Commentary: Who do you want involved in your family’s health care?

Utah Legislature has no business limiting care for transgender youth.

(Trent Nelson | The Salt Lake Tribune) Troy Williams of Equality Utah reacts to a statement by intern Ari Webb, which was read by Sen. Nate Blouin, D-Salt Lake City, as the Senate gives final passage to a bill aiming to crack down on the ability of doctors to prescribe hormone therapy for minors who are transgender, at the Capitol building in Salt Lake City on Friday January 20, 2023.

We are a group of interprofessional medical providers, recognized as national experts in our fields, serving patients throughout Utah. We are also, perhaps more importantly, parents who have had to navigate the health care system when our children have needed significant care.

Among all of us, our children have needed critical and life-saving surgeries, consultations with specialists such as pediatric cardiologists and neurosurgeons, evaluations for developmental disorders, work with social workers, speech and learning therapists, routine medical care, occupational therapy and medications prescribed specifically to kids. We all recognize the immense privilege that we have of access to excellent health care.

Working closely with our childrens’ health care providers and trusting their expertise in decision-making is critical to providing the best care to our children. With all of these consultants, who have trained their entire careers to manage the health care needs of pediatric patients, it never occurred to us that we should think about consulting the Utah Legislature about their care.

All of us in Utah want to access the highest quality health care for our kids. The medical providers here are board-certified, having attended school and additional training for years. They participate in between 50 and 100 hours of additional training and continuing education each year. All of the other members of the health care team have advanced degrees and professional certifications and participate in hundreds of hours of additional continuing education across their careers. They are licensed by the state, overseen by state boards and allowed to practice by institutions that determine what they are allowed to do, as far as medical practice and procedures. They read constantly, participate in research and follow practice guidelines that are informed by years of research, written by additional experts in their field.

Medicine is dynamic, constantly improving and advancing and requires constant dedication and commitment to education in order to stay current.

Unfortunately, during this legislative session, there are several proposed measures to restrict the access that Utahns have to the highest-quality health care.

Gender-affirming care is as equally life-saving and as important as treatment for asthma, autism, heart conditions or type I diabetes. It is evidence-based, widely recommended care that has been developed to help transgender people, meaning those whose current gender identity (sense of their gender on the inside) doesn’t match their assigned sex at birth. This care involves a variety of services including, but not always, medications, some surgeries, voice therapy, primary care and mental health care.

In our community, this care is delivered by medical experts who have dedicated years of their lives to training in this field, and decisions to engage in care are not made lightly. Treatment decisions for minors are made together with Utah families in thoughtful consultation with their healthcare teams. They are conservative, safe and based on national and international guidelines that are supported by a wealth of research.

When decisions are made to provide treatment to adolescents with gender dysphoria, they are done because the entire team, including parents, believe that doing so would be in the best interest of the child.

It is impossible for our part-time legislature, who in a 45-day session need to address all of the business of managing our state, to stay abreast of all of the updates and current practice guidelines in medicine. It is simply not within their scope, available time, training and education. Also, with the board certifications, state regulations and licensure, and professional society guidance, legislative interference is unnecessary and redundant.

We admit that the legislators who propose this legislation likely believe that what they are doing is protecting children from harm. But we, the medical providers who offer care to the transgender community in the great state of Utah, believe that this legislation is primarily going to cause tremendous harm.

Restricting access to services does not make the demand for these services any less. If anything, it increases demand and drives people to extremes. Transgender people are already marginalized and ostracized, with profound difficulties in accessing high-quality, evidence-based care. Please do not allow the Utah Legislature to create even more barriers to services and interference with health care that should be trusted to working relationships between parents and their children’s healthcare providers

Joanne Rolls, MPAS, MEHP, PA-C; Cori Agarwal, M.D.; Erika Sullivan, M.D., MS; Erica Johnstone, M.D.; Norelle Walzer, PA-C; Nicole Mihalopoulos, M.D., MPH; Isak Goodwin, M.D.; Jim Hotaling, M.D., MS; Marisa Adelman, M.D.; Johanna Greenberg, MPAS, PA-C; Abbey Bentley, MSN, CPNP; Hayley McLaughlin, RN, BSN; Katherine Hayes, M.D., FACOG; Sarah Eyberg, M.D.; Adam Dell, M.D. FAAP; Julia Piwowarski, PA-C.