This is why SC state lawmakers like me voted to ban transgender health care for children

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This month, the South Carolina General Assembly sent the “Help not Harm” bill concerning so-called gender-affirming healthcare to the governor’s desk. The appropriately-named legislation prohibits the performance of experimental, life-altering gender transition procedures upon minors.

An investigation by Reuters labeled Youth in Transition showed in 2022 that gender dysphoria diagnoses among youth are skyrocketing. In her recent book, psychiatrist Dr. Miriam Grossman offers a snapshot of the rapid growth of gender-affirming care: “London is home to the world’s largest gender clinic for minors. Serving the entire United Kingdom, it opened in 1989 and over its first decade saw an average of fourteen patients a year. By 2021-2022, that number exploded to 3,585 patients a year with a waiting list exceeding 5,300.”

Gender-affirming care is the standard of care, according to the testimony of the American Academy of Pediatrics (AAP) before a Senate Medical Affairs subcommittee in February. But what does gender-affirming care entail?

The World Professional Association of Transgender Health (WPATH) is the foremost voice in gender-affirming care. The organization is responsible for a document known as the Standards of Care, a guide for providers treating gender dysphoric individuals, with which the AAP is aligned.

The guidance offered in the Standards is revealing. According to WPATH, puberty blocking drugs, cross-sex hormones, and even surgeries are appropriate for some children. I have been told over and over again that gender-conforming surgeries are not happening in South Carolina. That may be the case for now. Nevertheless, these life-altering procedures are prescribed within the Standards themselves. When the AAP and others defer to the Standards of Care, they prop up a dangerous model of treatment that can include surgeries and other harmful procedures.

Consider the claim in the Standards that “there may be a benefit for some adolescents to having these procedures (genital surgery) performed before the age of 18.” Or, the troubling recommendation that “Chest masculinization surgery can be considered in minors when clinically and developmentally appropriate...” In making the latter recommendation, the Standards refers to a study of girls as young as 13 who have had mastectomies.

Remember that the next time someone says gender-affirming care is simply the standard of care.

Another glance at the Standards reveals a startling recommendation: “…in some cases, parent(s)/caregiver(s) may be too rejecting of their adolescent child and their child’s gender needs to be part of the clinical evaluation process.” You read that correctly: parents who are “too rejecting” could simply be cut off from the process.

Perhaps this is why activists are frustrated with a provision in South Carolina’s Help not Harm bill (House Bill 4624), which prohibits public schools from hiding a student’s transition from his or her parents.

Further review of the Standards offers no comfort. The Standards indicates there is only limited knowledge of the effects of blockers on brain development and suggests that pubertal suppression may lead to decreased bone mineral density. The document also concedes that the long-term effects of blockers and hormones are not fully known.

I believe the standard of care is harmful to children. So, what’s the answer? Several studies have shown that children who are not exposed to transition procedures are more likely to desist from gender dysphoria over time.

Contrast this with the reality that in almost all circumstances, children who begin puberty blockers receive subsequent cross-sex hormones. This relationship between puberty blockers and cross-sex hormones was essential to the 2020 decision by England’s High Court which found that children were unlikely to be able to give informed consent for puberty blockers. Western Europe is reversing course on gender-affirming care for minors. South Carolina must avoid it altogether.

Senators voted to do just that, and the House agreed to our changes. We voted to ensure children are left to simply be children and experience a natural childhood, as God intended. We chose to help, not harm.

Sen. Danny Verdin is a Republican state senator who represents Greenville and Laurens counties. He chairs the Senate Medical Affairs Committee.


Editor’s note: For another view on this bill, please read this commentary by Eric Childs.