COLUMBIA, S.C. (AP) - About five dozen advocates for transgender youth rallied outside the South Carolina State House as Republican senators joined their conservative counterparts nationwide in advancing a ban on gender-affirming medical care for minors.
A South Carolina bill to ban gender-transition surgeries, hormone therapy and puberty blockers for people under the age of 18 passed a Senate subcommittee on Wednesday.
The vote along party lines aligns South Carolina with a broader effort in Republican-dominated legislatures across the country. At least 11 states have enacted laws restricting or banning gender-affirming care for minors: Alabama, Arkansas, Arizona, Georgia, Iowa, Kentucky, Mississippi, Tennessee, Utah, South Dakota and West Virginia.
Federal judges have blocked the enforcement of laws in Alabama and Arkansas. Nearly two dozen states are considering bills this year to restrict or ban care.
South Carolina lawmakers heard testimony twice over the past week at tense subcommittee meetings. Supporters of the bill included two de-transitioning women from other states who chronicled the pain they have felt since regretfully undergoing hormone therapy as adults.
Matt Sharp, a senior counsel for the Alliance Defending Freedom, a national Christian conservative advocacy group, said it “would protect children and parents from being pressured into agreeing to these harmful, experimental gender transition procedures.”
Research shows such regret is rare, and major medical associations endorse transgender medical treatment for youths.
Republican Sen. Josh Kimbrell, one of 25 Republican sponsors, compared the restrictions to other age limits on voting, tattoos, drinking and tobacco purchases.
“Changing one’s gender is significantly more consequential than any of those things,” Kimbrell said. “There needs to be a boundary to protect these children from, frankly, whims they may not be able to reverse later.”
Transgender adults and children challenged those notions. Niko Dittrich-Reed, 11, told rally attendees Wednesday that his transgender identity is not a choice but “who I am.” Gender-affirming care, he said, provided a “light at the end of the tunnel” after hours of crying over something he feared he could not change.
“I am here to represent minors suffering from the law forcing them to be someone else,” he said.
Other transgender adults detailed the negative impact of going through puberty’s physical effects — such as breast development or facial hair growth — without puberty-blocking medication.
South Carolina pediatricians testified that no doctors in South Carolina perform gender-transition surgeries on minors. Evidence-based treatments like puberty blockers, they said, can be reversible and, like other medications, are only prescribed to adolescents after discussions of the side effects.
“Puberty blockers essentially buy the adolescent time, protecting their mental health while they have the chance to grow, mature and develop the ability to make more adult decisions about their future,” said Dr. Deborah Greenhouse, a past president of the South Carolina Chapter of the American Academy of Pediatrics.
Several parents of transgender youth said the process to obtain such care is all but swift and criticized the bill for limiting what they called the lifesaving treatment options available.
David Bell outlined the lengthy process his family undertook to get “fundamental healthcare” that he said saved his 14-year-old transgender daughter. After meeting with a social worker four times over a three-year period to verify proper treatment and signing many documents, Bell said his daughter began receiving puberty blockers. In the more than two years since, he said his daughter has grown more social after experiencing bullying and lost the suicidal ideation she had previously displayed.
“We made all these decisions with trusted medical providers every step of the way,” Bell said. “No family in South Carolina wakes up one day and has their child immediately prescribed hormone therapy. This is a complicated healthcare and it’s best decided by a child, their parents and medical professionals.”
The bill would also require any school employee “who suspects or knows” that a student has gender dysphoria to share that information with the student’s legal guardian. Some parents have argued they deserve to know, while others warn it could jeopardize the mental health and physical safety of gender-nonconforming children.
The subcommittee also advanced a bill banning changes to the gender marker on a birth certificate after one year, effectively preventing transgender people from updating their official documentation.
The process currently requires a family court’s approval, which is typically contingent on a physician’s affidavit. Critics said transgender people seeking to change their birth certificates should be able to do so without the costs and delays often involved with the court. Advocates on Wednesday instead endorsed the state health department’s proposed regulations to streamline the process by removing the family court’s involvement.
Ivy Hill, the executive director of Gender Benders, a transgender advocacy group in South Carolina, said they have seen firsthand the joy that updated documentation can bring.
“Having updated identity documents means safety. It means being seen as who you truly are. It means validation of identity,” Hill told lawmakers Wednesday. “That validation of identity may not mean a whole lot to y’all, but it means a whole lot to us.”
An upcoming procedural deadline threatens either proposal’s chances at becoming law this session. Bills that do not pass by April 10 must get two-thirds supermajority approval in the other chamber. With the Senate scheduled to take a break next week, the bills would likely have to get near-unanimous support from House Republicans.
Regardless, advocates say the measures’ consideration puts a target on the transgender community. Greg Green, the executive director of Transgender Awareness Alliance, said the bills inspire hate.
“You’re bringing things up that aren’t necessary, and it’s definitely creating long-term damage to not just the trans community but to society in terms of people being able to express themselves and be themselves,” Green told The Associated Press after testifying last week.
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