Michigan Republicans aim to ban gender-affirming medication, surgery for minors

• Republicans seek to block puberty blockers, hormone therapy and gender transition surgeries for Michiganders under the age of 18
• More than two dozen states have limited gender-affirming care, but the Michigan bills could face resistance in the Democrat-led Senate
• Gender-affirming care is rare, with researchers documenting 3,678 surgical cases across the US between 2016 and 2020

LANSING — Minors in Michigan would no longer be able to receive gender-affirming care under legislation introduced Wednesday by Republicans in the state House and Senate. 

The bills would prevent minors from receiving puberty blockers, hormone therapy or anatomy-alternating surgeries. The proposal would prohibit medical professionals from providing such care and allow anyone who alleges a violation of the law to seek court intervention, financial damages or other legal remedies. 

While critics contend the legislation would prevent transgender youth from potentially life-saving medical care that is generally supported by the American scientific community, sponsors argue the bills are necessary. 

Allowing gender-affirming medication or surgery is “misleading a child to believe that they can change their sex,” said sponsoring Rep. Brad Paquette, R-Niles. 

“This legislation seeks to uphold the medical policy of do-no-harm,” he said. 

More than two dozen states have already enacted limits on gender-affirming care as part of a national push by conservatives. While Michigan statistics are not available, nationally, well less than 1% of minors nationwide seek medical assistance during a gender transition.

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The Michigan proposal is unlikely to become law: Even if it passes the GOP-majority House, it faces a likely roadblock in the Democrat-controlled Senate. An identical bill introduced Wednesday by Sen. Thomas Albert, R-Lowell, was immediately sent to a committee chaired by Majority Leader Winnie Brinks, D-Grand Rapids, that is often used to kill bills. 

State House Speaker Matt Hall, R-Richland Township, did not take an immediate position on the proposal. “I have to look at the specifics of this bill,” he said Wednesday, telling reporters he would see how the plan progresses in the House Health Policy Committee before weighing in.

Albert said the legislation came from “an obligation to protect kids” and compared the medical treatments to drinking or smoking.

“I want any kid that is going through a difficult time to get the support that they need, that care should be evidence-based and always in the child's best interest, both now and in the future,” he said.

But it’s the science around gender-affirming care for minors that remains a central point of contention for advocates on both sides of the issue.

The American Medical Association, American Academy of Pediatrics and American Psychiatric Association endorse the availability of gender-affirming care for minors.

“The package that we're talking about today goes against all established science,” said. Rep. Emily Dievendorf, D-Lansing. “Access to health care is the only proven treatment for gender dysphoria and our priority needs to be supporting our kids as they are, as their authentic selves.”

Jamie Reed, an activist supporting the legislation who previously worked at the Washington University Transgender Center at St. Louis Children’s Hospital, cited other research, most prominently the ​​Independent Review of Gender Identity Services for Children and Young People, a review in the United Kingdom that led that country to effectively ban gender-affirming care for minors. 

It found the evidence to support transition interventions for youth was “remarkably weak,” both for surgical interventions and administration of puberty blockers. France, Denmark, Finland and Sweden now push for counseling over medical interventions for youth, but with some exceptions.

In the US, 27 states had enacted laws or policies limiting youth access to gender-affirming care as of March, according to KFF, a health policy research organization based in California.

Earlier this year, an Ohio court partially overturned a ban on hormone blockers in that state, ruling it violated the Ohio Constitution by interfering with parental rights to care for their children.

The US Supreme Court is now considering the fate of a similar puberty blocker and hormone therapy ban in Tennessee, and conservative justices reportedly appear poised to uphold the law.

Dievendorf placed the legislation within a larger context of restrictions on transgender Americans, particularly enacted at the federal level. 

“We have reason to be afraid of losing ground on basic human rights,” said Dievendorf, who was an LGBTQ rights activist before she was elected to the Legislature in 2022. “It's already happening. At the very least, we need to hold the line on fairness and equity and how to treat our neighbors humanely.”

In the US, it is quite rare for minors to seek and receive gender-affirming care.

A national study of teenagers aged 13-17 with private insurance found just .01% received gender-related medicines between 2018 and 2022.

A similarly small number of people aged 12 to 18 underwent transition-related surgeries between 2016 and 2020, according to national research. Of the 3,678 instances identified by researchers over that five year span, 3,215 were for chest or breast procedures, while 405 were for genital surgery.