The nation’s first trial on a state law that restricts gender-affirming medical care for minors began in Arkansas this week and, after emotional testimony, the plaintiffs rested their case Wednesday.
The Save Adolescents From Experimentation Act bars minors in the state from receiving certain gender-affirming medical care, including puberty blockers, hormone therapy and surgeries.
Gov. Asa Hutchinson, a Republican, vetoed the bill in April, calling it a “vast government overreach,” but the Legislature overrode the veto, making Arkansas the first in the country to pass a restriction on transition-related health care.
Republican Attorney General Leslie Rutledge said the law is “about protecting children,” according to The Associated Press.
“Nothing about this law prohibits someone after the age of 18 from making this decision,” she said. “What we’re doing in Arkansas is protecting children from life-altering, permanent decisions.”
The American Civil Liberties Union filed a lawsuit in May on behalf of four trangsgender youths and their parents, as well as two physicians who provide gender-affirming care. In July, about a week before it was slated to take effect, a federal judge issued a temporary injunction.
This week, ACLU attorneys made their case against the law in three days of testimony from the families and doctors they are representing, as well as other experts.
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Evidence for gender-affirming care
The ACLU called nearly half- dozen medical experts — including plaintiffs Dr. Michele Hutchinson, a pediatric endocrinologist who founded the Gender Spectrum clinic at Arkansas Children’s Hospital, and Dr. Kathryn Stambough, a gynecologist who also works in the Gender Spectrum clinic — to explain how gender-affirming medical care works, its benefits and the risks of abruptly stopping it should a law like Arkansas’ be allowed to take effect.
On Monday, Dr. Dan Karasic, a psychiatrist who has worked with transgender people for nearly three decades, responded to arguments made against gender-affirming care for minors, according to Gillian Branstetter, a communications strategist at the ACLU. For example, critics of the care often cite controversial research that found that most trans youth come to identify with their birth sex as they get older.
Karasic said that, in his experience treating thousands of trans people, none of his patients have detransitioned, or stopped identifying as trans.
Dr. Anne Adkins, an endocrinologist who practiced at Arkansas Children’s Hospital, explained to the court the nature of puberty blockers, which are generally recommended to trans youth at the onset of puberty to delay it, and hormone therapy, such as estrogen or testosterone, which is most often prescribed to teenagers.
During the cross-examination of Adkins, the state focused on the side effects of the medications, according to KARK-TV, an NBC affiliate based in Little Rock, Arkansas. Adkins said side effects can include blood clots, liver dysfunction, irregular ovulation, weight gain, slowed down calcium production and a delayed growth rate, KARK reported. Adkins also said side effects are rare and closely monitored.
“In general, my patients do quite well,” she said of puberty blockers, KARK reported. “They’re able to focus on the important parts of growing up.”
On Wednesday, the ACLU called Dr. Michele Hutchinson, who treated three of the teens who are also plaintiffs in the suit, and walked the court through her usual treatment protocol. She said that she will usually see patients for 10 months or more before recommending a treatment, according to KARK.
She said that after the bill passed the Arkansas House of Representatives in the spring, four of her patients attempted suicide, and she’s worried about what will happen should the law go into effect.
“Forcing a kid to wait until they’re 18, I just worry these kids are going to hurt themselves,” she said, according to KARK.
Stambough said she has the same fears. “Not every patient could make it to 18,” she said.
‘Changed my life for the better’
The parents of four transgender young people represented in the suit spoke to how gender-affirming care has improved their children’s lives.
Donnie Saxton of Vilonia, Arkansas, said his 17-year-old son, Parker, became “a new person” after coming out as trans and receiving gender-affirming medical care, according to the Arkansas Democrat Gazette.
“A complete turnaround of the broken, anxious, depressed shell that he was before testosterone. It’s amazing. Truly amazing,” he said.
He said Parker now has “huge confidence” and laughed while adding, “almost too much at times, but that’s good. He’s kind of like his old dad, so that’s good.”
In response to a question about what would happen if Parker lost access to his care, Saxton said, “I’m not going to think about that,” according to Branstetter at the ACLU.
Aaron Jennen, a U.S. attorney for the Western District of Arkansas, became emotional during his testimony about his 17-year-old daughter, Sabrina, local radio station KUAR reported.
He said “it’s not an option” for Sabrina to stop the hormone therapy she began in January 2021.
“I worry about her withdrawing back into the person she was before she started it, a person who was unhappy, who said things to her mother and me like, ‘What’s the point of life?’ and things like, ‘I don’t see a future for myself,’” Jennen said, according to KUAR.
The last plaintiff to take the stand on Wednesday was 17-year-old Dylan Brandt, who will be the only transgender person to testify during the trial, according to Branstetter.
He said he started hormone therapy in August 2020 and that he’s much happier and more confident in himself.
“My outside finally matches the way I feel on the inside,” he said, according to The Associated Press. “I have my days, but for the most part this has changed my life for the better. I can look in the mirror and be OK with the way I look and it feels pretty great.”
He said that if the law is allowed to take effect, he and his mother Joanna would have to move.
“It would mean uprooting our entire lives, everything that we have here,” he said.
Chase Strangio, one of the ACLU attorneys arguing the case, said that he called Brandt, his “hero,” to the stand so that the court could hear from a trans person.
“We will reclaim the truth of our lives from these insidious and noxious debates,” Strangio said.
The defense will begin its arguments Friday, according to Branstetter.
Three other states — Alabama, Arizona and Tennessee — have also passed measures restricting gender-affirming care for minors. Arizona’s law doesn’t take effect until May 2023, and a federal judge blocked part of Alabama’s law this past May. Similar laws have been proposed in at least 19 other states this year, according to the ACLU.
