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Utah governor signs bill banning gender-affirming hormone treatment and surgery for minors

By Rebekah Riess and Zoe Sottile, CNN

Utah Gov. Spencer Cox signed a bill on Saturday, January 28, that banned hormone treatment and surgical procedures for minors seeking gender-affirming care, the latest in a series of anti-trans bills involving minors that have been passed across the country.

Senate Bill 16, which the governor signed a day after it was sent to his desk by the Utah Legislature, prohibits health care providers from “providing a hormonal transgender treatment to new patients who were not diagnosed with gender dysphoria before a certain date” and prohibits them from “performing sex characteristic surgical procedures on a minor for the purpose of effectuating a sex change.”

It also directs the Utah Department of Health and Human Services to conduct a “systematic review of the medical evidence regarding hormonal transgender treatments.”

Hormone therapy is one of a variety of treatment options for transgender people. The therapy consists of either “feminizing (estrogen) or masculinizing (testosterone) hormones” which transgender people take “as part of a gender transition to help their bodies and appearance align with their gender identity,” according to Planned Parenthood, some of whose affiliates provides gender-affirming hormone care.

The American Academy of Pediatrics says in a policy statement that hormone replacement therapy is appropriate for early adolescence onward, while gender-affirming surgeries, like “top surgery” to remove or enhance the breasts or genital surgeries, are typically appropriate for adults.

In a statement, Cox said that the bill is “not perfect” and called for greater research into treatments for transgender youth.

“Legislation that impacts our most vulnerable youth requires careful consideration and deliberation,” said the Republican governor in the statement. “While not a perfect bill, we are grateful for Sen. (Michael) Kennedy’s more nuanced and thoughtful approach to this terribly divisive issue. More and more experts, states and countries around the world are pausing these permanent and life-altering treatments for new patients until more and better research can help determine the long-term consequences.”

“We will continue to push the Legislature for additional resources to organizations that work to help this important Utah community,” he added. “While we understand our words will be of little comfort to those who disagree with us, we sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures.”

Previously, the ACLU’s Utah chapter issued a statement opposing the legislation. The non-profit said that “further studies of hormone treatment, as required in this bill, are unnecessary as there is already a wealth of scientific evidence and consensus among major medical and professional organizations supporting hormone treatment for transgender youth.”

The burdens placed on health care providers by the bill “may discourage them from providing care for transgender youth,” added the ACLU.

Utah follows other states restricting gender-affirming care

The World Professional Association for Transgender Health, a professional organization composed of health care professionals who treat transgender patients, says that specialized healthcare for transgender adolescents has been provided since the 1980s. Although data on transgender youth is limited, the organization says that the research that does exist demonstrates “a general improvement in the lives of transgender adolescents who, following careful assessment, receive medically necessary gender-affirming medical treatment.”

Major medical associations — including the American Medical Association, the American Psychiatric Association, the American Academy of Pediatrics, and the American Academy of Child & Adolescent Psychiatry — also agree that gender-affirming care is clinically appropriate for children and adults and can be lifesaving. The US Department of Health and Human Services calls gender-affirming care “crucial to overall health and well-being” for transgender youth.

But treatment for transgender youth has come under attack, particularly in Republican states, over the past year. Over 58,000 transgender youth aged 13 and older face restricted access or proposals for restricted access to gender-affirming care, according to estimates from UCLA’s Williams Institute, which conducts research on sexual orientation and gender identity law and policy.

Utah’s law comes in the wake of similar restrictions in other Republican-controlled states. In April of last year, the Florida Department of Health advised against any gender-affirming care for children and adolescents, including social transition, in which a child or adolescent adopts a name, gender pronouns, and clothing that match their gender identity.

In the same month, Alabama passed its own law making it a felony for doctors to provide gender-affirming care to minors. And in February, Texas Gov. Greg Abbott ordered the Department of Family and Protective Services to investigate gender-affirming care as child abuse.

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CNN’s Alta Spells and Jen Christensen contributed to this report.

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