GOP West Virginia Governor Jim Justice signed a bill banning gender-affirming care for minors on Wednesday, joining at least 10 other states that have enacted similar laws that restrict or outlaw medically supported treatments for youth that identify as transgender.
The bill outlaws children under the age of 18 from being prescribed hormone therapy and puberty blockers. It also blocks minors from receiving gender-affirming care.
Unlike similar measures that have been passed in other states, West Virginia’s law contains a specific exemption: It allows doctors to prescribe medical therapy if a teenager is considered at risk for self-harm or suicide.
The law, which will take effect in January 2024, states a patient can be prescribed hormone therapy and puberty blockers after receiving a diagnosis of severe gender dysphoria from two clinicians, including an adolescent medicine specialist and a mental health provider as well along with parental consent.
Both clinicians must have received training to diagnose and then treat young people with gender dysphoria. The practitioners must provide written testimony that medical interventions are needed to limit or prevent actual or possible self-harm.
The provisions were added at the strong urging of physician and Senate Majority Leader Tom Takubo.
“These kids struggle. They have incredible difficulties,” said the GOP senator on the Senate floor earlier in the month. Takubo pointed to more than a dozen peer-reviewed studies that show a decrease in suicidal ideation rates as well as attempts among youth with severe gender dysphoria who had been given access to medication therapy.
Gender dysphoria is defined by medical clinicians as severe psychological distress that are experienced by individuals whose gender identity is different from their biological sex.
The legislation also bans minors from being prescribed hormone therapy prior to the age of puberty, which physicians in West Virginia maintain doesn’t happen any longer in the state.
The dosage of medication for any child must be the lowest possible needed to “treat the psychiatric condition and not for purposes of gender alteration,” according to the legislation.
The West Virginia law comes as GOP lawmakers across the country have pursued several hundred proposals during the year to counter LGBTQ+ rights, specifically rights for transgender residents, including keeping transgender people from using restrooms in agreement with their gender identities, banning girls who identity as female from girls’ sports, and requiring or allowing schools to deadname trans students.
West Virginia lawmakers claim bans are needed to prevent long-term danger
West Virginia lawmakers, along with other states are moving to enact bans on transgender healthcare for young adults and youth, characterize gender-affirming treatments as potentially dangerous and medically unproven in the long-term and a symptom of “woke culture.”
All major medical organizations, including the American Academy of Pediatrics, the American Psychiatric Association and the American Medical Associations all support gender-affirming care for youth.
UCLA Law’s The Williams Institute issued a study in 2017, estimating West Virginia had the highest per capital rate of transgender youth in the U.S.
The rate of having suicidal ideas or thoughts, called suicidal ideation, for West Virginia transgender youth is three times higher than the rate for all other youths in the state according to the survey data from West Virginia Youth Risk Behavior Survey.
Natalie Frazier, who oversees gender-affirming care for Planned Parenthood in Virginia, North Carolina, South Carolina and West Virginia says the bill Gov. Justice signed was “better than it could have been.”
“But it’s still unnecessary — just and unnecessary barrier to care that is going to end up harming people,” said Frazier. She added that not every child’s family will have the resources to travel to two different medical practitioners to receive a medical diagnosis.
Frazier maintains that the diagnosis of gender dysphoria with the risk of suicide “could probably apply to just about any kid gaining access to gender-affirming care.”
“That’s why people are so invested in providing the care because there is a disproportionate risk,” said Frazier. “That’s something that any of these kids could be at risk for and nobody’s going into this care lightly.”
The ban in West Virginia also includes exemptions for people taking treatments for injury, disease, infection, or disorder that has been “caused by or exacerbated by the performance of gender transition procedures.”
Surgeries are able to be performed if a child is at risk for “imminent danger of death or impairment of a major bodily function.”
At least 11 states have already enacted laws banning or restricting gender-affirming care for miniors: Arizona, Iowa, Tennessee, Utah, Mississippi, Arkansas, Alabama, Georgia, Kentucky, Tennessee, South Dakota, and now West Virginia. Federal judges have blocked enforcement of the laws in Arkansas and Alabama. Almost two dozen states are considering legislation this year that would restrict or ban care.
