- As Republican lawmakers advance bills that members of Iowa’s LGBTQ community say targets them for discrimination, the Iowa House now may take up a ban on providing gender-affirming care for transgender minors, House Speaker Pat Grassley said Thursday.
His comments came as the House Government Oversight Committee heard testimony from doctors that deal with transgender patients, who said providing gender-affirming care to minors is a methodical and deeply personalized process that involves multiple doctors and the consent of parents.
“Based on some of the information we’ve had shared with us, I think that there could be an expectation of seeing some legislation potentially moving forward,” said Grassley, a New Hartford Republican, before the hearing Thursday. "But obviously we want to see how that hearing plays itself out."
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Grassley did not say what exactly the legislation would entail, but he said it could include a ban on puberty blockers, hormones and surgeries, all interventions that are used with varying frequency on youth whose gender identity does not align with their sex at birth.
The move would contradict the guidance of several major medical groups, including the American Medical Association, the American Pediatric Association and the American Association of Psychiatrists. In a letter to state governors in 2021, the American Medical Association urged against limiting the practice and said gender-affirming care correlates with a reduction in mental health problems and suicide attempts.
A wave of similar legislation in Republican-led states has been considered this year, and Utah and Florida are among the states that have enacted such bans.
House Minority Leader Jennifer Konfrst of Windsor Heights said the hearing on gender-affirming care was “performance” and Democrats would oppose any legislation that bans gender-affirming care for minors.
“At the end of the day this is really just a show,” she said. “If something does come forward or if something moves along from the Senate or some language moves forward, of course we’ll be opposing that. But we want to make sure that any legislation we do with regard to health care is based on science and expertise and not internet conspiracy theories.”
Legislation has been proposed in the Senate that would ban gender-affirming puberty blockers, hormones or surgeries for minors, and would allow a person to bring a lawsuit against a doctor who performs the care. But the measures have not moved through the committee process.
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In the hearing Thursday, lawmakers heard from Katie Imborek, co-director of the University of Iowa Health Care’s LGBTQ+ Clinic. and Dave Williams, chief medical officer at UnityPoint Health, on the medical care that the facilities provide.
Imborek said the UI follows guidelines set out by medical organizations, including the Pediatric Endocrine Society, to treat youth with gender dysphoria.
The clinic treats minors that have been diagnosed by a mental health professional. The clinic does not use any medical intervention on minors before they’ve reached puberty and does not perform genital reconstruction surgery on minors, Imborek said.
When a patient who has been diagnosed with gender dysphoria reaches puberty, the clinic may prescribe a medication that stops puberty, called puberty blockers. Later in adolescence, it may prescribe hormone treatment and in some cases perform a surgery to remove breast tissue.
Imborek said gender-affirming care leads to a decrease in behavioral and emotional problems, depression and suicidal ideation.
“No one is rushed through this process,” she said. “Minors are not provided care without parental support. … The evidence shows it not only helps, but can be life-saving.”
Republicans raised concerns about providing irreversible or semi-irreversible care to minors who they said are not old enough to make informed decisions about their gender identities. Rep. Brooke Boden of Indianola, who chairs the committee, said the brain is still developing in adolescence and questioned whether a teenager can make the decision to undergo a mastectomy.
Imborek said gender transition surgeries are rare for minors — it has been performed five times in the last year at the UI hospitals — and on people who have been living in their gender identity for a long time and have severe gender dysphoria.
Republicans also asked about the frequency of “de-transitioning,” or people deciding to discontinue gender transition care. Imborek said she can count “on one hand” the number of patients who have chosen to stop hormone therapy in her practice. She said data on adults who de-transition shows that a vast majority of them do because of social pressures, not because they change their gender identity.
“When we’re talking about irreversible surgeries or partially irreversible surgeries, or really changing children’s endocrine systems that affect them over a lifetime, I don’t think we know that we’re not doing harm to those children,” said Rep. Phil Thompson, R-Boone. “Especially the ones that choose to reverse those therapies.”
Imborek said she is worried a ban on gender-affirming care would have “devastating” effects on her patients, who she said have thrived with care.
“I am probably worried most that my patients who have already started down this path that are minors, that this would be really devastating for them, she said.
Keenan Crow, a lobbyist with LGBTQ activist group One Iowa, said banning the care would be dangerous for transgender youth.
“We should be letting evidence, science and medical consensus drive these conversations, not the biases of a few politicians trying to score political points against a marginalized group of children,” Crow said.
www.thegazette.com
His comments came as the House Government Oversight Committee heard testimony from doctors that deal with transgender patients, who said providing gender-affirming care to minors is a methodical and deeply personalized process that involves multiple doctors and the consent of parents.
“Based on some of the information we’ve had shared with us, I think that there could be an expectation of seeing some legislation potentially moving forward,” said Grassley, a New Hartford Republican, before the hearing Thursday. "But obviously we want to see how that hearing plays itself out."
Advertisement
Grassley did not say what exactly the legislation would entail, but he said it could include a ban on puberty blockers, hormones and surgeries, all interventions that are used with varying frequency on youth whose gender identity does not align with their sex at birth.
The move would contradict the guidance of several major medical groups, including the American Medical Association, the American Pediatric Association and the American Association of Psychiatrists. In a letter to state governors in 2021, the American Medical Association urged against limiting the practice and said gender-affirming care correlates with a reduction in mental health problems and suicide attempts.
A wave of similar legislation in Republican-led states has been considered this year, and Utah and Florida are among the states that have enacted such bans.
House Minority Leader Jennifer Konfrst of Windsor Heights said the hearing on gender-affirming care was “performance” and Democrats would oppose any legislation that bans gender-affirming care for minors.
“At the end of the day this is really just a show,” she said. “If something does come forward or if something moves along from the Senate or some language moves forward, of course we’ll be opposing that. But we want to make sure that any legislation we do with regard to health care is based on science and expertise and not internet conspiracy theories.”
Legislation has been proposed in the Senate that would ban gender-affirming puberty blockers, hormones or surgeries for minors, and would allow a person to bring a lawsuit against a doctor who performs the care. But the measures have not moved through the committee process.
Doctors speak
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In the hearing Thursday, lawmakers heard from Katie Imborek, co-director of the University of Iowa Health Care’s LGBTQ+ Clinic. and Dave Williams, chief medical officer at UnityPoint Health, on the medical care that the facilities provide.
Imborek said the UI follows guidelines set out by medical organizations, including the Pediatric Endocrine Society, to treat youth with gender dysphoria.
The clinic treats minors that have been diagnosed by a mental health professional. The clinic does not use any medical intervention on minors before they’ve reached puberty and does not perform genital reconstruction surgery on minors, Imborek said.
When a patient who has been diagnosed with gender dysphoria reaches puberty, the clinic may prescribe a medication that stops puberty, called puberty blockers. Later in adolescence, it may prescribe hormone treatment and in some cases perform a surgery to remove breast tissue.
Imborek said gender-affirming care leads to a decrease in behavioral and emotional problems, depression and suicidal ideation.
“No one is rushed through this process,” she said. “Minors are not provided care without parental support. … The evidence shows it not only helps, but can be life-saving.”
Republicans raised concerns about providing irreversible or semi-irreversible care to minors who they said are not old enough to make informed decisions about their gender identities. Rep. Brooke Boden of Indianola, who chairs the committee, said the brain is still developing in adolescence and questioned whether a teenager can make the decision to undergo a mastectomy.
Imborek said gender transition surgeries are rare for minors — it has been performed five times in the last year at the UI hospitals — and on people who have been living in their gender identity for a long time and have severe gender dysphoria.
Republicans also asked about the frequency of “de-transitioning,” or people deciding to discontinue gender transition care. Imborek said she can count “on one hand” the number of patients who have chosen to stop hormone therapy in her practice. She said data on adults who de-transition shows that a vast majority of them do because of social pressures, not because they change their gender identity.
“When we’re talking about irreversible surgeries or partially irreversible surgeries, or really changing children’s endocrine systems that affect them over a lifetime, I don’t think we know that we’re not doing harm to those children,” said Rep. Phil Thompson, R-Boone. “Especially the ones that choose to reverse those therapies.”
What would happen under a ban?
Imborek said she is worried a ban on gender-affirming care would have “devastating” effects on her patients, who she said have thrived with care.
“I am probably worried most that my patients who have already started down this path that are minors, that this would be really devastating for them, she said.
Keenan Crow, a lobbyist with LGBTQ activist group One Iowa, said banning the care would be dangerous for transgender youth.
“We should be letting evidence, science and medical consensus drive these conversations, not the biases of a few politicians trying to score political points against a marginalized group of children,” Crow said.
Iowa House may ban transgender medical care for minors
The move would contradict the guidance of several major medical groups, including the American Medical Association, the American Pediatric Association and the American Association of Psychiatrists.
www.thegazette.com
