Kentucky doctors say forcing them to halt care for trans kids could do harm
Kentucky Senate Bill 150 would require doctors to discontinue gender-affirming hormone therapy for trans patients under 18 years old. Three doctors say that could endanger the kids’ mental health.
This story mentions suicide and mental health issues. If you or someone you know is struggling with thoughts of suicide, you can reach the national Suicide and Crisis Lifeline by phone at 988, or online at https://988lifeline.org/.
If you’re looking for transgender peer support, you can reach Trans Kentucky at 859-448-5428 or online at transkentucky.com. You can also contact the Trevor Project, which provides free, confidential counselors who specialize in helping LGBTQ youth.
Some of the transgender kids who’ve come to Dr. Keisa Fallin-Bennett for help were so uncomfortable in their bodies that they barely left the house.
They let their parents answer her questions and kept their eyes on the floor.
But then, with support from Fallin-Bennett, UK HealthCare’s Transform Health initiative and the gender-affirming care they provide, she watched them find relief.
“I see people really just so come into themselves and get so much of a sense of confidence and this comfort in their body that they didn’t have when they first started seeing me,” Fallin-Bennett said.
Gender-affirming care encompasses a spectrum of mental health and medical services – including, for some minors, hormone therapy.
Fallin-Bennett worries what will happen to some of these kids if legislation takes effect in Kentucky that would force doctors to discontinue hormone therapy they’re already providing to trans patients under 18 years old.
“I think it’s going to be devastating for them,” she said.
Fallin-Bennett and two other Kentucky doctors told LPM News that they have serious concerns about Senate Bill 150. The measure would require doctors to stop providing hormone therapy, including estrogen or testosterone treatments and medication that delays puberty, to current patients under 18 years old.
They also emphasized that gender-affirming medical and mental health care is recommended by a broad range of major medical associations.
Democratic Gov. Andy Beshear vetoed SB 150, but the Republican-run Kentucky Legislature is expected to override that on Wednesday or Thursday. If that happens, the ACLU of Kentucky has indicated it will probably sue to block the bill.
With SB 150, Fallin-Bennett said lawmakers are asking doctors like her to commit malpractice.
“And I feel like that’s really unprecedented,” she said. “To say it’s an evidence-based treatment that you cannot give, and you must detransition people, which has been proven to cause harm.”
Dr. Suzanne Kingery, a pediatric endocrinologist for Norton Healthcare, said discontinuing hormone therapy would cause patients to experience distressing changes to their bodies.
For example, a trans girl could experience developments like a deepening voice while a trans boy could resume menstruating. Kingery said that could worsen their gender dysphoria and harm their mental health. And that’s a major concern, since national surveys indicate young trans and nonbinary people experience suicidal thoughts at especially high rates.
Fallin-Bennett said teenage patients who currently receive hormone therapy also would gradually lose some of the physical changes that made them feel more comfortable in their bodies.
“Not every change they’ve gotten will just disappear overnight, but they're the ones left seeing those changes that are going to disappear going away,” she said. “It’s just kind of a longer-term torture.”
If SB 150 becomes law it’s unclear exactly how many trans kids would be impacted by the ban on certain types of gender-affirming medical care, including puberty blockers and hormone therapy.
Kingery expects that about 200 Norton patients under 18 would be affected, in some way, if the bill becomes law.
She said many, but not all, of those patients – who come from across Kentucky and Southern Indiana – receive some form of hormone therapy.
At UK HealthCare, in Lexington, a spokesperson said they estimate about 50 of their current patients would be directly affected by SB 150’s restrictions.
Fallin-Bennett, who works there, said the “preponderance of the evidence” shows gender-affirming medical care helps trans patients’ mental health.
She’s scared that withdrawing access to that care will not only harm the mental health of young patients right now but that “the trauma of this…will reflect into these kids’ futures.”
Amy Parish is a parent who lives in the Louisville area and is deeply worried about how SB 150 could impact her trans daughter.
Her daughter recently got a puberty-blocking treatment that lasts two years – a decision Parish said they made, in part, because they feared the state legislature might enact a bill like SB 150.
Parish said accessing gender-affirming was already a challenge to access fully.
“You can’t just walk into a pediatric endocrinologist off the street and say ‘Hey, I want to give my kid hormones,’” she said. “There’s a whole referral process you have to go through in conjunction with a social worker and your mental health care provider.”
Now, Parish has serious concerns about how SB 150 could affect her daughter and the health care she receives moving forward.
Dr. Christopher Bolling, a retired pediatrician in northern Kentucky, said lawmakers chose a path with uncertain implications for many patients.
Bolling represents the Kentucky Medical Association and the Kentucky chapter of the American Academy of Pediatrics, both of which oppose SB 150.
If that bill takes effect, he said it could force families with trans kids who don’t want to halt their treatment plans to seek these services out of state, if they have the ability to travel and the money to pay for it.
“These are vulnerable patients, vulnerable families. They need our support. They don’t need to be cut off [from treatment],” he said. “It’s kind of unconscionable, honestly.”