Transgender health bills often came from a handful of far-right interest groups, AP finds

A nonprofit that was launched to oppose diversity initiatives in medicine has evolved into a significant leader in statehouses to ban gender-affirming care for transgender youths.

SHARE Transgender health bills often came from a handful of far-right interest groups, AP finds
Advocates for transgender youth rally outside the New Hampshire statehouse in Concord, N.H., in March.

Advocates for transgender youth rally outside the New Hampshire statehouse in Concord, N.H., in March.

Holly Ramer / AP

At least 17 states have enacted laws restricting or banning gender-affirming care for transgender minors, and many of those bills sprang not from grassroots or constituent demand but from the pens of a handful of conservative interest groups.

Many of the proposals, as introduced or passed, are identical or very similar to model legislation those groups have suggested, an Associated Press analysis found.

Such ready-made bills have been offered and used in statehouses for decades, often with criticisms of carpetbagging by out-of-state interests. In the case of restrictions on gender-affirming care for youths, they have allowed a handful of far-right groups to spread a false narrative based on distorted science, critics say.

The AP obtained the texts of more than 130 bills in 40 state legislatures from Plural, a public policy software company, and analyzed them for similarities to model bills peddled by the conservative groups Do No Harm, which also criticizes efforts to diversify staffing in medicine, and the Family Research Council, which has long been involved in abortion restrictions.

One of the clearest examples is in Montana, where nearly all the language in at least one bill can be found in Do No Harm’s model. Publicly available emails from December show the Republican sponsor, Sen. John Fuller, tweaked the model before introducing it weeks later. Democrats criticized his efforts.

“This is not a Montana issue; it is an issue pushed by well-funded national groups,” Democratic Sen. Janet Ellis said during debate in February.

State Rep. Barry Usher, R-Billings, speaks during a meeting of the Joint Rules Committee on the House floor at the Montana State Capitol in Helena, Mont.

State Rep. Barry Usher, R-Billings, speaks during a meeting of the Joint Rules Committee on the House floor at the Montana State Capitol in Helena, Mont.

Thom Bridge / Independent Record via AP

Republicans pushed back.

“Someone mentioned this is not a Montana solution, and I can tell you that I won my election on this issue,” said Republican Sen. Barry Usher, who ran unopposed in the general election after winning his contested primary.

The Montana bill passed in March with much of Do No Harm’s model language intact and has been signed into law.

Do No Harm’s model and the 2021 Arkansas bill endorsed as a model by the Family Research Council also have many similarities, including the assertion — rebutted by major medical organizations — that the risks of gender-affirming care outweigh its benefits.

Dylan Brandt speaking at a news conference outside the federal courthouse in Little Rock, Ark., on July 21, 2021. Brandt, a teenager, is among several transgender youth and families who are plaintiffs challenging a state law banning gender confirming care for trans minors.

Dylan Brandt speaking at a news conference outside the federal courthouse in Little Rock, Ark., on July 21, 2021. Brandt, a teenager, is among several transgender youth and families who are plaintiffs challenging a state law banning gender confirming care for trans minors.

Andrew DeMillo / AP

Republicans’ recent focus on legislation to restrict aspects of transgender life appears largely to be a strategy of using social “wedge issues” — in the past, abortion or same-sex marriage — to motivate their voting base, according to political observers.

A Pew Research Center survey a year ago found broad support among Republicans but not Democrats for restrictions on medical care for gender transitions.

“These organizations are not introducing this model legislation to make legislators’ jobs easier, to support kids in their constituencies,” said Heron Greenesmith, a senior research analyst who monitors anti-LGBTQ+ rhetoric for Political Research Associates, a liberal think tank. “They’re introducing this model legislation to gain wealth, to gain eyes, to gain power and to gain access.”

Such bills often distort valid science that supports gender-affirming care for youths, said Dr. Jack Drescher, a psychiatry professor at Columbia University who edited the section about gender dysphoria in the American Psychiatric Association’s diagnostic manual. Do No Harm cites the manual in its model bill.

“These bills are not at all interested in patient care,” Drescher said. “These bills are designed to inflame.”

It’s problematic “any time policymakers are cherry-picking isolated studies or scientific research that arrives upon a different conclusion than the rest of the community or that relies upon studies without having that expertise,” said Marty P. Jordan, an assistant professor of political science at Michigan State University. “It’s problematic for the individuals that the legislation could impact. It’s problematic for the larger public and problematic for democracy writ large.”

Kent Syler, a political science professor at Middle Tennessee State University, said: “If it’s a good bill, no one should be shy about where they got it because that’s the federal system working correctly.”

Do No Harm was launched last year with an initial focus on the role of race in medical education and hiring, and the Virginia nonprofit has registered lobbyists in at least four states. People associated with it have testified in statehouses around the United States.

Asked about Do No Harm’s legislative activity, founder and chair Dr. Stanley Goldfarb responded: “Do No Harm works to protect children from extreme gender ideology through original research, coalition-building, testimonials from parents and patients who’ve lived through deeply troubling experiences and advocacy for the rigorous, apolitical study of gender dysphoria.”

The Family Research Council, an advocacy group that opposes abortion and LGBTQ+ rights, has been behind what it calls the Save Adolescents from Experimentation Act, or SAFE Act. Among other things, it falsely asserts that “ ‘gender transition’ is an experiment.”

A leader of the Family Research Council declined to answer questions about its model bill, including where it had been used and which legislators it had worked with.

Instead, Jennifer Bauwens, the organization’s director of family studies, responded by saying: “What should be an issue debated in the scientific community now has to be dealt with through legislation. The SAFE Act gives minors a chance to experience development before imposing lifelong chemical and surgical procedures that increasingly show evidence of psychological and physiological harm and completed suicide after the transition.”

The movement to restrict gender-affirming care worries Aaron and Lacey Jennen, who say they’re heartbroken at the prospect they might feel they need to move out of their lifelong home state of Arkansas to one of a dwindling number of states where gender-affirming health care for their transgender teenage daughter Sabrina isn’t threatened.

“We were, like, ‘OK, if we can just get Sabrina to 18 ... we can put all this horrible stuff behind us,’ ” Aaron Jennen said. “And, unfortunately, that’s not been the case, as you’ve seen a proliferation of anti-trans legislation here in Arkansas and across the country.”

Sabrina Jennen — who will turn 18 in July — continues to receive gender-affirming health care while a lawsuit that her family has filed makes its waythrough the courts.

“For these outside groups to carry more weight than the people these legislators were elected to represent is very upsetting,” Aaron Jennen said. “They didn’t listen to us before. But now they have to listen to us because we filed a lawsuit and went to court.”

Contributing: Andrew DeMillo, Amy Beth Hanson, Michael Goldberg. Emily Wagster Pettus

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