Health Care, Law & Principles

Child-transgender limits headed to governor

September 29, 2022

Ray Carter

Legislation that supporters said would force the closure of a clinic that provides puberty blockers and transgender-surgery services to Oklahoma children won easy approval in the Oklahoma House of Representatives.

“We’ve been made aware that OU Children’s Hospital has been performing some of these procedures, and it is the feeling of a lot of Oklahomans that taxpayer dollars should not be used to fund those procedures for gender reassignment,” said state Rep. Kevin West, R-Moore.

Senate Bill 3XX, which West carried on the House floor, provides a $108 million appropriation in federal American Rescue Plan Act (ARPA) funds to the University Hospitals Authority, including $39.4 million earmarked “to expand the capacity of behavioral health care for the children of this state.”

But the bill also includes language that restricts the funding of life-altering transgender treatments for youth.

The legislation states that “no monies” may be spent by the University Hospitals Authority “for the benefit of any facility owned by the University Hospitals Authority or University Hospitals Trust performing ‘gender reassignment medical treatment’” on any patient younger than 18 years of age.

The legislation targets “interventions to suppress the development of endogenous secondary sex characteristics,” “interventions to align the patient’s appearance or physical body with the patient’s gender identity,” and “medical therapies and medical intervention used to treat gender dysphoria.”

The legislation was advanced following controversy over the University of Oklahoma Children’s Hospital, which operates the Roy G. Biv Program. The website for the Oklahoma Children’s Hospital states that officials with the Roy G. Biv Program will serve youth “moving toward gender affirmation,” including “Female-to-male transgender” and “Male-to-female transgender.”

The OU website promises the children’s hospital will provide “gender-affirming scope of treatment” that includes “pausing puberty to further explore gender,” “managing gender-affirming hormone therapy,” and “helping find surgeons who perform gender-affirming surgeries.”

Supporters said the bill is needed to protect children from potentially life-altering decisions that cannot be fully reversed and that they often regret by adulthood, if not sooner.

In a meeting with state lawmakers, West said OU officials reported performing five “top” surgeries on Oklahoma patients within the past year.

“Even by the admission of the doctors that we spoke to, two of the five that received the surgeries have expressed regret since that,” West said. “So, that’s nearly 50 percent right there.”

West noted that Sweden, where gender-reassignment surgeries and treatments have been allowed for decades, has collected data on outcomes.

“According to the data out of Sweden, people—especially youth—who received these types of procedures are 19 times more likely to commit suicide than those who do not,” West said.

State Rep. Jim Olsen, R-Roland, called the transgender treatments performed or facilitated by OU Children’s Hospital “child abuse.”

Referencing medical literature, Olsen noted that males who take estrogen have a roughly three-times greater risk of heart attack, along with increased risk of stroke, gallstones, and breast cancer. Females who take testosterone have increased risk of cardiovascular death, severe liver dysfunction, hypertension, breast cancer, uterine cancer, and ovarian cancer.

“These things are harmful,” Olsen said. “The mutilations, I can only think of atrocities in the past to compare this to.”

State Rep. Randy Randleman, a Eufaula Republican who is a licensed psychologist, said he does not support gender reassignment.

While Democratic opponents of the bill accused supporters of not talking to the families of child patients who might be affected, state Rep. Kyle Hilbert said that is not the case.

“I personally have talked to a parent whose daughter went through this process and regretted it and is trying to transition back and will never be the same,” said Hilbert, R-Bristow.

Democrats waved off the experiences of such individuals.

“People have elective procedures that they regret,” said state Rep. Emily Virgin, D-Norman. “It happens all the time.”

State Rep. Mauree Turner, an Oklahoma City Democrat who identifies as nonbinary, said youth should have access to transgender treatments that include hormone therapy and surgeries if they desire them.

“Our youth and our adults want access to our rights, to be able to decide our own best medical practices between ourselves, our families, and our physicians,” Turner said.

State Rep. Cyndi Munson, D-Oklahoma City, said the bill sends the message that “we don’t trust our parents, we don’t trust physicians, and we definitely do not trust Oklahomans to make their own personal and private health-care decisions.”

State Rep. Meloyde Blancett, D-Tulsa, called the bill a “political stunt,” and other Democrats called it an election ploy.

State Rep. Andy Fugate, D-Oklahoma City, predicted the legislation would be overturned in court.

“The reality is this is going to wind up in a lawsuit,” Fugate said.

A share of House Republicans also opposed the bill, saying it would not succeed in ending child transgender treatments at OU Children’s Hospital and calling for passage of a statewide ban. Legislative leaders have said a ban will be considered during the regular 2023 session.

State Rep. Rick West, R-Heavener, said OU Children’s Hospital could still refer child patients to out-of-state doctors who will perform “gender reassignment” surgeries, and warned that OU Children’s Hospital may also be able to continue doing the procedures despite the bill’s passage.

“This bill will not stop these procedures from going on in Oklahoma,” West said.

State Rep. Wendi Stearman, R-Collinsville, voiced similar concerns about OU Children’s Hospital.

“A verbal commitment to end the Roy G. Biv program from an entity that stands to gain millions of dollars is not enough assurance to proceed,” Stearman said. “At the very least, we need evidence that these procedures are no longer occurring before awarding so much money.”

“This is a mental health issue,” said state Rep. Justin Humphrey, R-Lane. “You don’t address a mental-health issue by mutilation. You address mental-health issues through mental-health care.”

He said the arguments put forth by supporters of child gender-reassignment efforts defy reality.

“If I thought I was a pirate, according to the logic of many in this room, you would cut off your leg and put a peg leg on at seven years old,” Humphrey said.

SB 3XX passed the Oklahoma House of Representatives on a 67-24 vote. The bill proceeds to the governor.