Proposed Legislation Threatens Gender-Affirming Care for Minors in Washington State

Newcastle, WA – A newly introduced bill, House Bill 1038, seeks to ban gender-affirming medical care for minors in Washington State. Sponsored by Republican Representatives Jacobsen, Marshall, McEntire, Ley, Walsh, Schmidt, and Eslick, the bill explicitly prohibits puberty blockers, hormone therapies, and surgeries that affirm a minor's gender identity when it differs from their assigned sex at birth. This aligns with similar bills in other states, which collectively represent a coordinated effort to restrict access to gender-affirming care. These measures often use similar language and justifications, indicating a broader political movement to legislate against transgender healthcare nationwide.

The bill narrowly defines "sex" as biological—encompassing chromosomes, hormones, and genitalia at birth—while relegating "gender" to a psychological and cultural concept. This framing disregards the lived experiences of transgender individuals and medical perspectives that recognize gender as a multidimensional construct. It also challenges current healthcare practices that rely on an individualized, nuanced understanding of gender diversity to provide effective care. By codifying these definitions, the legislation underscores a profound philosophical divide between its proponents and advocates for gender diversity and transgender rights.

Implications of the Proposed Legislation

The proposed restrictions signal a dramatic shift in healthcare access for transgender and gender-diverse youth in Washington. Gender-affirming care—widely recognized by major medical organizations such as the American Academy of Pediatrics and the American Medical Association—has been shown to improve mental health outcomes and reduce suicide risk among transgender youth.

For instance, a 2020 study published in Pediatrics (Turban et al.) found that access to gender-affirming care significantly reduced depression and suicidal ideation in transgender youth. The Endocrine Society's Clinical Practice Guidelines (2017) emphasize the safety and efficacy of these treatments, including puberty suppression using gonadotropin-releasing hormone agonists and gender-affirming hormones, which are administered after confirming the persistence of gender dysphoria and obtaining informed consent. If enacted, House Bill 1038 would block these interventions, raising serious concerns about the mental health and well-being of affected minors.

Exemptions and Their Limited Scope

While the bill includes exemptions for minors with intersex conditions or those requiring urgent medical intervention, it notably excludes transgender and gender-diverse youth seeking care to align their physical characteristics with their gender identity. This selective application of medical exceptions highlights the discriminatory nature of the legislation and its potential to worsen existing healthcare disparities.

Fact-Checking and Debunking Legislative Claims

Proponents of House Bill 1038 have presented various justifications for the bill, many of which are misleading or lack factual support. Here, we address and debunk some of the most common claims:

1. "Gender-affirming care is experimental and unproven."

Fact: Gender-affirming care is supported by extensive evidence demonstrating its safety, efficacy, and mental health benefits:

• Improved Mental Health: Gender-affirming surgeries reduce depression and anxiety over the long term (Bränström & Pachankis, 2020).
• Well-Being: Gender-affirming hormone therapy (GAHT) alleviates gender dysphoria and enhances quality of life (Puckett et al., 2018).
• Lifesaving Impact: Access to gender-affirming care lowers suicide risk and reduces severe mental health crises (Carswell et al., 2022).
• Medical Consensus: Leading medical organizations affirm that gender-affirming care is evidence-based and medically necessary to prevent adverse health outcomes (Seigel et al., 2019).

2. Children are too young to make decisions about their gender.

Fact: Gender-affirming care for minors involves thorough evaluations by multidisciplinary teams, parental consent, and ongoing assessments. Research confirms that, with proper support, children and adolescents can make informed decisions (Kimberly et al., 2021; Mårtenson & Fägerskiöld, 2008).

3. Banning care protects children from irreversible changes.

Fact: Puberty blockers, which are fully reversible, provide transgender youth time to explore their identities without undergoing unwanted physical changes. Typically, these medications are introduced at the onset of puberty, corresponding to Tanner Stage G2/B2, as recommended by the Endocrine Society's 2017 Clinical Practice Guidelines. Denying care exacerbates mental health struggles and worsens long-term outcomes (Hughes et al., 2021).

4. There is no harm in waiting until adulthood for such care.

Fact: Delaying gender-affirming care can lead to irreversible changes during puberty, exacerbating gender dysphoria and increasing mental health risks. Early intervention is critical to improving long-term well-being (Sorbara et al., 2020; Lee et al., 2023).

A Broader Trend in U.S. Legislation

House Bill 1038 reflects a growing political movement to restrict gender-affirming care for minors. While proponents claim these measures protect children, critics argue they undermine medical expertise, erode personal autonomy, and disproportionately harm vulnerable populations.

As debate over House Bill 1038 unfolds, the stakes are high for transgender and gender-diverse youth in Washington. Advocates must prioritize transparency, accountability, and evidence-based dialogue to counter the potential harm of this legislation.

Take Action

We urge readers to oppose House Bill 1038 by contacting their state representatives at https://app.leg.wa.gov/PBC/Bill/1038. Your voice is essential to protecting the rights and well-being of transgender and gender-diverse youth.

Help spread awareness by sharing this information with friends, family, and on social media! Together, we can ensure that compassionate, evidence-based care remains accessible to all who need it.