Bills on transgender youths’ medical care, bathroom use in schools pass Senate

By: - March 7, 2023 10:38 pm

The Iowa Senate passed bills Tuesday prohibiting gender-affirming health care for minors and restricting transgender people's use of school restrooms. (Photo by Getty Images)

Democrats questioned whether a ban on gender-affirming medical care for transgender youths, which passed the Iowa Senate on Tuesday, would violate the Iowa Civil Rights Act.

Senate File 538 contains language specifying that the legislation will not constitute a violation of the Iowa Code’s chapter on civil rights. The civil rights act protects Iowans from discrimination on the basis of gender identity “regardless of the person’s assigned sex at birth.”

The bill passed along party lines with a 33-16 vote, with one senator excused.

The bill specifically says that medical treatment, including puberty blockers, hormone replacement therapy and surgical intervention, would not be banned for children who are not transgender. Puberty blockers may be given to children who enter puberty early, and hormone replacement therapy can be prescribed to certain minors who have a hormonal imbalance.

Senate Minority Leader Zach Wahls, D-Coralville, said by allowing gender-related medical care to remain accessible to children who are not transgender, the bill conflicts with civil rights protections.

“That’s why you feel it’s important to specify that this is not in violation of the Civil Rights Act,” Wahls said. “Because this is targeting a specific group of people.”

But the bill’s floor manager, Sen. Jeff Edler, R-State Center, said treatments for transgender patients are “experimental,” unapproved by the Food and Drug Administration, and should not be given to children. He said children “should not be pushed” to receive these medical treatments, as transitioning can result in sterilization or permanent physical changes.

“Every child deserves a natural childhood, one that allows them to experience puberty and other natural changes, that shape who they will become,” Edler said.

Democrats shared testimony from parents who argued their children would have committed suicide if they were forced to go through the puberty correlating with their gender at birth. Sen. Liz Bennett, D-Cedar Rapids and Wahls read letters from constituents with transgender children who talked about going through months or years of therapy and doctor’s appointments with their children before pursuing medical interventions like hormone treatment or puberty blockers. Parents expressed in the letters they were worried they would be forced to move out of Iowa to ensure their child’s safety if this bill passes.

“The statistics on transgender youth and suicide are one of the biggest reasons I chose to support and love my child unconditionally. I would rather have a transgender child than a dead child,” Wahls read from a parent’s letter. “A ban on gender affirming care would cause suicide rates amongst LGBTQ youth to rise and for families like ours to leave the state rather than risking having a dead child.”

Bennett asked Edler about why Senate Republicans were pursuing this legislation when medical studies show that transgender suicide rates decrease when patients are given gender-affirming care. Medical care organizations, including pediatric groups like American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatry, have released statements supporting the efficacy of gender-affirming care for transgender youth.

Edler argued the studies she cited only show the short-term benefits of gender-affirming care, but that he has seen studies that show long-term negative outcomes for people who transition in childhood.

In a Swedish study, mortality rates of transgender adults were 19.1 times greater than the control group due to suicides. Deaths due to cardiovascular diseases or neoplasms, the growth of abnormal tissues, were also higher among transgender patients than the control group in this study.

“These experimental procedures push vulnerable children down a one-way street that leads to permanent sterility and a lifetime of medical intervention,” Edler said. “The state has the right and should utilize its authority to regulate these practices based solely on these reasons.”

LGBTQ research organizations, including the suicide prevention group the Trevor Project, have released studies showing that LGBTQ youth were 40% less likely to attempt suicide when they had at least one accepting adult in their life.

“This is a dark day for Iowa,” Becky Tayler, executive director for Iowa Safe Schools, said in a news release. “While Iowa has historically been a leader for civil rights, the Iowa Legislature has sought to relentlessly demonize and harm transgender Iowans this year. This legislative session has seen over 30 bills attacking LGBTQ people, with many of them specifically targeting transgender youth. It is disappointing that Iowa Senate Republicans do not believe parental rights extend to parents of transgender children.”

Senate passes restrictions on school bathroom use

The Senate also approved a bill Tuesday banning schools from allowing people to use school facilities such as bathrooms, locker rooms or shower rooms that do not align with their assigned gender at birth.

Senate File 482 passed on a 33-16 vote and moves to the House.

Republicans said the measure was necessary to ensure children maintain the right to privacy. Allowing kids to use bathrooms other than those corresponding with their assigned gender at birth would violate other students’ privacy rights, Sen. Cherielynn Westrich, R-Ottumwa, the bill’s floor manager, said.

“We all want the best for our kids,” Westrich said. “And when we send them off to school, we expect them to be safe, well cared for. Senate File 482 does just that. Iowa kids are all going to be safe, they’re all going to be well cared for, and they’re all going to be provided provided facilities where they can have privacy.”

The bill allows school districts to provide accommodations, like single-occupancy bathrooms, upon request by the parents of a student.

But Democrats argued this “alternative facilities” accommodation is still in violation of federal law. In the U.S. Court of Appeals for the Fourth Circuit, a transgender student won a case against his school district for being prohibited from using the school restroom corresponding to his preferred gender.

Westrich said that other Court of Appeals cases have ruled in favor of “bathroom bills.” She said the appellate court in the Eighth Circuit, which includes Iowa, has not ruled on the issue, meaning the bill will be presupposed constitutional until proven otherwise.

Outside of legality, Democrats also said the bill will put transgender students at a higher risk of bullying. Bennett said there have been no cases in Iowa of a transgender person harming another person in a bathroom, but this bill will put transgender people — who face higher rates of violence — at greater risk.

“Ignoring this information betrays the hostility behind this bill,” Bennett said. “And perhaps the intent is not hostile, but the impact certainly is. This bill ushers in a world which is smaller, meaner and scarier for anybody who doesn’t conform.”

Westrich said bullying is already prohibited in schools.

“Bullying will still not be allowed in our schools,” Westrich said. “This bill does not change that. … we are going to continue to work together and treat all students with dignity while protecting all students’ privacy rights.”

The gender-affirming care ban, as well as a measure prohibiting instruction related to gender identity and sexual orientation for K-6 students, are on the House debate calendar for Wednesday.

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Robin Opsahl
Robin Opsahl

Robin Opsahl is an Iowa Capital Dispatch reporter covering the state Legislature and politics. They have experience covering government, elections and more at media organizations including Roll Call, the Sacramento Bee and the Wausau Daily Herald.