Consider This from NPR - A Patchwork of Transgender Healthcare Laws Push Families Across State Lines

Episode Date: July 26, 2023

When Utah passed a ban on gender-affirming care for people younger than 18, Kat and their family had to make a tough choice. Should they uproot their lives and leave the state?Kat is 14 and transgender. The Utah law banned the medical care that Kat was considering.Around 20 states have passed similar laws — meaning many families could face the same tough decision: whether to leave their homes and where to go. Often it's to a state like Minnesota, where elected officials have protected trans health care for patients and providers. We speak with reporters Saige Miller from KUER in Salt Lake City and Dana Ferguson, a political reporter with Minnesota Public Radio to hear how this patchwork of laws in both states affects trans patients and their doctors.In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

This message comes from Indiana University. Indiana University performs breakthrough research every year, making discoveries that improve human health, combat climate change, and move society forward. More at iu.edu forward. Today, we want to introduce you to Kat. Kat is 14. 14 years of age. Sorry, I'm a bit articulate when I'm nervous. Loves the show Sherlock Holmes, the one starring Benedict Cumberbatch, to be clear. I can talk about it all day. And has always called Utah home. But that got a lot harder earlier this year.

Well, the state of Utah has banned gender-affirming health care for transgender youth. That new law keeps kids from getting gender-affirming surgeries while putting an indefinite moratorium on things like puberty blockers and hormone therapy. The law goes into effect immediately. Cat is transgender. They had been considering medical treatment that was instantly banned under that new state law. So when it passed back in January, it forced their family into a difficult decision. Stay or go? Here's Kat's mom, Jen. I've always said, like, living here in Utah, I feel like a salmon trying to swim upstream.

And I'm really tired. My fins are very worn. We aren't using Jen and Kat's last name because they have concerns for their safety. Utah isn't alone. There are about 20 states with bans on gender-affirming care for minors. That means lots of families could be faced with the same hard choices as Kat's. How can I possibly stay and let my child be treated like this? Consider this, a patchwork of state laws on medical care for transgender children and teens

is sending some patients across the country to get treatment. We'll look at how that's affecting families and doctors. It's 2023 and we're making refugees within the United States of America. From NPR, I'm Juana Summers. It's Wednesday, July 26th. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today or visit WISE.com. T's and C's apply. It's Consider This from NPR. For families like Katz feeling pressure to leave their home when

a state like Utah passes a ban on gender-affirming care for trans youth, that's just half of this story. The other half is about where that family goes. Often, it's a state like Minnesota where elected officials have protected trans health care for patients and providers. To understand how these pieces fit together, my co-host Scott Detrow spoke with two reporters, KUER's Sage Miller in Salt Lake City, Utah, and Minnesota Public Radio's Dana Ferguson in St. Paul. So we started hearing about a family in Utah there, but Dana, fill us in on what's going on in Minnesota. Yeah, so lawmakers here, because Democrats have the majority in the Senate, the House, and the governor's office, were able to pass gender-affirming care protections this year. So that means that patients who come to Minnesota seeking gender-affirming care are legally protected against laws that might be in place in the states that they're coming from, and providers will be able to have those protections if they practice here as well. And I should mention that about 12 other states have similar protections they've put in place,

though they vary a little bit depending on where you are, what those protections do. So that's a group of states going in one direction. And Sage, Utah, is one of the states going in a very different direction. We heard a little bit about Kat and Kat's family. Tell us more broadly what's been happening in the statehouse in Utah. We've definitely seen a shift in politics in the state legislature when it comes to transgender issues. About two years ago, Utah's Republican Governor Spencer Cox vetoed a ban on transgender youth participating in school sports. But the Republican supermajority overrode that veto, and ultimately the courts blocked the law, at least for now. But Kat's family have been on guard since that legislative

move alone. Then Utah was the first state this year to ban gender-affirming care for transgender youth. And there's about 20 states that have done so as well, and about five have holds on such bans by the courts. So you're seeing Utah kind of go more and more in that direction. Broadly speaking, why are lawmakers pushing for these bans? What do they say they're worried about here? So the lawmakers that I have spoke to and heard give their testimony on the floor was that they were worried about the lack of evidence surrounding the impact of this medical treatment on transgender youth, even though around 30 medical associations say that gender-affirming care is safe and effective for trans youth. State leaders do expect this law to be challenged in the courts.

However, nothing has come to fruition as of yet. But the ban on trans care becoming law was really just the straw that broke the camel's back for Kat's family. And Scott, it's really the little things that hit the hardest for the family, like leaving behind their garden. Every year over Mother's Day weekend, they buy seeds and plants for their backyard garden in their home in Utah. Well, this year, I was buying moving boxes at Lowe's to pack up our stuff. And when I saw the plants, I just sat in the parking lot and cried. Because it was the perfect illustration of how our lives have been turned upside down by someone who can flippantly say, well, just let the courts decide. Sitting in a nearly empty two-story house,

Jen somberly recounts the events that forced her family to leave the state they love. Kat is her youngest child. The 14-year-old says they've faced immense backlash since coming out as trans, including people using their dead name. That's the name given at birth. I mean, especially my school. I've been constantly harassed and actually bullied out of the school for about a month. I had to stay home and I get shivers of even thinking of going to school. I've been misgendered, teased with my dead name. Earlier this year, the Utah legislature voted to restrict access to gender-affirming care for transgender youth. State Senator Mike Kennedy, the bill sponsor, said the bill was necessary because of the lack

of evidence on the impacts of gender-affirming care on minors. But dozens of medical associations agree that such care is safe and effective. Kennedy himself has questioned whether the bill meets legal muster. But I've tried, along with others, to do my best in this area, and I would bet every dollar that I have in my bank account right now that this will be litigated. Catt was scrolling Twitter, down a Sherlock Holmes rabbit hole, when the news popped up on their timeline. Now that the governor had signed the ban, Catt wouldn't be able to get the medical care they've been considering.

People were freaking out, and I just remembered I just felt like I blacked out. And then I woke up hours later with just a tear-soaked pillow. Jen says the whole family couldn't sleep for days afterward. She noticed her physical health was declining. Kat went from honor roll to 20-plus absences in school. All of this, Jen says, left them with no option except to leave Utah. Utah and specifically Senator Kennedy and everybody else who's participated, they have forced this choice on me. How can I possibly stay and let my child be treated like this?

So Kat's dad began looking for a new job. He landed one in Washington state. They put the house on the market and started throwing their lives into boxes. It was a quick decision and no one took the move easily, but it hit Kat the hardest. It's just the only place I ever knew is where all my friends are. And knowing that I'm going to have to go to 10th grade, probably one of the craziest grades to move states from, because everyone already has their little cliques. It's just going to be, it's going to be vile. That's reporting from Sage Miller at KUER in Salt Lake City. Sage, I will say, I moved to another state in 10th grade,

so that last point really resonates with me hearing that. How is the family doing? The family is settling into their new home in Washington. But as you would know, Scott, it's definitely tough to be uprooted. And Kat still really misses Utah, their friends, and the memories that they made there. And they really value control, and they feel like that control has kind of been ripped out from underneath them. However, on the flip side, Jen says Washington feels amazing, and she's cried many tears of happy relief to just feel less stress and to be able to exist in her own home. Yeah. How'd they end up in Washington State? What specifically led them there? I do know that Kat's dad was able to snag a job there first,

but more importantly, they were looking ahead. They had considered Minnesota, but the family had concerns about how long those gender-affirming care for transgender youth protections would last because of the politics in the state. It's traditionally a purple state, and Democrats control the state for now. But they were worried that state leaders would reverse those protections if Republicans gained control again, and they really didn't want to have to pack up their stuff again and leave. So Dana Ferguson, let's go back to you. You're in St. Paul. Is there something to that concern that the protections in place right now could go away one or two elections down the line, depending on what happens?

Yeah. As we've talked about a little bit, Democrats have control over three levers of power in St. Paul right now. But there is a sense that in future as well as LGBTQ groups that there might be additional need to put these gender-affirming care protections in the Constitution. And that's something that Democratic leaders have talked about. They're weighing a constitutional amendment for next year that would provide some equal rights protection, and they're hopeful that even if a future legislature came in and wanted to wipe out these protections, that they would be solidified in the state's constitution. So those are some choices or some things that might happen down the line. What else do we need to know about the protections that are in place right now in Minnesota?

I want to get to that, Scott, but I also want to give listeners just a quick heads up that we're getting to a part in this story where we're talking about suicide and youth mental health. But to answer your question, for Minnesota doctors who provide gender-affirming care, this year has been a whirlwind. Calls from patients out of state have surged in the last year with more and more bans. It's 2023 and we're making refugees within the United States of America. That's Dr. Kelsey Leonard-Smith. She practices gender-affirming care in the Twin Cities. Leonard-Smith says the clinic used to get a few calls from out-of-state patients each year, but now they're getting that many each week. In the clinic's lobby, guests are welcomed by floor-to-ceiling floral murals,

and they can pick up colorful buttons that express their pronouns. Staff members press a variety of button options. If I want to see her, I'm going to do a they-he next. More patients are coming here to start or continue hormone treatments that have been outlawed in their states. And some are making a permanent move. Clinics like this one and hospitals have had to train more providers to offer services, and they're still having trouble keeping up, says Leonard Smith. You run a real risk of like doing wrong by trying to do right, trying too hard to take care of

everybody so that you're not doing a good enough job and finding the right balance is really tough. We are hearing from people all over the country. Dr. Katie Miller works at Children's Minnesota in the hospital's gender health program. We've had families call from Florida, from Texas, Iowa, a lot from Iowa, North Dakota. Miller says patient requests have surged 40 percent at Children's Minnesota since other states began enacting bans. The hospital is working with other clinics, but it still has a one-year wait list. Miller says patients traveling here have a lot on their minds. I think another challenge is that people feel very afraid of what might happen next. People feel victimized by the government.

It's led to just a degree of fear and anxiety about accessing medical care that I haven't seen before. Both Miller and Leonard Smith say their out-of-state patients feel like they're becoming political refugees. But even here, they're still on edge. Here's Leonard Smith. People are updating their passports, and I know folks who bought a new car because they wanted to make sure that if they needed to drive to Canada, their car wouldn't break down. Miller says she feels like she's working under a microscope. If she gets something wrong, it could become a political talking point.

But her more pressing concern is keeping her patients alive. My biggest fear is that one of my patients will commit suicide. And that's really pervasive. It's gotten worse. We know that these laws and these bans impact the mental health of gender diverse youth. We know that trans and gender diverse youth are at much higher risk of suicide. Both doctors say they worry about the ongoing trauma, but they plan to stay the course in Minnesota to be there for their patients, no matter where they come from. And that's Dana Ferguson with Minnesota Public Radio, who is talking to me along with Sage Miller of KUER in Salt Lake City about what's going on in two different states here. And just a reminder,

if you or someone you know is in crisis, you can call or text the 988-SUICIDE-IN-CRISIS-LIFELINE, just those three digits, 988. So let's go back to Utah one more time with Sage Miller. Sage, you mentioned the possibility of a court challenge to the care ban that we started this conversation with. What might that look like? So we haven't seen a challenge to the state law just yet, but the ACLU of Utah says it's working on one. And from there, you know, it'll go through the traditional methods, work its way up the courts, and they will decide in Utah whether the law should stand. But for now, the ban on gender affirming care for transgender youth in Utah is here to stay. That was Sage Miller, who's a political reporter with KUER in Salt Lake City. Also heard from Dana Ferguson, a political reporter with Minnesota Public Radio. They were speaking with my co-host Scott Detrow.

It's Consider This from NPR. I'm Juana Summers.