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Montana lawmakers advance revived bill to block medical treatment for trans youth

Montana lawmakers advance revived bill to block medical treatment for trans youth

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On a nearly party-line vote, revived legislation that would prohibit some medical procedures for transgender youth passed out of the House Judiciary Committee on Monday.

One Republican voted with all Democrats, who are in the minority, against House Bill 427, carried by Rep. John Fuller, R-Whitefish. The bill cleared the committee on an 11-8 margin.

The legislation is similar to a previous bill Fuller carried, House Bill 113. The same committee last month passed that bill by the same margin, but it was later voted down in the House.

Monday's vote came during a day-long session in which the House Judiciary Committee was scheduled to hear and potentially take action on 20 bills. The committee did not discuss HB 427 before voting. 

Opponents outnumbered the four people who gave testimony supporting Fuller's bill. The legislation would prohibit gender transition procedures and the removal of otherwise healthy or non-diseased body parts or tissue to treat gender dysphoria for minors. It would also bar doctors from making a referral for such care and make doctors who do so subject to penalties. HB 113 included those measures, in addition to proposing outlawing puberty blockers or hormones.

Dr. Lauren Wilson, the vice president of the Montana chapter of the American Academy of Pediatrics and a pediatrician in Missoula, said to her knowledge the genital procedures banned in the bill have never occurred in Montana. Wilson added the procedures are not recommended for those under the age of 18 by standard medical guidelines. About three-quarters of people who are transgender never have surgery, Wilson said.

Wilson said the chest surgeries prohibited in the bill are very occasionally decided upon by minors and their families following best medical practices at a minimum age of 16 and require consent by parents and the patient, as well as a full evaluation by the insurance provider. Wilson said that type of surgery is usually done in severe cases of dysphoria that have not been solved by less invasive measures and is a measure of last resort.

"Not one of these families takes this decision lightly," Wilson said.

Dr. Erin Grantham, a pediatric urologist at Billings Clinic, said the bill would make it professionally unsafe for doctors to do medically necessary procedures that have nothing to do with gender.

"The middle school boy who can't stand to pee, who's afraid to go to the bathroom because he doesn't want to get bullied. The young couple who is facing what would have been preventable infertility. The high school girl who doesn't want to change in the locker room with her other members of the team so she's avoiding sports. All of these outcomes are preventable if we can continue to provide appropriate treatment for children with different genitals and anatomic issues," Grantham said. "However, these surgeries would be too high of a litigation risk to perform, or even refer for, if HB 427 becomes law."

Wilson also told the committee that because of the additional legal scrutiny placed on doctors, the bill would make the already difficult job of recruiting pediatric specialists to Montana much more difficult.

Laurel Hesse, the legislative program manager for ACLU of Montana, said that the bill singles out transgender minors by banning care that would remain available to non-transgender peers.

"(That) raises serious equal protections problems," Hesse said. "Under this bill, mastectomy and breast augmentation would remain available for non-transgender minors, but would be prohibited for transgender minors, even if medically necessary."

Hesse asked the committee why the bill would call the same procedures dangerous for some youth but not others.

"This bill is not at all about protecting kids, but instead is driven by insidious purpose in bare desire to harm transgender people, a historically marginalized group who have been particularly targeted across the country," Hesse said.

Fuller said the bill was "designed to protect children from the imposition of surgical procedures," though the doctors who testified against the bill pointed out that such care is not best practices for minors, nor is it performed in Montana.

Fuller said he felt society had a "vested interest in protecting children from potentially dangerous actions."

"We do not allow children to make many kinds of unhealthy decisions, smoking drinking, child pornography, sex with adults and illegal drug use to list a few," Fuller said, equating those actions to care doctors testifying against the bill said would only come after extensive other treatments and is seen as a last resort in only the most severe cases.

Fuller objected to how opponents characterized the bill and his motivations.

"This bill is not designed to encourage discrimination and this bill is not in any way, shape, fashion or form putting an onus on any particular section of the population. I resent deeply the implication that I'm doing so out of such motives," Fuller said. " ... I've spent my life's work teaching children, educating children, helping them pursue their dreams, trying to keep them healthy, giving them positive mental attitudes, positive outlooks on life."

Jeff Laszloffy, president of the Montana Family Foundation, spoke in support of the bill.

"People are free to do whatever they want, but when you have a minor that's that's growing up, they have no idea or the ability to forecast 10 years into the future and know what they will want for themselves," Laszloffy said.

Shawn Reagor, program director with the Montana Human Rights Network, testified about spending the night in the parking lot outside an emergency room over the weekend. waiting to learn the fate of a 19-year-old transgender woman who had attempted to die by suicide.

"Fortunately, her roommate found her in time," Reagor said. " ... The consequences (of the bill) for the transgender community members are life and death. The roommate shared with me late last night that it was this bill and this fact that it came back came back that completely caused her to lose hope. The actions that you take today, and the votes that you take today, will have life-and-death effects."

SK Rossi, a longtime lobbyist who has addressed the committee many times through the years, told lawmakers the testimony from the supporters of the bill sent a hurtful message.

"Two proponents relied upon their religious beliefs for supporting this bill. Another proponent said that trans people are mentally ill and generally being trans it's not real. And that implies to me that some proponents think that trans people should just not exist. The problem with that is that we do exist," Rossi said. " ... We talk to you every day about policy. We come to you during every single one of these hearings and ask you to just leave us alone. We're not mentally ill. We're people with jobs, and families that we're trying to support. ... The intent of this bill, as far as I can tell from the supporters, is to push trans people out of the state. We're not going anywhere. And we'd appreciate it if you left us alone."

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