man, said “gender-affirming care for (youth) is ethical, moral and compassionate. Please set aside your opinion about trans people. What are the experts saying?”
Joiner asked committee members, “If somebody decided they were going to deny you medically-necessary care that would save your life, how would that make you feel?”
Decker, who was flanked by two out-of-state providers and a doctor from Knox County, said, “we do not allow parents to give alcohol or cigarettes (to kids) until age 18. The state has a compelling interest in protecting children from decisions that cause irreparable harm.”
Dr. Roger Hiatt, Jr., a child and adolescent psychiatry specialist in Arkansas speaking in favor of the bill, likened gender-affirming care by way of puberty blockers to “child abuse.” He said the most promising route to curbing disproportionately high suicide rates among trans youth was through “desistance,” or a “return to gender identity consistent with biological reality.”
Decker did not win the support of all her fellow Republicans. Rep. Kim Moser, R-Taylor Mill, Rep. Kim Banta, R-Fort Mitchell, and Rep. Stephanie Dietz, R-Edgewood, all voted no on Decker’s bill. They later were the only House Republicans to cast no votes on the House floor.
Moser, a retired nurse, called the bill “short-sighted and discriminatory.”
“Nothing says we value health care workers like a 30-year statute of limitations,” Moser said, referencing the time allowed for an aggrieved patient to bring a lawsuit against a provider for providing gender-affirming care. “The message we are sending to our health care workforce is atrocious.”
At the Capitol Annex Thursday, tensions were high among the crowd that had amassed to speak on the House Bill 470. As soon as the vote tallies were announced by Chairman Daniel Elliott, a member of the crowd shouted, “Murder!” This outburst was followed by collective chants of “Shame, shame, shame,” as bill opponents spilled into the hallway and made their way across the lawn to the Capitol.
What happens next?
Though it cleared the House, the fate of House Bill 470 is equally dependent on the Senate, which will have to review and potentially make changes to the bill before giving it final passage. The fate of the Senate’s own bill, Senate Bill 150, which has also drawn the ire of House Bill 470 opponents, could be tied to the House’s.
Senate Bill 150, from Sen. Max Wise, R-Campbellsville, passed easily through the Senate in late February. The bill would, among other things, allow teachers to choose if they want to use students’ preferred pronouns.
It begs the question: what trans-related legislation will get full passage in both chambers, and could provisions of any of the raft of anti-LGBTQ legislation filed get tacked onto a bill late in the legislative process?
Wise wouldn’t say whether or not he supported House Bill 470, but said he’s anxious to get his own bill full passage in the House.
Senate Majority Floor Leader Damon Thayer, R-Georgetown, said that Wise and Sen. David Givens, R-Greensburg, are working with House members to make minor changes to Wise’s bill.
“There’s a lot of ongoing discussions right now on how the bill will continue to play throughout the process, and that’s about all I can share,” Wise said.
Herald-Leader writer Austin Horn contributed to this report.
This breaking story will be updated.
This story was originally published March 2, 2023 at 2:21 PM.
