Georgia House approves ban on some gender-affirming care for transgender children

Caption

SB 140, a bill restricting access to some health care for transgender children, passed the Georgia House Thursday, March 16.

Credit: Georgia House of Representatives

The Republican-led Georgia House of Representatives voted 96-75 to ban transgender minors from receiving some gender-affirming care in the state Thursday over fierce protest from Democrats who warned of the negative consequences the restrictions would cause.

Senate Bill 140, which would prevent doctors from prescribing hormone replacement therapy or performing surgeries that would alter "primary or secondary sexual characteristics," was also immediately transmitted back to the Senate after the House committee that vetted the bill amended language to remove protections from criminal or civil liability for physicians that provide banned care.

Georgia is one of many Republican-controlled legislatures that has moved forward with bills targeting the rights and activities of transgender Americans, particularly young people. Of the states that have enacted similar partial or total bans on gender-affirming care, at least two are temporarily blocked by the courts.

While almost all of the Republican caucus voted in favor of the bill (Marietta Rep. Sharon Cooper, who chaired the public health committee that heard the bill, skipped the vote), only four of them spoke from the well in support of the measure that conservatives say is necessary to protect children who have gender dysphoria from making irreversible decisions about their bodies.

Numerous medical organizations, such as the American Academy of Pediatrics, support gender-affirming care for transgender children, and note that hormone replacement therapy or surgery is not the first step — or even a common step — in treatment of minors.

Rep. Mark Newton (R-Augusta) compared "trusted organizations" who support gender-affirming care to "trusted organizations" in the health field that began overprescribing certain drugs that has led to the opioid epidemic. Rep. Ginny Ehrhart (R-Powder Springs) said the bill would stop "children from being sterilized and surgically altered by irreversible experimental medical procedures" and Rep. Will Wade (R-Dahlonega) said "childhood is about giving young people time to develop and letting them learn by trial and error, but while still protecting them from long-term harms."

"The idea that a child's declaration of their gender identity should clear any obstacles to irreversible gender transition surgery stems [from] more extreme political orthodoxy than from what's in the best, long-term interests of the child," Wade said.

The bill does not outlaw the use of puberty blockers, has exceptions for treatment of intersex children and for the use of hormone therapy or banned surgical procedures if used for purposes other than treating gender dysphoria, and also allows those who began hormone treatments before July 1 to continue treatment.

Many Democrats delivered emotional remarks imploring their colleagues to vote against the bill after most of the committee testimony came from transgender Georgians, parents of transgender children and health care providers opposed to limiting care.

"What you are talking about today is somebody's child, their children," Rep. Karla Drenner (D-Avondale Estates), Georgia's first openly gay lawmaker, said. "You are telling these parents that they are bad parents because they want to take care of their children."

Drenner went on to encourage transgender children affected by the bill to not lose hope.

"Please don't give up, please don't kill yourself," she said. "This world is worth it. We need you."

Rep. Park Cannon (D-Atlanta), spoke of polling that showed bipartisan opposition to the bill, warned of families forced to seek black market treatments and asked her colleagues to vote no because the bill "does not allow for the nuances that happen in gender-affirming care."

"I'm asking you as a person in this body who loves someone who is transgender, who transitioned as a child, and who is a state of Georgia employee," she said. "I'm also asking you, because I have a staff member who's watching right now who transitioned as a child here in Georgia and is thriving."

Speaker after speaker from the Democratic caucus spoke of mental health challenges transgender youth face, statistics about the effectiveness of gender-affirming care and how the legislation ran counter to medical guidance from numerous health care organizations.

"The Georgia state legislature should not be in the practice of dictating or restricting the standards of care determined by those who actually care for patients," Rep. Michelle Au (D-Johns Creek), who is a physician, said. "Further, there was an amendment introduced to SB 140 in committee which would create a course of action where doctors could be held civilly or criminally liable for caring for transgender and gender diverse children according to the standards of care under which we are ethically obligated to practice. Simply put, SB 140 amounts to state-mandated malpractice."

One of the Republicans who spoke in favor of the bill, Rep. Josh Bonner (R-Fayetteville), compared the restrictions to laws limiting minors' access to guns, alcohol, tattoos and other activities. But Rep. Teri Anulewicz (D-Smyrna) pointed out that children could in fact access those things with the consent of their parents, just as with gender-affirming care.

In a fiery speech, Anulewicz also said Republicans were hypocritical by championing legislation that give parents more control over personal decisions relating to getting vaccines, wearing masks and schooling but restricting those decisions if they have a transgender child.

"To that end, people have stated in this chamber parents have the right to make decisions about their children's health care without interference from the government," she said. "We have declared in this chamber parents are the first and most important teachers in a child's life, and they should have the freedom to choose the educational path that fits their child's needs. A question I asked in committee that was not answered, and a question I put forth before each of you today is what makes this different?"

Since the bill was amended by the House, it now returns to the Senate and could be taken up before the session ends March 29.