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politics bloomington

'How am I going to save my baby’s life?': families grapple with ban on gender-affirming care for minors

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Editor’s Note: This story includes mention of suicide. If you are struggling with suicide or your mental health, you are not alone. Resources are available here

From the moment she gave birth to her daughter 13 years ago, the mother had held onto one promise: she was going to protect her child. It should have been easy — her kid is just like every other young student in Bloomington. The mother — like any parent — had expected to shield her child from common threats, such as insecure bullies on the elementary school playground or the disappointment of getting cut from a team. Until the 2023 legislative session, however, she hadn’t expected to have to protect her daughter from the Indiana government.

Indiana Gov. Eric Holcomb signed Senate Enrolled 480, — which bans gender affirming care for minors — into law in April. The law, which banned puberty blockers, hormone replacement therapy and certain surgical procedures for minors, was originally supposed to take effect July 1. However, U.S. District Court Judge James Patrick Hanlon issued a preliminary injunction in June blocking the legislation from taking effect.

While the ban has not yet taken effect at the time of publication, members of the transgender community and parents of transgender children have said the proposed legislation has disrupted their lives and fear the preliminary injunction will be overturned.

[Related: Federal judge blocks Indiana law banning gender-affirming care for minors]

The mother, who asked to remain anonymous for fear of retribution, was filled with an overwhelming devastation upon hearing about the bill. Her daughter, who is transgender, has been on puberty blockers which are used to delay the changes of puberty in transgender and gender-diverse youth who have started puberty, for a year. She planned to start estrogen hormone therapy when she turned 14 years old. 

The mother said puberty blockers have been life saving for her child, who has grappled with gender dysphoria for years. Gender dysphoria refers to psychological distress that a person may experience when their gender identity differs from their sex assigned at birth or sex-related physical characteristics, according to the Mayo Clinic. Suddenly, in the span of a few months, the mother began trying to answer one question: “How am I going to save my baby’s life?”.

“There has never been a single moment — not a sleeping moment, not an awake moment, not a working moment, not a parenting moment — in my life since learning about this that has not been filled with anything but terror,” she said.

* * * 

The mother first learned about Senate Enrolled Act 480 when the legislation was advanced by the Indiana Senate Committee on Health and Provider Services in February. Sen. Tyler Johnson, R-District 14, authored SEA 480 and said during his testimony the legislation would protect kids from “life altering decisions until they are adults.”

“This bill is common sense public policy to protect Hoosier children from irreversible, unproven and life altering procedures,” Johnson said in his committee testimony.

According to the U.S. Office of Population Affairs, most gender-affirming care treatments are reversible. Gender-affirming care such as social affirmation and puberty blockers are completely reversible and hormone therapy is partially reversible. Gender-affirming surgery — which a person does not have to undergo to be transgender — is not always reversible. However, transgender and non-binary youth do not receive gender-affirming genital surgeries until they are adults, according to the Human Rights Campaign. While there have been limited exceptions for 16 or 17-year-olds, these patients have taken gender-affirming hormones and received approval from their parents and doctors prior to undergoing surgery.

[Related: Indiana Senate committee advances bill that would ban gender transition procedures on minors]

In the committee hearing, Troy Castor, a representative from Riley Hospital for Children and senior vice president of governmental affairs at IU Health, opposed the legislation, stating it interferes with parents’ right to choose quality and potentially lifesaving care for their children. Castor also said Riley Hospital for Children does not perform gender transition surgeries on anyone under 18 years old, refuting claims from bill proponents that youth are regularly receiving this form of gender affirming care.

Following the preliminary injunction, Riley Hospital for Children’s Gender Health Clinic will continue to provide gender-affirming care to patients under 18-years-old with their family’s consent and in accordance with the injunction, Riley Hospital for Children Public Relations Manager Lisa Tellus said in an email.

The American Medical Association passed a resolution supporting access to gender-affirming care for transgender and gender-diverse individuals in June, saying that gender-affirming health care is evidence-based and that decisions should be made by patients, their relatives and health care providers. More than 30 medical associations have also issued statements supporting gender-affirming care for transgender and gender-diverse individuals.

* * * 

Knowing she needed a plan to secure medication that she describes as “lifesaving” for her child, the mother quickly set up an appointment with her doctor. While her family had until June 30 to receive estrogen hormones, she did not know how she would be able to get puberty blockers for her child.

Afraid of how her child would react to this news, the mother waited until the day before the appointment to share the progress of the bill with the 13-year-old.

“It’s my job to protect my child and the fear that I feel, I cannot even imagine the fear that my child would feel,” she said. “I didn’t even want my child to know that such horrible things are happening in the world. That there were people out there that would allow or even want something like this to happen.”

After hearing about the passed legislation, her daughter started crying and became angry, asking her mother “what are we going to do?” and “how could you raise me in Indiana?” The mother said their family’s decision to allow their daughter to transition and start receiving gender-affirming care was not made lightly.

“When a child is put on hormone blockers, that is not something that a parent, a child or a doctor are able to just decide,” she said. “It takes so much time and so much energy and resource searching and therapy and so many doctors' appointments to get to a point where that’s a decision that the doctor and parent and child come to.”

[Related: Legislative roundup: 8 major moves by the Indiana Statehouse in 2023 session]

Now, the mother said her family’s right to make medical decisions for her child — ones that have saved her daughter’s life — is being stripped away. She feels the recent legislation is “ensuring the death of my child.” Fearful that the lack of gender-affirming care may drive her daughter to commit suicide, she said her family may move out of the state if the legislation is enacted. She also worries her daughter will be forced to experience a painful, distressing transition when she is an adult without access to puberty blockers and hormone therapy.

“If your child is so brave and so strong and makes it through this, somehow, they’re going to be damaged beyond repair and you’re going to have to hold their hand as they are a young adult — when they should just be going to college and figuring out what kind of career they would like to have — while their face bones are broken and put back together and their faces burned with a laser,” the mother said.

* * * 

Meghan, a transgender woman, did not start transitioning until she was 33 years old. Meghan asked to be identified only by her first name for this story. Meghan said receiving gender-affirming care — such as puberty blockers and hormone replacement therapy — in her youth would have “changed my life immeasurably for the better.” Meghan has spent thousands of dollars to receive medical treatment to transition as an adult.

“The fact that a handful of injections when I was younger and starting HRT at the right time could have prevented that,” Meghan said.

Meghan said she felt ashamed and horrified at the changes she experienced while going through male puberty. While she did not know “transgender” was a term to describe her experience during her youth, Meghan said she always knew she was a girl.

“I remember the moment I realized that facial hair came back every day as particularly devastating — that shaving wouldn’t last more than 12 hours, the body odor, the way that my face was changing. I had a suicide attempt when I was 14 years old and there was nothing I could put my finger on. The idea of gender transition was never introduced to me.”

When Meghan was a child, she recalls saving up money to purchase women’s clothing on her own, which she would hide from her parents. When her parents were asleep or out of the house, she would wear these gender-affirming clothing items.

“As I was going through puberty and as my body was changing shape, one night, my favorite green dress ripped,” Meghan said. “That was the impetus for the very next day I attempted suicide.”

To cope with her feelings of shame, loneliness and fear, Meghan tried to turn to her religion. She would read gospel stories that focused on themes of regeneration and renewal, hoping these messages would repress her gender dysphoria. She even went to seminary school with the intention of becoming a pastor.

“I never felt like a boy,” Meghan said. “I never felt connected to the culture of American manhood. It was foreign to me even as I was trying my best to live it. Even as I was trying my best to become a good Christian man, a good Christian husband.”

[Related: ACLU of Indiana challenging law prohibiting instruction on human sexuality]

Meghan said anti-trans legislation and rhetoric has made her fear for her own life, and the lives of other trans children and adults across the country. She said social media platforms like Facebook and Twitter — which had previously allowed members of the trans community to share resources and experiences — have been disrupted by anti-LGBTQ+ hate speech. In their annual Social Media Safety Index report, the Gay and Lesbian Alliance Against Defamation said Twitter was “the most dangerous platform for LGBTQ people.”

“It doesn’t feel safe, being out in the world,” Meghan said. “It feels unsafe for me to attach my name to this article because any trans person who steps out, whose name gets put out there, becomes a target or potentially becomes a target.”

Meghan said one of her own children may need gender-affirming care in the future. She said her family is trying to move out of Indiana by the end of 2024 — ahead of next year’s legislative session.

“It’s a terrifying prospect for us to be on the cusp of losing the healthcare we rely on to live a normal life,” Meghan said. “To see our identity debated on a day to day, moment to moment basis. To see our place in society debated in committee by people who are risking nothing themselves, who have no stake in this fight and just want to stoke rage, that is incredibly demoralizing.”

* * * 

IU senior Stefanie Sharp publicly came out as a trans woman at 15-years-old. The following year, she started receiving hormone replacement therapy. For Sharp, who was born and raised in Indiana, receiving gender-affirming care in her youth allowed her to begin her adult life in college as her “true self.”

“It was like ‘okay, now life can be getting started,’” Sharp said. “It was nice to be able to start as myself in life and I just really came into my own.”

Sharp testified against SEA 480 in a House of Representatives hearing in March. In her testimony, she told House representatives gender-affirming care was not only lifesaving for her, but “life-giving.”

“I feel like we lived in a completely different world in December,” Sharp said. “The amount of legislation that was introduced is insane. There were only a couple of weekdays where there weren’t hearings and videos of people’s testimony popping up online. It was a constant bombardment.”

[Related: Proposed bills in Indiana House and Senate target transgender youth]

According to the Human Rights Commission, state legislatures across the country introduced 220 bills specifically targeting transgender and non-binary people this past legislative session. Sharp said SEA 480 is an indicator of more restrictive legislation to come. In May, Montana Gov. Greg Gianforte signed SB 458 into law, which defines “sex” strictly as “male” or “female.” Some experts believe this limited definition could exclude LGBTQ+ people from protections against discrimination based on sex.

Like Meghan, Sharp said she has made an “escape plan” in case she must leave the state. While she plans to graduate from IU before the next legislative session, she has spoken with university advisors about how to fulfill her degree requirements out-of-state if she needs to flee Bloomington. She described the increase in legislation targeting members of the LGBTQ+ community as “genocidal” and said it should be taken very seriously.

“There’s a lot of discourse about using that word ‘genocide,” because when do you say that something is ‘genocide’?” Sharp said. “Is it a genocide after the camps are built? Do you say it whenever they start building the camps? Do you say it whenever they start thinking about building the camps? I don’t know if it will materialize in terms of camps in the United States, but it’ll be something similar.”

* * * 

Bruce Smails, director of the LGBTQ+ Culture Center and special assistant to the Vice President for Diversity Equity and Inclusion, said many IU students are unsure what the legislation may mean for their futures.

“When you look at all of the bills that are happening, not only in Indiana but across the U.S., it’s really impacting a lot of individual rights that are there and just the existence for people who are part of the LGBTQ community,” Smails said. “When you look historically, there’s been a struggle for acceptance over all these years and there’s been a lot of progress in our humanity and to see that shift go back where it’s almost to the point of we’re not equal citizens.”

Smails said that, as of now, the legislation will not impact the LGBTQ+ Culture Center, which receives outside financial support. He said the culture center offers resources for students who may be struggling with this legislation.

For instance, the culture center developed an LGBTQ mentorship program to support incoming IU students. The culture center also partners with the IU Counseling and Psychological Services to provide drop-in and embedded counseling for students.

Students can also access a gender-affirming closet, which offers free gender-affirming clothing to students regardless of gender identity or expression, LGBTQ status, IU affiliation or financial need.

Smail also said the Office of the Vice President for Diversity, Equity and Inclusion is planning to launch an LGBTQ faculty council in the fall, which will aim to support and amplify the voices of LGBTQ students at IU Bloomington.

A list of resources is available here if you or someone you know is struggling with suicide or mental health. 

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