Arkansas Court Case Will Decide Future of Trans Youth Health Care

Photo Illustration by Luis G. Rendon/The Daily Beast; Getty
Photo Illustration by Luis G. Rendon/The Daily Beast; Getty
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The fate of necessary health care for transgender teenagers in Arkansas is to be decided in a court case starting next week.

On Monday, District Court judge James Moody in the Eastern District of Arkansas will begin hearing arguments for the case Brandt et. al. v. Rutledge. The case was filed by the American Civil Liberties Union, along with four families with transgender teenagers and two doctors, after Arkansas passed HB 1570.

HB 1570 was the first law passed in the country that would ban doctors from prescribing treatment for the purposes of gender transition for minors. This means a whole suite of holistic gender-affirming care would be illegal for children currently receiving it.

‘We Love Her’: The Parents and Trans Teens Who Will Fight Arkansas Health Care Ban in Court

The law upended families across the state, and lawyers quickly secured an injunction stopping it from going into effect before next week’s trial.

“If the law was struck down? We would celebrate in the streets,” Brandi Evans, the mother of a transgender teenager, told The Daily Beast. “I mean, we’re always on kind of high alert to what could happen [otherwise].”

Evans’ son Andrew is 17, meaning if he were to suddenly lose access to all his care, the family has begun to make plans to prepare for the next year of his ongoing medical transition before he is legally allowed to make medical decisions on his own.

For families in Arkansas, the passage of HB 1570 has galvanized a small, tight-knit community pushing families to fight for each other in an effort to keep their kids’ medical care from getting shut down.

This meant added responsibilities such as advocating for themselves, showing up at the state Capitol and making themselves visible, because you never know who is watching.

Danielle May and her family’s life was “blown up our world in the best way possible” when her son Phoenix came out as transgender in 2021. Had an injunction not been granted that year stopping the implementation of HB 1570, Phoenix would not have had access to gender-affirming care.

Contrary to many narratives around gender-affirming care, he did not start Hormone Replacement Therapy right away. In fact, Phoenix’s first health-care provider was targeted by lawsuits, forcing the family to relocate to another clinic in order to continue his medical transition.

Now, May told The Daily Beast that “I’m getting to see my child move through the world with confidence and peace and joy,” alongside his brothers and supportive family. She says that without this affirming environment and care she would have been deeply scared for Phoenix’s mental state and his risk for self-harm.

Studies have shown that transgender adolescents who have access to gender-affirming care have fewer suicidal thoughts and improved mental health outcomes.

Evidence like these studies and other experts on pediatric endocrinology were not able to sway legislators during the 2021 legislative session in Arkansas when HB 1570 was debated. The state’s governor at one point even vetoed the bill after it passed, before it was overridden by the legislature.

Recently, Arkansas’ Attorney General Leslie Rutledge—who will be defending HB 1570 in District Court—was interviewed by Jon Stewart about the law, and justified the law under the guise of allowing “those young people who are facing gender confusion and dysphoria allow them to become adults and to make that decision” even if such practices were opposed by major medical organizations such as the American Medical Association and American Academy of Pediatrics.

Rutledge could not name the expert testimony that was used in support of the bill, telling Stewart to refer to the briefs filed in the upcoming court case. She also spelled out some false claims about transgender youth to justify the bill.

“We have 98 percent of young people who had gender dysphoria,” said Rutledge. “That they are able to move past that and once they had the help that they need, no longer suffer from gender dysphoria.”

These claims, along with recent harmful threats to gender-affirming care providers are part of a broader reactionary backlash to transgender rights, which this case hopes to provide legal precedent to halt, Chase Strangio, Deputy Director for Transgender Justice, ACLU, said in a conference call.

“Ultimately, it will be this trial in Arkansas beginning on Monday that will be the first to fully hear the evidence on the merits, challenging these types of restrictions that unfortunately, we’ve seen over and over again across the country,” Strangio said. “We look forward to being able to advocate in court for our clients and for all transgender Arkansans who deserve the right to receive the care that they need, just like everyone else in Arkansas.”

The ACLU’s case rests on three claims: singling out restricting gender-affirming care violates the equal protection clause; targeting minors in restrictions of care intrudes on the rights of parents to make medical decisions for this children; barring gender-affirming care violates the free speech of doctors to provide the most medically accurate information to their patients.

Leslie Cooper, Deputy Project Director at the ACLU LGBTQ and HIV project, said that the ACLU is confident the state of Arkansas has not met the high burden of proving this care is inherently harmful to minors and doctors have not accurately assessed the risks of gender-affirming care. Three of the four witnesses Arkansas plans to call have had their claims discredited by other court decisions, and have limited to no experience in transgender health care, she says.

“In this trial, we will show the court that the attack on trans health care does nothing to protect children but rather endangers the health and well being of transgender youth across across Arkansas, and prevents parents from taking care of their children,” Cooper said.

The results of the trial will almost certainly be appealed, Strangio said. While Cooper said it was too early to determine what a positive verdict would mean for similar laws around the country. Currently, the case is being tried in District Court, meaning a verdict would apply state-wide, and the initial appeal would only be in the Eighth Circuit, which covers the Dakotas, Nebraska, Minnesota, Iowa, Missouri, and Arkansas.

“Oftentimes lawmakers are not particularly affected by the prospect that their laws are unconstitutional,” Strangio said. “I think that as a matter of precedent this will be hugely important, but what we’re seeing, and what we continue to see in states around the country, is that [lawmakers are] posting laws that they know to be unconstitutional, despite the fact that they’re well aware that they could be liable for a substantial amount of attorneys fees.”

Meanwhile, as this case goes to trial there is no doubt that families have been upended by the mere passage of HB 1570, with some even going as far to leave the state of Arkansas for their safety.

Emily Spurrier and her family left Arkansas two months after the passage of HB 1570 with their 17-year-old transgender son. The family made this decision to ensure that their gender-affirming care would not be disrupted, as they were able to immediately change clinics when moving to New Mexico. At the time an injunction on the implementation of HB 1570 had not been granted, but the family was not taking chances.

The consequences of this law still ring true for the Spurrier family despite being able to care for their son out of state. Their extended family even outside of Arkansas has told Spurrier that they will not allow them to visit, for fears that the mere presence of their transgender son would indoctrinate their children, a common trope spread by anti-transgender activists. The misinformation the family has seen has at times been worrisome, she said and worries that this movement will be entrenched for a long time.

“Even if the ACLU wins, even nationwide, the damage has been done and it will take years to repair,” Spurrier told The Daily Beast. “An ACLU win won’t automatically change the opinions of so many in Texas, Arkansas, Idaho and other such states. That’s a long, hard, uphill road.”

For both May and Evans there still is the notion of fighting to continue to provide spaces for transgender kids in Arkansas, beyond the outcome of this case, although given the age of May’s son there have been painful conversations about the potential to need to leave Arkansas to ensure his medical care continues.

Still, if the case strikes down this law May says her family “will continue showing up and doing the work because we’ve seen how easily a basic human right can be taken away.”

Evans’ son Andrew has seen the battle play out and it has galvanized him to want to be a teacher growing up. He wants to teach English, right now, but mostly he just wants to be the teacher he never had making sure that queer kids know they have an ally in their school and a space to be themselves no matter the prejudice they face from their peers. It's clear that he gets that fight to create space for those who may not have it at home from his mom.

“I want trans kids to know if you don’t have that affirming person in your life: find me,” Evans said. “You can message me, you can find me, because I will be your mom, aunt, cousin, or wherever you need me to be. I will be that because I want you to be the light that this world deserves.”

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