Congress finds little compromise on parents' rights on procedures known as 'gender affirming care'

Congressional Democrats on Thursday repeatedly denounced what they consider government interference in parent-child relationships for children distraught by their sex.

They balked at the possibility of federal legislation that would protect parents' rights to decide whether their children receive puberty blockers, cross-sex hormones and surgical removals of healthy breasts and genitals. 

They staked their positions in a House Judiciary Constitution subcommittee hearing on such medical interventions – known as "gender affirming care."

The contentious hearing was also marked by Democrats and Republican accusing each other of undermining parents through either red-state restrictions on such interventions or blue-state restrictions on parental consent and notification when children express a gender identity at odds with their sex.

Committee Democrats highlighted several federal courts having halted restrictions on the interventions, which have near-universal support among American medical organizations.

Tennessee Democratic Rep. Steve Cohen said members of GOP-led panel should have let the American Medical Association, American Psychological Association and similar mainstream bodies pick the witnesses.

They ignored repeated Republican invocations of France, Finland, Norway, Sweden and the U.K. pulling back on GAC for children, in light of weak evidence of benefit versus stronger evidence of harm.

American regulators are aware of problems as well.

A year ago, the Food and Drug Administration added a warning to gonadotropin-releasing hormone agonists, essentially an estrogen blocker used off-label for GAC, due to their "plausible" connection to spontaneous increases in intracranial pressure in girls.

A 2022 study found youth suicide increased over 10 years in states that let kids bypass parents for GAC.

Panel Chairman Mike Johnson, R-La., showed "a little sample of barbarism" from Oregon Health and Science University youth surgeon Blair Peters, who recently went viral for admitting "no one's published" research on genital operations on "pubertally suppressed adolescents" and describing the gruesome method of procuring skin from a child to make vaginal lining.

"No parent has a constitutional right to injure their children," Johnson said, comparing GAC to letting parents ignore seatbelt laws for their children.

Rep. Wesley Hunt (R-Texas) compared it to letting children eat ice cream at every meal, while Rep. Harriet Hageman (R-Wyoming) called the practices "sexual lobotomy" – now mainstream but soon to be discredited.

If Republicans had invited Peters to testify "he could have helped dispel some myths," her GOP colleagues have, Rep. Veronica Escobar (D-Texas) said, claiming that transgender children don't get surgeries.

When Pennsylvania Rep. Mary Gay Scanlon, the panel's top Democrat, claimed that parents are involved in "every phase of decision-making" on GAC and told colleagues to stay out of her children's medical decisions, Rep. Tom McClintock (R-Calif.) crowed that the parties have found common ground.

They evidently agree that California went too far by letting children evade parental involvement in GAC, he said, offering to cosponsor GAC parental-rights legislation with Scanlon.

"I think you're mischaracterizing the 'complete agreement,'" she responded. 

Democrats repeatedly introduced evidence into the record purportedly demonstrating GAC's sterling record contrasted with high rates of depression and suicidality in transgender adolescents without it, some of which have been methodologically challenged.

The parties' witnesses also provided wildly different characterizations of the safety and effectiveness of GAC for minors, based on disputed scientific research but also personal experiences in different eras of GAC.

Children's trauma-therapy clinician Jennifer Bauwens reviewed the research in detail in her 63-page submitted testimony.

Gender dysphoria has the "most invasive interventions connected to a psychological issue with the lowest quality evidence," the Family Research Council director of family studies testified.

She cited the case of 9-year-old "Mike," whose gender therapist recognized the boy couldn't distinguish fantasy from reality yet wrote up a plan for GAC all the way through surgery while ignoring the boy's diagnosis for autism, which is highly correlated with gender confusion.

Miriam Reynolds, a mother, said her family went through "extensive interviews" and a "meticulous" intake process when her tomboyish daughter started identifying as a boy seven years ago, at age 11, before "hysteria" set in over GAC. Doctors asked the child at every treatment if the child wanted to stop, Reynolds said.

Detransitioner Chloe Cole, who turned 19 on Thursday, said her transition process starting at age 15 made her suicidal, sent her grades plummeting and gave her ongoing medical problems, "unknown fertility" and irreversible physical changes including sexual dysfunction.

(A detransitioner is a person who attempts to bring to end or reverse gender transition.)

Looking in the mirror, "I feel like a monster" after a double mastectomy created nipples that produce "weeping fluid," she said. 

National Center for Lesbian Rights legal director Shannon Minter, born a woman but identifying as a man, said GAC has been practiced safely for 20 years. 

Rep. Matt Gaetz (R-Fla.) asked Minter how long parents should wait before the state tells them their missing gender-confused child showed up at a state-licensed shelter, referring to a new Washington state law that hides from parents the whereabouts of their children if they're considered "runaways" seeking GAC.

Minter said Cole's harrowing experience only represented 2% of GAC youth patients, because the other 98% continue treatment.

Cole responded that "it's incredibly difficult to go back" even before medical interventions. She wept while describing how Reynolds reminds Cole of her own scared parents, fearing that Reynolds' child will develop Cole's complications and regret.

One GAC researcher highlighted the difference between Minter's adult and Cole's teenage transitions. 

Though Minter told Johnson "I wish I could have transitioned earlier," the transgender man "had the opportunity to mature, intact, into adulthood, ensure that his ... symptoms were not a passing phase, develop reproductive functions, avoid the side-effects of puberty blockers, etc.," Manhattan Institute senior fellow Leor Sapir tweeted.