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Analyzing the Latest Gender-Affirming Care Restrictions in State Laws

by Mark A. Fadel, MD, JD, and Yolanda L. Troublefield, MD, JD • August 15, 2023

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(It’s important to note here that Tennessee’s gun control laws are relaxed compared to other states’ laws. The state does not require a license or permit to purchase a firearm, or even to register it [Tenn. Code Ann. § 39-17-1301-66]. The AR-15 military-style rifle used at the tragic school shooting at The Covenant School in Tennessee on March 27, 2023, was legally purchased by the offender.)

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Explore This Issue
August 2023

The Eighth Circuit Court [cited] ample medical evidence revealing the positive effects of genderaffirming care on suicidality and quality of life.

The lack of support and increasing barriers to care for the transgender community has already been shown to be harmful—even deadly—with more than 50% of transgender youth experiencing severe depression and over 40% admitting to self-harm or suicidal ideation (JAMA Netw Open. 2022;5:e220978). This vulnerable population experiences higher rates of suicidal ideation and attempts, homelessness, physical violence, substance abuse, and HIV. Restricting access to this care leads to potentially endless downstream effects. Poor access means higher feelings of rejection, making it less likely they will seek care of any kind, leading to higher acuity of care, worse medical outcomes, higher rates of mental health problems, and suicidal ideation or attempts. The rhetoric used by legislators not only restricts care but marginalizes this already disregarded community. Hate can take root in the most subtle of places.

Is Your State Next?

Facial plastic surgeons, laryngologists, and rhinologists across the country should follow this change in legal landscape because Tennessee is not the first and won’t be the last. Arkansas has already passed a similar law. On April 6, 2021, the Arkansas state legislature overrode a veto by the governor to pass the Save Adolescents from Experimentation (SAFE) Act (Act 626 of 2021. https://encyclopediaofarkansas.net/entries/act-626-of-2021-15789/). This made physicians who provide gender-affirming care to minors subject to loss of licensure and civil liability. Many other states have also introduced similar bills that are sitting in their legislature still under consideration.

Fortunately, the Arkansas courts acknowledged the overwhelming scientific support of this care and agreed with the opposition. In Brandt v. Rutledge, a transgender minor, their parents, and two healthcare providers filed a lawsuit alleging that the act violates the Equal Protection and Due Process Clauses of the Fourteenth Amendment. Essentially, the act discriminates on the basis of sex and prevents the parents from accessing their fundamental right to seek medical care for their children. The Eighth Circuit Court agreed, citing ample medical evidence revealing the positive effects of gender-affirming care on suicidality and quality of life. Arkansas attempted to disprove these facts by criticizing the structure and integrity of these studies, but the court quickly referenced the wide breadth of national and even international research on the topic. Arkansas’ arguments were “clearly erroneous.”

Pages: 1 2 3 | Single Page

Filed Under: Departments, Home Slider, Laryngology, Practice Focus, Viewpoint Tagged With: state law, transgender careIssue: August 2023

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  • Transgender Care: Otolaryngologists Can Help Fill an Unmet Need for This Patient Population

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