“House Bill 1399 would essentially prohibit gender reassignment surgeries, gender reassignment procedures on any Texan under 18,” Krause explained.
“There’s some penalties involved, as in a doctor or physician who does one of these procedures could lose their license or not be eligible for a license.”
Specifically, Krause’s bill would ban any surgery that sterilizes the child or cuts away healthy body tissue. It also forbids doctors from giving children cross-sex hormones — “supraphysiologic” doses of testosterone to girls, or estrogen to boys — or any drugs to block or slow puberty. Like other similar proposals in the state House and Senate, Krause’s bill makes an exception for children who are intersex, meaning their bodies have male and female sex traits.
The largest program of its kind in the Southwest to administer “gender-affirming care” to transgender children is located in Texas: the GENECIS program in Dallas. Jeff Younger, the Texas father whose son James inspired similar bans in the Texas legislature and took center stage in a custody battle after his mother claimed he identified as a girl named Luna, says James’ mother had explored the possibility of physical treatment for him at GENECIS.
The first speaker at last night’s hearing was Kevin Stuart, a social science researcher and frequent witness at bill hearings, who registered as a neutral testifier. Stuart said the research doesn’t bear up body alteration as an effective treatment for children uncomfortable with their sex, calling it a “myth” that transgender people tend to commit suicide due to lack of puberty blockers and cross-sex hormones.
“Multiple studies show that there’s no statistically significant difference [in suicide rates] between patients who receive drugs and psychological support and patients who receive only psychological support. In other words, psychological support is doing the work. In fact, multiple studies have shown that over the long run, those that transition have increased rates of suicidality, not decreased,” Stuart claimed.
“The use of puberty blockers has significant adverse effects on health, and cross-sex hormones especially in the doses required are associated with a host of adverse health effects. As one patient stated, the blockers aren’t a pause but a push down a dangerous path that leads to a lifetime of health complications. The alternative is to allow puberty to proceed, and when that happens, dysphoria desists, for 88 percent of the patients, a finding confirmed as recently as last year.”
Frisco pediatrician Seth Kaplan would later rebut Stuart’s 88 percent statistic, claiming it came from a poorly performed study. Opposing the bill, Kaplan represented a number of organized medical associations, including the Texas Pediatric Society, Texas Medical Association, Texas Academy of Family Physicians, and Texas Association of Obstetricians and Gynecologists.
“We all strongly urge you to oppose HB 1399, which would cause incredible harm to transgender youth in Texas and criminalize physicians for following best-practice medical care despite the many myths that you’ve already heard tonight,” Kaplan said.
“We’ve also heard tonight, by way of reference, this 80 to 90 percent statistic of transgender children growing out of it… The conclusions of that study are completely invalid. The largest study that we have, which is the Amsterdam Cohort of Gender Dysphoria, that had data collected over the course of… over 43 years, shows that only 0.6 percent of transgender women and 0.3 percent of transgender men expressed regret in their decision to identify as transgender. So a very small percentage.”
Questioned by state Rep. Erin Zwiener (D-Driftwood), Kaplan said “unequivocally” that eight-year-olds are not undergoing gender reassignment surgery.
However, not all medical professionals showed up to oppose the bills. One supporter was Clifford Alan Hopewell, a neuropsychologist, former chief psychology resident of the sexual surgery team at the University of Texas Medical Branch, American Psychological Association Fellow, and former president of the Texas Psychological Association. Before buoying Stuart’s “88 percent” statistic, Hopewell called the hearing “a very complicated and tragic situation” and decried sex-transitioning procedures before adulthood.
“We cannot damage children with life-altering surgery and drugs when they do not have the consent or the ability to do that… I tell you this right now as a doctor: when I walk into my office tomorrow, I cannot prescribe certain antidepressants to children because it’s forbidden by law because it will harm them,” Hopewell said.
“The research is now overwhelming that what helps people, what helps them the most, is psychotherapy. Some people will choose to remain with certain identities, and we recognize that. But a lot of people don’t. About 88 to 90 percent of children who present with these problems eventually resolve and assume their sex… We’re finding an increased number of people with mental problems — autism, borderline personality — who are so very confused that they’re not sure what to do and they need help, and it helps not to castrate them and provide life-altering surgery the first go-around.”
State Rep. Tom Oliverson (R-Houston), a practicing anesthesiologist, said he had prepared for the hearing by reading fresh medical research from England — where government researchers are currently wrestling with treatment of gender dysphoria among children — and questioned Hopewell on the effectiveness of hormonal drugs in improving the wellbeing of children with gender dysphoria.
“There seems to be a growing body of evidence that shows that puberty-blocking drugs do not improve dysphoria. Can you comment on that?”
“Many of these puberty blockers are frankly just steroids,” Hopewell answered. “And most of us probably know what steroids do. Other blockers have specific blocking effect on testosterone, estrogen, so forth. But they are not going to treat the underlying gender dysphoria. They’re simply going to medicate the system in a cosmetic way, and actually they’re going to medicate the system in a way that’s constantly at war with itself.”
Hopewell went on to compare hormonal drugs for children with gender dysphoria to amphetamines for the depressed, calling gender dysphoria a mental rather than physical problem that is best solved by therapy instead of body-changing drugs.
“Especially a drug that doesn’t really have a whole lot of psychoactive effects,” Oliverson echoed.
“I mean, this is not like we’re giving an antidepressant or an antipsychotic or a mood stabilizer.”
Earlier this week, Oliverson presented a bill to the House floor to establish a prescription drug savings program for the uninsured. State Rep. Bryan Slaton (R-Royse City) offered an amendment to exclude puberty blockers and other hormonal drugs from the program. Though the bill passed, Slaton’s amendment failed, 57 to 79, with Oliverson voting “nay.”
Though not an identical companion bill, Krause’s proposal strongly resembles Senate Bill (SB) 1311 by state Sen. Bob Hall (R-Friendswood), which underwent an impassioned hearing on Monday at the other end of the state capitol in the Senate. Other similar bans on sex-change procedures for children differ on enforcement measures. For example, another bill in the House would classify gender reassignment surgeries or drugs as child abuse, similar to a bill in the Senate that would be enforced by Child Protective Services.
Update: HB 1399 was voted out of committee on April 15.
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