SCOTT SIMON, HOST:
Gender-affirming care for transgender youth is now banned in Utah after a law passed there in late January. It prohibits young people from getting a range of treatments, from puberty blockers to gender-affirming surgeries for people under the age of 18. Some patients who had been diagnosed for treatment prior to the ban can continue to get treatment. There are over 306 similar bills introduced by state lawmakers over the past two years. Dr. Ellie Brownstein is a pediatrician and is president of the Utah chapter of the American Academy of Pediatrics. She joins us from Salt Lake City. Thanks so much for being with us.
ELLIE BROWNSTEIN: Glad I could join you.
SIMON: Supporters of banning these treatments say that there's just not enough research, it's too new and that banning the treatment should allow for more research to be done. Are they wrong?
BROWNSTEIN: Well, our bill actually doesn't allow us to do any research. It doesn't allow people to be put in studies to determine the long-term effects of some of these medications. Now, I will say puberty blockers have been used for 30 years, for a number of conditions, such as precocious puberty, where, you know, 5-, 6-, 7-year-old might start through puberty. Well, you don't want them to be going through puberty at that age. So we use medication to block that. That's the same thing we're talking about in older kids. Those have been deemed fairly safe and used for a long time. We have less information regarding hormones to affirm gender in older kids, but we'd like to do research. We don't have that option, at least in Utah.
SIMON: And what's the result of that? What are your concerns?
BROWNSTEIN: My concerns are that gender-diverse kids are at high risk for mental health issues. Over 50% of those kids have either contemplated or attempted suicide. And we're now saying that we're not allowed to help them, that we're not allowed to use the evidence-based therapies that are available to help kids feel comfortable with who they are and in their own skin.
SIMON: I guess the opponents of what you've been doing don't accept that it's evidence based. They're wrong?
BROWNSTEIN: There is evidence that has been collected. It's used across the world - the medical organizations, the Academy of Pediatrics, the Academy of Family Practitioners, the endocrinologists, the gynecologists all work with the same set of protocols and information based on the information we have. We can always use more. But I do believe that we have evidence-based information that says that gender-affirming care is important to kids.
SIMON: What kind of treatments are permitted now, or will still be permitted?
BROWNSTEIN: The first thing that any patient needs is acceptance of who they are - you know, feeling love, acceptance from family, from friends, and that you, as a person, are an acceptable person is vital to all of us. And that, we can all still do. The other thing that is available is many folks socially transition. They will wear the clothes that feel good to them. They will dress and use makeup and hairstyles and even choose names that are appropriate to them. And for some, that's all they may ever need. But for some, at least that part is available.
SIMON: I gather a number of your patients are trans and gender-nonconforming, and I wonder if you've heard from them and their families since this legislation?
BROWNSTEIN: I've heard from a number. I have families who want to know what they can do, how they can change things, because they feel hurt, injured, stopped in their medical care by someone who's not involved. I have some families who - with means - who have said, I'm going to establish care out of state. But that's not available for everybody. Not everybody can do that. I am concerned that some of our families will use the internet and seek care where they can get it. They may find hormones that may not be, you know, FDA approved, that may not be available in this country, that may not be actually what they're sold as on the internet, and then these kids are at higher risk.
SIMON: What are your concerns as a physician who treats individual patients you come to know - you come to know them and their families?
BROWNSTEIN: That it takes a long time for most patients to come to their own terms with what they feel, with who they are. And that process can take years in and of itself. And then it takes the families' time to come together, and they come to us and seek treatment, or where do I go from here? And then we're saying that the government has come in and said, well, we can't help you. They're stepping into that relationship that takes years to develop and deciding that these kids should not be allowed - or these families, I should say, because it's never kids alone - it's families and kids seeking the appropriate care and finding the right path forward for them, which is different in every family, as I would say with almost anything. But it concerns me that the government is now coming into our exam room and deciding that this is not appropriate.
SIMON: Dr. Ellie Brownstein, president of the Utah chapter of the American Academy of Pediatrics.
Dr. Brownstein, thanks so much.
BROWNSTEIN: You're welcome.
SIMON: And for anyone experiencing thoughts of self-harm, the National Suicide and Crisis Lifeline number is 9-8-8.
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