West Virginia Lawmakers Advance Ban On Gender-Affirming Care

CHARLESTON, W.Va. (AP) — West Virginia lawmakers in the House Judiciary Committee voted Monday to add a ban on hormone therapy to a bill prohibiting gender-affirming surgery for minors before advancing the legislation to the full House of Delegates.

The bill was greenlit after considerable conversation during which the committee's Democratic minority raised concerns about whether it could harm minors who already are at a greater risk for experiencing mental health challenges. One Democratic lawmaker said the legislation “bullies people.”

Republicans in support of the legislation insisted that they don't want to harm transgender and nonbinary people. They said people should wait until they are older to make elective medical decisions that can have long-term consequences.

But Democratic Dels. Joey Garcia and Evan Hansen said they were concerned that the sponsors had not spoken to enough — or any — medical providers who actually perform gender-affirming care.

Hansen said every major national medical association has come out strongly opposed to bills barring children from accessing gender-affirming care. Data indicates that 82% of transgender individuals have considered killing themselves and 40% have attempted suicide, with suicidality highest among transgender youth, according to a 2022 study published in the peer-reviewed Journal of Interpersonal Violence.

“This is a mental health crisis that (providers) are trying to address in the sense of helping kids get to adulthood and actually survive,” Hansen said. Advocates for young transgender people say decisions about health care should be left to children, their parents and their doctors.

Co-sponsor Republican Del. Todd Kirby said he and other sponsors have received emails from people against the bill saying that the bill is “transphobic.” He said his support for the bill has nothing to do with “demonization or hate towards any community.”

“It’s not a jab at any community,” he said. “It is simply us doing our duty to protect children who do not, in many instances, have the ability to protect themselves.”

“We’re not anti-transgender, we’re not anti-homosexual — at least I’m not," Republican Del. Mike Honaker said, speaking in support of the bill. “I don’t hate anybody. I just don’t want to see a child, even with the facilitation of a parent’s help, make a decision that will drastically change their life and again, it will be irrevocable, irreversible and catastrophic.”

Garcia said treatments of any kind are about “risk reduction” for young people, and echoed Hansen’s concerns about the increased risk of suicide for transgender and nonbinary youth.

Garcia said he spoke with providers at West Virginia University's Gender and Sexual Development Clinic, which provides primary and gender-affirming care. Experts there said minors in West Virginia are not receiving gender-affirming surgery now, and that the vast-majority of people chose to defer that decision until they are adults. But some minors in the state do pursue gender-affirming hormone therapy treatments.

“As I grew up, I was always told that if you see people who are being bullied, you got to stand up for them," he said. "The legislation itself is something that bullies people, that stigmatizes people and that this type of legislation can cause people I think, to commit suicide and to lose hope.”

In recent years, Republican lawmakers have targeted gender-affirming health care for youths, including surgery and hormone therapy.

Republicans in other states who have moved to limit access to the treatments for minors have often characterized the treatments as medically unproven and potentially dangerous in the long term, as another political battle against liberal ideologies. They also say teenagers shouldn’t undergo irreversible surgeries.

Many doctors, mental health specialists and medical groups have argued that treatments for young transgender people are safe and beneficial, though rigorous long-term research is lacking. Federal health officials have described the gender-affirming care as crucial to the health and wellbeing of transgender children and adolescents.

After lawmakers advanced the bill Monday, Director of Public Affairs for Planned Parenthood South Atlantic Alisa Clements said medical practice already includes protections and safeguards for minors, including informed consent before medical interventions like hormone therapy.

“Decisions about what interventions may be appropriate at different ages is a complex question that should be left to the individual, their family members, and their health care providers,” she said. "This bill interferes with private health decisions, insults health care providers, and plays politics with people’s lives.