Utah Bans Gender-Affirming Care for Youth

Utah has become the first state this year to ban transition-related healthcare for youth, and the fourth state overall to pass similar legislation. Senate Bill 16 was signed into law by Utah Governor Spencer Cox (R) prohibiting people under the age of 18 from receiving gender-affirming care, including puberty blockers, hormone replacement therapy, and surgical intervention.

The law also put into place a medical evidence review to look at the efficacy of hormone replacement therapy, or the more commonly used hormone blockers, for minors. Though leading medical organizations such as the American Medical Association, the American Psychiatric Association, and the American Academy of Pediatrics, all recommend gender-affirming care for trans youth, the outcome of the state’s medical review will determine whether the ban on HRT and blockers is lifted.

Trans youth living in Utah who are already prescribed hormones or blockers will be permitted to remain on these medications, however, providers will have to meet a slew of new bureaucratic requirements  such as obtaining and maintaining a “transgender treatment certification.” According to the law, providers must attend at least 40 hours of training on the treatment of trans youth from an approved organization. Though the certification provision will go into effect July 1 of this year, Utah officials have yet to define which organizations have been approved for such training.

In addition, the law calls for providers to determine whether a minor seeking gender-affirming care has “other physical or mental conditions,” document those conditions, and “consider whether treating those conditions before gender dysphoria would give the minor better long-term results.” The law goes on to suggest alternative medical treatment or behavioral intervention before gender-affirming care.

Unsurprisingly, these recommendations go against what modern science has found in relation to mental health in trans youth. A study conducted in February of last year found that “access to gender-affirming care was associated with mitigation of mental health disparities among [trans and nonbinary] youths over one year.”

“At baseline, 59 individuals (56.7%) had moderate to severe depression; 52 individuals (50.0%) had moderate to severe anxiety, and 45 individuals (43.3%) reported self-harm or suicidal thoughts,” the study reads. “We observed 60% lower odds of depression and 73% lower odds of suicidality among youths who had initiated puberty blockers or gender-affirming hormones compared with youths who had not. There was no association between PBs or GAHs and anxiety.”

Under the Utah law, providers would also be required to inform minors seeking gender-affirming care of the potential permanent ‘risks’ of puberty blockers and hormone replacement therapy. However, the risks listed by the law lack substantial medical evidence.

Related Article: Transgender Healthcare Targeted in 2023 Legislative Session

The final provision of the law allows patients who had at one time consented to gender-affirming care to sue medical providers for malpractice before they turn 25. Whether the care was given before, during, or after the effective date of the law, patients may file malpractice suits against providers, creating yet another reason for medical providers to shy away from gender-affirming care.

“In signing this bill into law, Governor Cox has directly placed the LGBTQ+ youth he previously claimed to want to protect in harm’s way,” says Cathryn Oakley, HRC’s State Legislative Director and Senior Counsel.

“Parents, doctors, and transgender youth together discuss possible care and make the deeply individualized decision about what kind of care is most appropriate for each young person. Politicians with no medical training and no real understanding of the harmful impact these bans have on transgender people should have no say in how best practice, age-appropriate care is delivered.”