Gender-affirming care provision draws little opposition in House Judiciary

Photo courtesy of the University of Vermont Medical Center

With the rise of politicized medical procedures in recent years, some liberal-majority legislatures like Vermont’s are trying to protect patients who receive reproductive and gender-affirming care — and their providers.

H.89, introduced in the Vermont House in January, looks to shield patients and providers from prosecution in states where abortion or gender-related procedures are illegal. Utah legislators recently passed a bill banning minors from accessing gender-affirming procedures, joining more than 20 other states considering similar restrictions.

But the bill has been met with opposition in recent House Judiciary Committee hearings, mostly surrounding the bill’s protection of gender-affirming health care in all cases, even for minors. The care includes therapy, hormonal treatment, surgery and more. 

Renee McGuinness, a member of the Vermont Family Alliance, testified against the bill last Wednesday with a collection of concerns mostly stemming from the findings of a British review  on gender-affirming care that the country’s health service adopted called the Cass Review. McGuinness made sure members of the committee had copies.  

McGuinness’ primary concern with H.89 is that it is “shielding a system of care for which there is no consensus on the standard of care,” once again citing the Cass review. 

Rep. Angela Arsenault, D-Williston, said the review still affirms that youth experiencing gender dysphoria need to access health care. Arsenault said the bill advocates for the same idea, and so she was confused why McGuinness would cite the report in opposition to the bill. 

In response, McGuinness said that she agreed with the idea that those youth do need access to support from health services, but that H.89 prescribes a one-size-fits-all approach that cannot account for every person's needed path. The report says there are multiple ways to address each individual's experience and situation, McGuinness said, while the bill "excludes all other options. It means all psychiatric care, all medical care, is geared toward gender-affirming only. That's not addressing each individual."

McGuinness, who was the only person testifying against the gender-affirming care bill Wednesday, repeatedly referred to the “experimental” nature of gender-affirming care for adolescents. In response to a question by Rep. Thomas Oliver, R/D-Franklin, McGuinness said puberty blockers can have unknown side effects for trans youth, a controversial topic nationwide. McGuiness implored the committee to “bring in balanced testimony on gender ideology.”

Rep. Barbara Rachelson, D-Burlington, a proponent of the bill, told McGuinness that gender-affirming practices like hormone therapy and puberty blockers are regulated by standards from national organizations already, including the American Academy of Pediatrics.

In 2018 the academy released a policy statement that supported all gender-affirming care for minors. 

McGuinness told Rachelson that she didn’t want to “rely on one source only.” 

The University of Vermont Medical Center’s Vermont Center for Children, Youth and Families  has also issued firm support of the types of care that would be protected in the bill. 

“Research is clear that gender-affirming care improves health outcomes (including lowering the suicide risk and enhancing psychological well-being) for transgender/gender non-conforming youth,” the center says on it website. “Limiting access to timely care can lead to significant mental concerns and fosters discrimination towards a vulnerable population of youth.”  

Most testimony on the bill has surrounded the implications for reproductive healthcare, especially after the U.S. Supreme Court’s overruling of Roe v. Wade. Even among supporters, though, there is concern about its finite number of protections — which mostly cover providers.

Lucy Leriche, vice president of public policy for Planned Parenthood of Northern New England, highlighted those worries in testimony to the committee Jan. 26.

“The downside to the shield law is that the protections are largely for providers, and it's sad to me that the legal construct of our world — it doesn't really provide an avenue to protect patients more,” she said, adding that she doesn’t want patients “to feel a false sense of security.

The bill would provide patients some protection by limiting interstate investigations, but Vermont can’t curb an out-of-state agency from suing, interrogating, investigating or arresting a patient once they leave Vermont.

Editor’s note (2/9/23): The original version of this story misquoted Renee McGuinness in relation to the lack of consensus on care methods. The quote has been corrected. Additional details of the exchange between McGuinness and Rep. Angela Arsenault have been added for greater clarity. A description of the side effects of puberty blockers has been made more exact. 

Several instances of language describing McGuinness’ views and beliefs have been altered. After the original publication, McGuinness contacted Community News Service to clarify that her appearance in committee did not reflect her personal views but the views of the Vermont Family Alliance.