Families and doctors challenge Montana’s ban on gender-affirming care for trans minors
Like many such laws around the country, SB 99 bars the use of puberty blockers, hormone therapies and surgeries such as mastectomies and facial alterations to help patients better align their appearance with their gender identity. Some of the banned services have been recognized by leading U.S. medical institutions as safe and effective treatments that are included among best-practices for minors who struggle with gender dysphoria, a clinical diagnosis that some transgender and gender diverse people experience. The bill also prohibits the use of public funds for the banned medical care, including at out-of-state facilities, and threatens Montana providers who violate the law with disciplinary action from their licensing board, a one-year ban on practicing medicine and increased exposure to lawsuits from patients or their parents.
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Transgender residents, their family members and health care providers opposed the Montana legislation for months, calling it discriminatory and an abuse of governmental power. They underscored research showing that youth who access gender-affirming medical care experience decreased rates of depression and suicidality. Many simply asked lawmakers to believe trans people when they say the medical services are important and help them live happier lives.
One of those people was Jessica van Garderen. Testifying before lawmakers during a March committee hearing, she recounted the experience of watching her daughter struggle with her mental health and motivation. After Scarlet came out, Jessica said, the family tried talk therapy but it “barely made a dent” in the teenager’s depression and anxiety. Multiple referrals, consultations and evaluations lead the family to new options: puberty blockers and, later, hormone therapy.
“Within a few weeks, I noticed changes in my daughter’s mood. Within a few months, she was smiling again. I’m happy to report she’s now thriving,” Jessica told the committee. “… Let’s face it. We are here today because some of you are uncomfortable looking at transgender people, so you are trying to make it harder for them to exist.”
The van Garderens, a family from Missoula and two Montana medical providers are suing the state to permanently block SB 99 from going into effect. The lawsuit names Gianforte, Attorney General Austin Knudsen, state health department Director Charlie Brereton, the state Board of Medical Examiners and the Board of Nursing as defendants.
The complaint focuses on the plaintiffs’ constitutional rights to equal protection, privacy, dignity, and health care and the right of parents to direct the upbringing of their children, all of which attorneys said are threatened by the looming law.
The lawsuit argues that gender-affirming medical treatments are essential for some people with gender dysphoria, described as a strong discordance between gender identity and gender as assigned at birth. A person’s sense of their gender is “innate,” the attorneys say, and transgender youth cannot “simply turn off their gender identities like a switch.” Living without treatment for gender dysphoria, the suit continues, can put transgender people at increased risk of depression, anxiety, self-harm, substance use and suicidality, a phenomenon exhibited in marked disparities between transgender youth and peers without gender dysphoria.