For over an hour, two Iowa doctors answered questions and corrected disinformation about gender-affirming health care for transgender children.
Iowa House Republicans held a hearing Thursday to get answers about how medical providers treat trans children. House Speaker Pat Grassley (R-New Hartford) confirmed Republicans are considering introducing legislation to ban that health care for people under the age of 18, though he didn’t share specifics with reporters.
Instead, the House Government Oversight Committee heard from Dr. Katie Imborek, co-director of the University of Iowa LGBTQ+ Clinic, and Dr. Dave Williams, the chief medical officer for UnityPoint Health.
The two doctors detailed the steps trans children and their families have to go through before receiving gender-affirming medical treatment. Those steps require months of counseling and consultation before any medical treatment is pursued.
“It is a long, arduous and methodical process by which our providers, in collaboration with mental health providers, like psychiatrists, psychologists or counselors, and in accordance with evidence-based standards of care, provide parents and their children information about risks, benefits and alternatives, so parents have the freedom and liberty to make the decision that is best for their minor child,” Imborek said, as reported by the Des Moines Register.
She emphasized that no one involved in the process takes it lightly and every step is taken with full consent from everyone.
Williams agreed. He said UnityPoint Health has served 46 different patients since 2020, and their treatment has involved hormone therapy, puberty blockers, and speech therapy, all over an extended period of time and with communication between patients and their guardians.
Transition care generally involves social transition first, which includes changing hairstyles, clothing, and sometimes names. Later, it can involve medical intervention such as puberty blockers and hormone-replacement therapy if the trans person wants it.
Genital surgeries are not performed on people under 18 and are not always pursued by trans people. Top surgeries are rarely performed before 18, and not without further consultation and years of a trans person living as their affirmed gender.
Gender-affirming care practices have been around for decades and leading health organizations agree they are necessary for health care and endorse their use.
Those organizations include the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the American Medical Association, the Endocrine Society, the Pediatric Endocrine Society, and the Society for Adolescent Health and Medicine.
Data from multiple studies also support the benefits.
Still, Republicans such as Reps. Brooke Boden (R-Indianola) and Jeff Shipley (R-Fairfield) leaned into the claims that gender-affirming care is irreversible and recipients might have regrets.
Imborek corrected both. She explained that puberty blockers are fully reversible, meaning the body will begin going through natural puberty once the blockers are stopped. Puberty blockers are also used to treat early-onset puberty. The only effect they have is to delay puberty until a child is ready.
The effects of hormone replacement therapy are partially reversible, depending on how long the patient has used them. Some effects of natural puberty aren’t reversible, either.
On de-transitioning, Imborek explained it doesn’t happen because the trans person regrets transitioning in the first place. Usually, people stop taking hormones because of external factors such as discrimination.
“They’re detransitioning because they have transitioned, and their family didn’t support them,” she said, according to the Iowa Capital Dispatch. “They transitioned and they lost their job, they transitioned and they just feel like they can’t do it anymore. And it would just be easier to live their life in in a gender that aligns with their assigned sex at birth, but they haven’t actually changed their gender identity.”
A ban on gender-affirming care would follow the pattern of several other Republican states, where residents are being forced to de-transition because they won’t be able to access the medicine. Those states include South Dakota, Tennessee, Mississippi, Alabama, Arkansas, and Utah. Florida has restricted the care via the state’s board of medicine.
Most bans are supported by faulty science or deliberately misinterpreting data. Many groups advocating for these bans have made it clear they eventually want to go after this health care for adults as well.
Imborek said a ban is one of her biggest worries because she knows her patients will be harmed.
“Some of them have been able to really do wonderful things like go back to school, feel like they can look in the mirror, feel like they can take a shower, feel like they finally are validating who they really are,” she said. “And my patients come in every day, and they tell me how worried that they are.”
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