Annie Berbert: Which children do Utah lawmakers think they are protecting?

Utah’s anti-transgender bill will do more harm than good.

(Trent Nelson | The Salt Lake Tribune) Clayton Middle School students protesting HB 11, which bans transgender students from competing in sports, in Salt Lake City on Friday, April 22, 2022.

I was 20 when I went on Lupron. But I’m not transgender, and I wasn’t receiving it as a puberty blocker. It was to calm my severe endometriosis, a hereditary condition that my transgender son now may have to navigate.

Now that the anti-transgender billSB 16 — has passed the Utah Legislature and been signed into law by Gov. Spencer Cox, the hurdles my son will face in getting the hormones his body needs to prevent endometrial overgrowth, however, will be far greater than those his cisgender peers will face for the same condition.

He will have to prove to medical professionals that his motive for accessing the hormone treatments is for endometriosis and not gender-affirming care.

Currently, transgender patients face significant medical discrimination. According to a CAP survey nearly half the transgender population experiences medical mistreatment, including care refusal.

The very drug that tempered my endometriosis is now being made inaccessible for my son solely because it has the dual use of supporting transgender care and treating endometriosis — and he could be rendered infertile, not because he receives hormone therapy, but because he can’t.

Here’s what I wish all Utahans understood.

Only one clinic in Utah treats transgender youth. To get in, trans youth must first be assessed by a primary care physician and obtain a referral. They are then wait-listed for six months to a year. The first appointment is a preliminary screening. That screening is not minor.

Everything is considered, from the child’s mental health to the parents’ religious preferences. Treatments require informed consent of both parents and the child. Each form of treatment is discussed in full, including both temporary and permanent side effects. So any public perception that liberal Utah doctors are handing out hormone therapy to trans kids like candy is blatantly wrong.

Additionally, surgical sterilization cannot be performed on youth under 18. Hence, gender-affirming surgery (GAS), refers primarily to top surgery — breast augmentation or reduction. About 300,000 youth ages 13 to 17 currently identify as transgender in the U.S., with 2,100 of those residing in Utah. Statistics from the American Society of Plastic and Reconstructive Surgeons indicate that 87,966 cosmetic surgical procedures and 141,774 minimally-invasive procedures were done on youth ages 13 to 19 in 2020 alone, a year greatly impacted by the pandemic.

However, only 1,101 of nationwide youth with gender dysphoria received puberty blockers in 2020; 3,163 received hormone therapy; and a whopping 256 got top surgery, indicating the 229,000 cosmetic procedures done in a single year were performed on cisgender youth.

Furthermore, a study analyzing 7,928 transgender patients who obtained GAS shows a regret rate of 1%. Whereas a survey in Britain of 2,638 respondents found regret rates of general cosmetic surgeries land around 65%.

Yet the Utah Legislature is not concerned with protecting the 65% of 229,000 cisgender minors who experience cosmetic surgical regret — and they didn’t fly a cisgender Californian to Utah to testify about her botched boob job (perhaps because Utah in 2017 ranked second-highest in number of plastic surgeons per capita). Instead they are only concerned with targeting the 1% of 256 trans kids who may experience regret.

No matter how many out-of-state witnesses Utah politicians bring to the stand to share their stories of regret—a tactic known as the narrative fallacy, using storytelling pathos to obfuscate data—these numbers tell the stories of the other 99%.

In addition, legislators completely negate male circumcision when claiming to protect minors from irreversible surgical regret. While a somewhat trickier conversation due to religious protections, around 22,000 male infants are born annually in Utah and approximately 42% of those experience permanent genital cutting without consent — with parental regret rates being around 27.5% and individual regret landing around 10%.

Lastly, legislators dismiss the extensive research that proves gender-affirming care reduces depression and suicidality — a dismissal that prioritizes “unknown” negative health outcomes (let’s not forget I had Lupron 28 years ago) over the known positive health outcomes, indicating cognitive bias directed towards a protected class.

A recent study from Stanford looked at 27,000 survey respondents and found transgender youth had better mental health if they started hormones in adolescence rather than adulthood. All this together raises the question: When legislators say they are enacting these laws to protect youth, which youth, exactly, are they protecting?

Annie Berbert

Annie Berbert, Layton, is a marketing content writer who has edited and revised mental health iTreatment modules for Crossover Health and written and published medical research in Medical Hypotheses, an imprint of Elsevier.