Arkansas trial on transgender treatment for children; new testimony from doctor Monday

LITTLE ROCK (KATV) — The nation’s first trial over a state’s ban on transgender transition treatment for children, which began in Arkansas on Oct.17, continued Monday.

The Arkansas Save Adolescents from Experimentation Act (SAFE Act), also known as Act 626, prohibits doctors from providing transgender hormone treatment, puberty blockers, or surgery to anyone under 18 years old. It also prevents doctors from referring patients elsewhere for such treatment. The act was filed in February, 2021.

A similar law has been blocked by a federal judge in Alabama, and a Texas judge has blocked that state’s efforts to investigate gender-confirming care for minors as child abuse. Children’s hospitals around the country have faced harassment and threats of violence for providing transgender transition treatment.

U.S. District Judge Jay Moody is hearing testimony and evidence over the law, which he temporarily blocked last year.

The families of four transgender youth and two doctors who provide transgender treatment want Moody to strike down the law, saying it is unconstitutional because it discriminates against transgender youth, intrudes on parents’ rights to make medical decisions for their children and infringes on doctors’ free speech rights of doctors to provide information to patients and the patient's families rights to receive that information.

“This latest wave of anti-trans fever that is now spreading to other states started in Arkansas and it needs to end in Arkansas,” said Holly Dickson, executive director of the American Civil Liberties Union of Arkansas, which filed the lawsuit on behalf of the families.

“As a parent, I never imagined I’d have to fight for my daughter to be able to receive medically necessary health care her doctor says she needs and we know she needs,” said Lacey Jennen, whose 17-year-old daughter has been receiving gender-confirming care.

"I've not always understood the term or what it means to be transgender, and I didn't always support transgender rights," Donnie Saxton, parent of a transgender child, said. "But as I watched Parker suffer and seen the things that he's gone through I've educated myself and I would learn more."

Saxton said all he wanted was for his son to be happy in life and said he worried that Act 626 would create a roadblock for his son.

"Before we started receiving gender affirming healthcare, Parker was distressed anxiety depression, he had a really hard time looking in the mirror," Saxton said. "Like the rest of us he just wants to see the person that he is looking back at him."

Arkansas was the first state to enact such a ban on transgender treatment, with Republican lawmakers in 2021 overriding GOP Gov. Asa Hutchinson’s veto of the legislation. Hutchinson, who had signed other restrictions on transgender youth into law, said the prohibition went too far by cutting off the care for those currently receiving it.

Plaintiffs Amanda Dennis and Joanna Brandt, both mothers of children who identify as transgender, expressed the disruptive impact it would have on their children and even their families, saying they would have to look into getting medical treatment in another state or even move out of state.

Multiple medical groups, including the American Medical Association and the American Academy of Pediatrics, oppose the bans and say the treatments are safe if properly administered.

Advocates of the law have argued the prohibition is within the state’s authority to regulate medical practices.

“The SAFE Act protects children from permanent decisions that they may desire to make as an underage child but could regret as an adult,” Arkansas Attorney General Leslie Rutledge said. "Nothing about this law prohibits someone after the age of 18 from making this decision."

"It is my hope that parents and children will be empowered by this information and avoid these permanent, life-altering procedures or medications for children," Rutledge said.

"One point that has been lost in the conversation surrounding the SAFE Act is that the State of Arkansas is not prohibiting children who identify as transgender from receiving the mental healthcare that they may need. Children who identify as transgender are still able to receive counseling services or medications for psychiatric diagnoses, just as any other child would. The State is protecting children from undergoing experimental surgeries and treatments for the purpose of gender transition," she said.

Pediatric endocrinologist at Arkansas Children's Hospital, Dr. Michele Hutchison, was called as a witness and spoke about the process her patients wanting to transition to another gender go through, saying a doctor informs the patients about the risks and the reversible and irreversible consequences the patients could experience.

Medical Director for Gender Clinic at Arkansas Children's Hospital, Luann Racher M.D.--also a witness--spoke about the patients who were previously under her care.

She gave insight into how many of her patients experienced dysphoria before gender-confirming treatments, giving testimonies on how treatments have provided patients with positive outcomes.

Racher said she doesn't think some patients could wait until the age of 18 to have these treatments due to suicidality and mental illness being factors in some cases.

Monday, Nov. 28, Stephen B. Levine, M.D., a psychiatrist known for his work in human sexuality, particularly sexual dysfunction and transsexualism, was called to the witness stand by the State.

Levine expressed that he did not generally support transgender transition treatment for minors, saying that the data and his experience with patients shows a high rate of negative health, psychological, vocational, and social effects later in adult life.

"The harms seem to outweigh the benefits, that's the state of science in 2022," he said. "Do we listen to science or to advocates and politics that come and go."

Levine, who has himself on rare occasion recommended and supported transgender transition treatment for minors in what he described as "fraught circumstances," explained through a day-long questioning and cross questioning that current American standards for informed consent of minors seeking to transition are inadequate.

He explained that countries such as the United Kingdom, Sweden, and Finland place an emphasis on a lengthy process of informed consent for minors seeking transition, beginning with psychotherapy by qualified, highly-educated mental health professionals.

He then mentioned examples from the United States--where informed consent procedures vary from clinic to clinic--of nurse practitioners serving as the (undefined) mental health professional required by The World Professional Association for Transgender Health (WPATH)'s Standards of Care to ensure informed consent. He also claimed that often in the U.S., diagnoses for children desiring transition are made within the first hour of evaluation.

Levine asserted that, in the field of transgender care in the United States, advocacy has replaced the scientific basis for medical care.

He cited a recent study showing that an estimated 20 to 25 percent of transgender individuals (out of 41) studied detransitioned, for reasons psychological or physical health concerns.

He went on to mention "permanent ramifications that mostly do not appear later in life," asserting that the suicide rate for people who even have all available trans procedures and care is "much higher than the general public."

"The data doesn't exist for medicalized trans care preventing suicide," he said.

"I am not motivated to prohibit care, I am motivated to find the scientific basis for care," Levine said.

"We seem to be opposed, but we are all concerned about the long-term health of these people," he said. "These people deserve compassionate, scientific care."

The trial is set to continue at 8 a.m. on Tuesday, Nov. 29.