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Ban on gender-affirming care for minors clears House and Senate committees

The Iowa Capitol dome at dusk.
John Pemble
IPR file
Lawmakers in the House Judiciary Committee took their discussions late into the night over bills including a ban on gender-affirming care for transgender minors in Iowa.

Republicans in the Iowa House and Senate are moving forward with proposals that would block minors from receiving gender-affirming health care.

The bills (SSB 1197/HSB 214) prohibit Iowa doctors from providing transgender youth with hormone treatments or surgery. Violating the proposal would put a doctor at risk of possibly losing their medical license or facing a lawsuit either from a person who received treatment or the state attorney general.

“Every child deserves a natural childhood,” said Sen. Jeff Edler, R-State Center, who chairs the Senate Health and Human Services Committee which passed the bill Thursday. “One that allows them to experience puberty and other natural changes that will shape who they will become.”

Now that the measure has passed out of committees in both the House and Senate, it is eligible for debate in both chambers.

The bill's GOP supporters call it a way to protect against a child or teenager making an irreversible medical transition. But Democrats opposed to the bill say it creates unnecessary obstacles for transgender youth to receive care that can reduce their risk of depression or suicide.

Sen. Janet Petersen, D-Des Moines, told the committee the bill interferes with families making difficult medical decisions.

“This bill takes away Iowa family rights, freedoms and choices,” Petersen said. “It bans them from having a chance to live the gender they themselves know to be on the inside.”

The Senate and House proposals were amended to state that the ban would not be in violation of Iowa civil rights law, which protects against discrimination based on gender identity.

“Saying that a bill does not discriminate doesn’t mean a bill doesn’t discriminate. This legislation is unconstitutional,” Petersen said, pointing to court orders that partially or fully blocked related laws in Arkansas and Alabama.

Edler justified the proposed ban by arguing the legislature should regulate gender-affirming care just as it has passed laws against minors using alcohol and tobacco.

“If a child lacks the maturity to enter into a binding contract, to vote or even get a tattoo, how can they be mature enough to consent to an experimental, irreversible, life-altering procedure that could end in permanent sterilization?” Edler said.

Medical organizations including the American Academy of Pediatrics support gender-affirming care for young people with proper guidance and supervision.

The bill passed on to the full Senate on a 9-4 vote with all Republicans in favor and all Democrats against.

In a meeting that started Friday morning after midnight, the House Judiciary Committee passed its version of the bill 12-8 with one Republican joining Democrats in opposition.

Rep. Ross Wilburn, D-Ames, said the proposed ban and other bills targeting gender identity in school curriculum and transgender students’ ability to use a bathroom that fits their gender make the state unwelcoming to LGBTQ families.

“These services are important and transgender youth must be given an opportunity to explore their gender identity under the safe and supportive care of a physician and mental health counselors,” said Wilburn, who mentioned he is also the father of a transgender son.

Rep. Megan Jones, R-Sioux Center, offered an unsuccessful amendment that would have kept the current system of care in place while enforcing the fact that parents must give their consent.

Talking to reporters Thursday, House Speaker Pat Grassley, R-New Hartford, was asked why Republican leaders support blocking parents from approving medical procedures for transgender youth but also back multiple education bills designed to emphasize that parents are the primary decision makers for their children.

Grassley said he considers them to be separate issues.

“Part of why we are here where we are today is I was surprised to find out that some of our major health care providers in the state were actually doing this when we inquired about it,” Grassley said. “I think there was a level of surprise amongst the members of our caucus.”

“We have laws on the books in the state all the time that don't allow parents to just say, well, the law says it but we get parental consent. This is something that we feel very strongly about.”

Grassley said, when it comes to gender-affirming health care for minors, GOP lawmakers want to err on the side of caution, even as the bill’s critics say it could create an emergency for youth who are forced to go without it.

Grant Gerlock is a reporter covering Des Moines and central Iowa