Efforts to protect gender-affirming care draw passioned testimony at State House

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May 12—Before attending middle school, Rory Tremble felt uncomfortable in their body. Trapped even. That feeling turned into "utter self-hatred" when they started puberty later in adolescence.

"I felt there was no way out," Tremble, a 16-year-old Standish resident, told lawmakers Friday. "I didn't want to deal with that terrible feeling anymore. It got so bad that living seemed more like a burden than a joy and I didn't want to live anymore."

Fortunately, Tremble said, they had a loving family to confide in. Their mother purchased a chest binder, which fattens breasts, and they are confident their parents would support additional gender-affirming care, such as hormone therapy or puberty blockers.

"I finally felt right with how I looked," Tremble said. "I am privileged, because if I choose to have access to this care then I would have it. But there are other people who don't have that and go home not to a home but to a house where people don't listen to them and the effects are irreversible."

Tremble was among dozens of people who testified before lawmakers Friday on two bills that seek to protect gender-affirming care for transgender individuals in Maine, including one that would allow 16- and 17-year-olds to begin taking puberty blockers and hormone therapy without their parent's knowledge or consent.

Proponents said gender-affirming care can literally save lives, noting the higher rates of depression and suicidal thoughts among transgender and nonbinary young people. But opponents argued that parents have a right to be involved in their child's health care decisions.

Sandra Labonte of Searsport opposed both bills, arguing that medical professionals and others should affirm a child's biological gender until they are adults and can make their own decisions.

"What is our state thinking?" Labonte asked. "Is it not better to affirm the gender that you were born with? This is a war on our children. Allowing or promoting the (mutilation) of their outside body parts and a hormone pill to wreak havoc inside as well is not love or concern for our children."

Rep. Erin Sheehan, D-Biddeford, sponsored the bill to allow minors to receive gender-affirming hormone therapy — not gender reassignment surgery — without parental consent, but only if it's deemed medically necessary by a health professional. Specifically, therapy could be provided without parental consent if the child has been diagnosed with gender dysphoria, which is when someone's expressed gender identity is incongruent with the gender assigned at birth for a sustained period of time.

Other conditions include a determination that the minor is experiencing or will experience harm if care is not provided, and that the health care provider receives informed consent, including objective information about the treatment and consequences. The health care provider would also have to tell the minor they may withdraw consent at any time and discuss the possibility of involving the minor's parent or guardian.

Details of the bill, L.D. 535, were released the night before the hearing and were not yet available online late Friday.

A separate bill, L.D. 1735, sponsored by Rep. Laurie Osher, D-Orono, seeks to protect Maine health care providers who provide gender affirming health care to out-of-state minors from criminal or civil liability from out-of-state laws, and would allow those providers to withhold medical records and other information.

The bills are among a slate of Democratic proposals designed to protect gender-affirming care in Maine. Such care is under attack from Republicans across the country, who are enacting and proposing bans on gender affirming care for minors and taking steps to consider qualifying consenting to such care for a minor as child abuse or neglect.

"The issues we are considering here are highly sensitive, even in the best of times," Sheehan said. "But today, transgender health care is being politicized and stigmatized in the press and on social media. Transgender people, including youth, are being explicitly vilified and branded a threat to their peers by grownups — even by leaders in their communities."

At least 474 anti-LGBTQ bills have been proposed in state legislatures across the United States, with Texas and Oklahoma leading the way with 51 and 35, respectively, according to the American Civil Liberties Union. Four anti-LQBTQ bills have been introduced in Maine.

Fifteen states already restrict gender-affirming care for people under 18, and 18 other states, including New Hampshire and New Jersey, are considering bans on gender-affirming care for minors, according to Human Rights Watch.

That comes even as age-appropriate, gender affirming care has been endorsed by major medical associations across the country, including the American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics and the American Public Health Association.

Opponents worried that the two proposals would make Maine a safe haven for gender-affirming care for out-of-state residents, and many cited religion to urge lawmakers to respect the gender assigned to someone at birth. Some used transphobic rhetoric, claiming "rainbow cults" would kidnap children, bring them to Maine and groom them.

Abigail Beal, of Cherryfield, stood in "firm opposition" to both bills.

"I'm here to expose the truth that gender transitioning is not health care, it's not about child safety or caring solutions to gender dysphoria," Beal said. "Rather, these bills are entirely about the mutilating, kidnapping and the destroying of children, both Maine citizens and those who are brought there to receive such treatment."

Dr. Joseph Anderson testified in support of Sheehan's bill on behalf of the Maine Chapter of the American Academy of Pediatrics, saying gender dysphoria is "a well-recognized medical diagnosis with an established and effective treatment."

Anderson said a person is considered to have gender dysphoria when their expressed gender identity is different from the gender assigned at birth for at least six months and is causing clinically significant distress in the person's life and relationships.

"This therapy can be life-saving in the case of young adults struggling with gender dysphoria," Anderson said in written testimony.

Other supporters included LGBTQ rights advocates as well as the Maine Medical Association and the National Association of Social Workers.

Neither bill was voted on Friday, which means lawmakers will continue debate in the coming weeks.