'No physician wants to risk their practice and their reputation and their medical license,' said an Arkansas pediatrician.
An Arkansas law banning gender-affirming care for transgender minors, including hormone treatments and puberty blockers, is putting physicians in a difficult position.
The law, which goes into effect this summer, will not only prohibit physicians from providing transition-related care to people under age 18, but will also instruct health care professionals that they "shall not refer any individual under eighteen (18) years of age to any healthcare professional for gender transition procedures."
Any such treatment or referral would be considered unprofessional conduct and could result in disciplinary action on the part of a licensing entity or disciplinary review board.
Hutchinson said of the legislation, "I wanted to express my own personal view that this is too extreme. It was too broad, and it did not grandfather in those young people who are currently under hormone treatment. And so this really puts a very vulnerable population in a more difficult position. It sends the wrong signal to them."
Physicians say they are being made to choose between risking their practices and giving transgender kids the care they need or referring them for care.
Dr. Gary Wheeler, board president of the Arkansas chapter of the American Academy of Pediatrics, said that until the law is challenged in the courts, physicians are unsure how to respond because they are scared of losing their practices. He said that the imprecise language in the bill makes it difficult for primary care physicians to know what exactly they're blocked from doing, whether they can provide referrals to out-of-state facilities or how referrals for telemedicine would be handled.
"In the pause that occurs before that happens, people are very gun shy and they don't want to push those things. No physician wants to risk their practice and their reputation and their medical license," Wheeler said.
Chase Strangio, staff attorney and deputy director for transgender justice at the American Civil Liberties Union, said earlier this year that if the Arkansas legislation passed, it could take anywhere from two weeks to a month for the ACLU to prepare a lawsuit challenging it.
Anna Strong, the American Academy of Pediatrics Arkansas chapter's executive director, said her group is worried about both the prohibition on referrals and the immediate halting of speciality care for transgender youth if the courts don't stop the law from going into effect.
And Wheeler, who has lived in Arkansas since 1991, said he's worried that this bill and other anti-LGBTQ bills could make health care professionals or their families reluctant to move to the state: "These actions, plus a number of other actions that have occurred at the legislature this year, I think will discourage large classes of people from wanting to come here and work."
Michele Hutchison, whose clinic at Arkansas Children's Hospital is the largest provider of gender-affirming care for trans youth in the state, told the Associated Press that four transgender children have attempted suicide since the legislature voted to override the governor's veto. The AP reported that while some parents of transgender youth are considering moving out of state, others say they will stay and fight for their rights, and still others say they couldn't afford to leave if they wanted to.
Wheeler said he's concerned about losing talent like Hutchison as well because the law is prohibiting her from providing care to transgender kids.
"She's an endocrinologist and she takes care of a large number of medical care issues that we desperately are suffering from in in Arkansas, particularly childhood diabetes, but many other things," he said.
Rob Todaro, a communications specialist with the Trevor Project, which provides crisis intervention and suicide prevention services to LGBTQ people, said in an email to the American Independent Foundation that over the last year, the group has supported over 850 crisis contacts in Arkansas.
Todaro said, "We have definitely heard from transgender and nonbinary youth in Arkansas (and across the country) who had already started receiving gender-affirming care and now worry that they will no longer be able to access it."
According to the Human Rights Campaign, at least 35 bills introduced this year in state legislatures would stop transgender youth from accessing transition-related care. A study conducted by the Williams Institute at the University of California, Los Angeles, released on April 13, estimates that 45,100 transgender youth are at risk of losing their gender-affirming medical care under the proposed legislation.
Published with permission of The American Independent Foundation.