Bill banning certain transgender treatments for minors filed in NC Senate

People gather for a protest in support of transgender rights. (AP Photo/Paul White)

RALEIGH — Three top Republicans in the N.C. Senate filed a bill on April 5 to restrict medical treatments given to minors seeking gender transition. The bill, Senate Bill 514, called “Youth Health Protection Act,” would ban surgeries and hormone treatments commonly used by health providers for those suffering from gender dysphoria, a condition where one feels their biological sex and inner-sense of gender do not match.

The bill says, “the cause of the individual’s impression of discordance between sex and identity  is unknown, and the diagnosis is based exclusively on the individual’s self-report of feelings and beliefs,” and that “this internal sense of discordance is not permanent or fixed, but to the contrary, numerous studies have shown that a substantial majority of children who experience discordance between their sex and identity will outgrow the discordance once they go through puberty and will eventually have an identity that aligns with their sex.”

Four types of medical practices would be prohibited by the bill: those that sterilize or castrate by surgery, mastectomies (the removal of the breasts) for healthy children, hormone treatments, and any other treatment that removes “otherwise healthy or nondiseased body part or tissue.”

Tami Fitzgerald, executive director of the North Carolina Values Coalition, spoke to NSJ about the bill on April 12, saying, “We provided research and examples of medical abuse related to the bill to Sen. Ralph Hise and other primary sponsors.”

“Basically, the bill would limit the medical treatment for minors by banning the use of hormones or puberty blockers or experimental surgical procedures that would conform a person of one sex to another sex,” Fitzgerald said.

When pressed on the term “experimental,” Fitzgerald said, “There are no long-term studies showing the efficacy of surgery, hormone-blockers or cross-sex hormones. These are experimental procedures, and they push children down a one-way street which leads to permanent sterility and a lifetime of medical intervention.”

EqualityNC, a LGBTQ advocacy group for the state, came out strongly against S.B. 514, saying in a statement on social media, “This horrific bill, like so many others across the country, is a direct attack on trans and gender-nonconforming young people. Decisions about a child’s medical welfare should be made between that child, their doctor and their parents or guardians — not lawmakers.”

In North Carolina, there are a few providers that provide these treatments: Duke Health’s Center for Child and Adolescent Gender Care, UNC Health’s Pediatric and Adolescent Clinic for Gender Wellness, Atrium Health’s Levine’s Children Center for Gender Health, as well as multiple Planned Parenthood locations across the state that offer hormone treatments, counseling and referrals for other treatments.

NSJ reached out to all four of these providers and only received comment back from UNC Health in time for publication.

“We don’t want to speculate on the outcome of this bill,” Tom Hughes, communications specialist for UNC Health, told NSJ when asked how the bill would affect treatments they provide for transgender patients. “Between the UNC Transgender Health Program (THP) and the specific subset of the Pediatric and Adolescent Clinic for Gender Wellness (PAC-G), THP treats approximately 700 transgender patients with a variety of their gender-affirming health care needs. Of those patients, approximately 350 would be directly affected by this bill, or 50% of the total of UNC’s current transgender patient population.”

Fitzgerald responded to the same question by saying, “I don’t know what the impact will be on gender clinics, but there aren’t any studies that have shown that these drugs and procedures are safe for children. But the permanent harm that they do is undeniable. Children should never be chemically or surgically castrated or sterilized nor should they remove healthy breasts and reproductive organs for minors. These gender clinics that have popped up around North Carolina are making a lot of money off of experimental procedures that cause permanent harm to children.”

A recent Gallup poll showed the number of people who consider themselves transgender has jumped by nine times in recent years — with only 0.2% of those in Gen X considering themselves transgender versus 1.8% in Gen Z.

“There has been a rapid increase in children who are claiming to identify as the opposite sex,” Fitzgerald said, while citing similar studies as the bill to show that the majority of these children will desist if allowed to pass naturally through puberty.

She said because there’s “no objective test” to know which of the children will desist and which won’t, “it’s irresponsible for people who are trained to provide medical care to perform physical interventions, some of which are irreversible … because without these interventions, the majority of them will accept their biological sex by the time they turn 20.”

The bill also requires schools to inform a student’s parents if that student changes their gender identity. Supporters say this informs parents of vital information that they are entitled to as guardians, while LGBTQ advocates say it “outs” them when they may not be ready to tell their family yet.

The bill also protects “any individual who gives or receives counsel, advice, guidance, or any other speech or communication, whether described as therapy or provided for a fee, consistent with conscience or religious belief,” even if this counseling uses a “wait and see” approach or encourages the child to accept their biological sex, a process denounced as “conversion therapy” by LGBTQ advocates.

This piece has been updated at the request of NC Values Coalition to provide a more accurate view of their role regarding the bill.