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Bills Restricting Treatment For Transgender Youth Could Have Unintended Consequences


Republican lawmakers in dozens of states are considering bills that restrict transgender young people. In Arkansas, the legislature overrode the governor's veto on a bill restricting gender-confirming treatments, including puberty-blocking medicines.

Yesterday, I asked Republican Governor Asa Hutchinson what he would tell trans minors already getting those therapies who will now have to stop.


ASA HUTCHINSON: Well, I'm sorry. And that's exactly the reason I vetoed the bill is because we wanted - did not want to interrupt a treatment that the parents had agreed to, the patient agreed to and the physician recommended.

SHAPIRO: Puberty blockers are not only used for trans kids. They are also prescribed for some cancers and for young people with adrenal issues or early puberty.

Dr. Joshua Safer is executive director at Mount Sinai's Center for Transgender Medicine and Surgery in New York City. And he told me supporters of these bills are wrong to claim that puberty blockers are irreversible.

JOSHUA SAFER: The point of puberty blockers is that they're a conservative option and that they are reversible. Puberty blockers are used in a number of medical situations, specifically so that hormones can be adjusted to a certain degree, and then they can be stopped, and things will revert to how they were.

SHAPIRO: And how often do doctors prescribe these medicines for kids - or for that matter, adults - who are not transgender?

SAFER: These medications are not super commonly used, but they certainly are used for other indications. The origins of what we call puberty blockers relative to kids are literally for delaying puberty for kids who have puberty earlier than would make sense for them socially. And so we have some experience with that.

SHAPIRO: Given that so many different state legislatures are considering bills, all of which have different language and details, are you concerned that some of them, if they passed, could have unintended consequences for kids with conditions that puberty blockers might treat - kids who are not trans, you know, who might have cancer or adrenal issues or early onset puberty?

SAFER: Anytime a state government tries to make a law around health care, it makes me nervous. I'm worried that there will be unintended consequences. There will be people who will be using these medications for other purposes who will be challenged. And certainly, with the large numbers of legislatures involved, the chance for error seems high to me.

SHAPIRO: There's a very misleading statistic that has gone viral on social media, which is that thousands of people who take these drugs have died. But are those deaths from trans kids who are delaying the onset of puberty or somebody who's being treated for something like terminal cancer?

SAFER: The statistics about people dying from puberty blockers are false. I'm trying to envision where the confusion even lies. When we use these medications for transgender kids as well as for kids with precocious puberty, they're incredibly safe. That's the reason why they are the conservative go-to medication for these kids. These medications are used for treating very severe prostate cancer, including those who are likely to die from prostate cancer, and I suspect that that's where the statistic for many people dying taking these medications comes from.

SHAPIRO: Have you been hearing from any doctors in states where these laws are being considered or have passed?

SAFER: I have actually been hearing from doctors in the states where these laws are being considered. The conversation usually revolves around how they can be good experts for their elected leaders and keep this from turning into the political issue that it's become in some places and rather keeping it a medical issue, which is what it should be.

SHAPIRO: Are they afraid for their patients?

SAFER: They're afraid for their patients at several levels. They are certainly afraid for their patients being victimized verbally by their state legislatures right now. And they are certainly afraid that their patients will lack access to care - so absolutely.

SHAPIRO: Dr. Joshua Safer is the executive director at Mount Sinai's Center for Transgender Medicine and Surgery in New York City.

Thanks for talking with us today.

SAFER: Really my pleasure, Ari.

(SOUNDBITE OF MT. WOLF SONG, "TUCANA") Transcript provided by NPR, Copyright NPR.