WV House OKs transgender care to ban mental health exemption

CHARLESTON, W.Va. (AP) – West Virginia’s Republican supermajority House of Delegates quickly accepted a proposal to add mental health exemptions to a bill that would ban certain health care for transgender youth during the final day of its 60-day legislative session Saturday.

The chamber approved changes made by the state Senate late Friday that would allow some transgender youth to continue receiving medical interventions, including hormone therapy, if they are at risk of self-harm or suicide.

The bill now returns to the Senate for final approval, which it is likely to receive on Saturday before going to Governor Jim Justice’s desk. The Republican governor has not taken a public stance on the measure.

Legislators in West Virginia and other states advanced bans on transgender health care for youth and young adults often characterize sex-affirmation treatments as medically unproven, potentially dangerous in the long term and a symptom of “woke” culture.

But every major medical organization, including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association, supports gender affirming care for young people.

House members — who passed a much more restrictive version of the proposal last month that did not include mental health exemptions — voted to approve the unanimous vote with little discussion. The amended bill later passed 88-10, with all the “no” votes coming from the body’s dwindling Democratic delegation.

The only lawmaker who spoke on the floor before the vote was Democrat Del. Ric Griffith, who cited data from peer-reviewed medical journals showing that hormone therapy and other interventions can dramatically reduce psychological distress and suicidal ideation for transgender teenagers.

“We talk a lot about, ‘Parents know what’s best for their children,'” he said. “That’s a pretty narrow allowance when a child could be suicidal.”

The rate of suicidal ideation, or having suicidal thoughts or ideas, for transgender youth in Virginia is three times higher than the rate for all youth in the state, according to comprehensive research by WVU Medicine physicians using data from the West Virginia Youth Risk Behavior Survey.

The West Virginia bill prohibits those under the age of 18 from being prescribed completely reversible hormone therapy and medication to suspend the physical changes of puberty, allowing patients and parents time to make future decisions about the hormone therapy.

But the change approved by House lawmakers Saturday – proposed by Senate Majority Leader Tom Takubo, a trained physician – would allow young people to access puberty blockers and hormone therapy if they are suffering from dysphoria of a severe kind, in certain circumstances.

Gender dysphoria is defined by medical professionals as a severe psychological distress experienced by those whose gender identity differs from their assigned sex at birth.

Takubo cited 17 peer-reviewed studies that show a significant decrease in rates of suicidal ideation and suicide attempts among youth with severe gender dysphoria who have access to medical therapy.

“These kids are struggling, they’re having incredible hardships,” he said.

He found a supporter in another trained physician, Senator Mike Maroney, chairman of the Senate Health and Human Resources Committee. Maroney said lawmakers are setting “a dangerous precedent” by neglecting medical research in favor of political gain.

“Who are we, to win an election, to tell people how to practice medicine? To change the treatments? It’s unbelievable,” said the Republican, adding that lawmakers should not apply the same standard for drugs for the cancer or mental illness.

The legislation includes a ban on sex-affirmation surgery for minors, something medical professionals emphasize won’t happen in West Virginia.

With Takubo’s change, a person under 18 would have to be diagnosed with severe gender dysphoria by at least two mental health or medical providers to access medical therapy. One would have to be a mental health provider or a specialist in adolescent medicine.

The dose should be as low as possible needed to “treat the psychiatric condition and not for gender reassignment purposes,” according to the bill.

Providers must be specifically trained to diagnose and treat severe gender dysphoria in adolescents and must provide written evidence that medical interventions are necessary to prevent or limit self-harm or the possibility of self-harm . The parents or guardians of the minor will be required to give written consent to the treatments.

Hormone therapy could not be provided to minors before the age of puberty, something doctors in West Virginia say would not happen anyway.

The bill includes exceptions originated in the House version for people born with a “medically verifiable disorder,” including people with ambiguous “external biological sex characteristics” and for people receiving treatment for an infection, injury, disease or disorder that was “caused by”. or aggravated by the execution of gender transition procedures.

People can also access treatment if they are in “imminent danger of death, or deterioration of a major bodily function, unless surgery is performed.”

The House vote came two days after a crowd of protesters descended on the state Capitol, where chants of “trans kids matter” could be heard from the Senate chamber as lawmakers debated the bills. The Democratic Del. Danielle Walker, the only openly LGBTQ member of the Legislature, led chants of the state motto: “Mountaineers are still free.”

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