Fight over medical care for transgender youth moves from state house to courthouse

A new Georgia law limiting medical care for transgender children is likely to face serious legal challenges, experts say. 

Republican Gov. Brian Kemp signed a bill into law Thursday that prevents Georgians under 18 from obtaining gender-affirming hormone replacement therapy or surgery.  

The Georgia chapter of the American Civil Liberties Union (ACLU) has vowed to sue the state over the new law. The challenge is likely to succeed, law professors told Capitol Beat.  

Federal courts have blocked, at least preliminarily, similar laws banning gender-affirming care in Arkansas and Alabama, said Katie Eyer, a professor of law at Rutgers University. Neither of those cases has reached a full conclusion yet, but preliminary injunctions indicate the courts are likely to find the laws invalid, Eyer said.

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“Federal courts have been pretty protective of transgender rights recently,” added Scott Skinner-Thompson, a professor at the University of Colorado Law School. “[The laws] are targeting trans kids and their parents and therefore discriminating against them on the basis of sex.

“[It] interferes with the parents and children’s right to make medical decisions about their lives, which the courts have also recognized as a fundamental right under the due process clause of the Constitution.”

The Georgia law, which takes effect July 1, is likely to face similar arguments.  

“We can and will file a lawsuit before then,” said Cory Isaacson, legal director for the ACLU of Georgia. “[The law] violates fundamental constitutional rights under both the state and federal constitutions, including the right to be protected from discrimination and the right to parental autonomy.”  

Georgia joins a growing list of states that have banned such care. Since the start of this year, similar laws have been enacted in South Dakota, Mississippi, Utah and Tennessee. 

Florida has taken a slightly different approach. The state’s Boards of Medicine and Osteopathic Medicine adopted a rule banning gender-affirming care that took effect this month.  

On Thursday, Florida parents of transgender children filed a lawsuit against the rule in federal court.  

In the Peach State, Georgia Attorney General Chris Carr will be tasked with defending the new Georgia law when it goes to court.  

“The Attorney General will do his job, which includes defending laws enacted by the General Assembly and signed by the governor,” Carr spokeswoman Kara Richardson said.

Carr and attorneys general of 18 other states have already signed onto briefs supporting the Arkansas law. 

“States … have broad authority to regulate in areas fraught with medical uncertainties,” one such brief argued.  

But medical experts disagree. Major medical societies such as the American Medical Association and the American Academy of Pediatrics (AAP) oppose the bans because they conflict with established protocols. The Georgia chapter of the AAP and many other medical professionals called on state legislators not to adopt the law.   

In contrast, some supporters of such bans in Georgia wish the law had gone even further. 

“We are disappointed that this bill remains one of the weakest in the country, and we are mindful of those who worked to undermine full protections for children,” said Cole Muzio, president of Frontline Policy Action, a Christian advocacy group.  

The Alabama and Arkansas laws both banned puberty blockers, while the Georgia law does not.  

Puberty blockers are typically used to stop puberty from starting in children with gender dysphoria, a recognized medical condition that results in mental distress because of a mismatch between the sex a person was born with and the person’s own sense of their gender. 

Puberty blockers often need to be followed by hormone therapy to help transgender youth go through the puberty process, said Ren Massey, an Atlanta-area psychologist who specializes in treating gender dysphoria.  

Massey and others are concerned that the ban on hormone therapy will prevent transgender youth from going through the normal stages of teenage development – psychologically, socially and physically.  

“Medical professionals try to approximate a normal pubertal development,” often starting with low doses of hormones, he said.

The gender transition process is a lengthy one that includes numerous psychological and medical assessments, Massey said.

He’s concerned that now doctors and psychologists won’t have all the tools they need to help children and teenagers with gender dysphoria – and that these Georgians will suffer.  

Massey expects to see an increase in self-harm, attempted suicides and completed suicides among transgender youths in Georgia.  

“I’ve had a couple of families already move out of Georgia because of fear of these kinds of laws,” he said. “I am hopeful that lawsuits will lead to an injunction. … [Transgender youths] are in desperate need of support and help to cope with this additional stress.” 

This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.