Through a recently proposed amendment to the reauthorization of Pennsylvania’s Children’s Health Insurance Program (CHIP), state lawmakers are attempting to restrict access to health care for transgender youth.
The proposed amendment to House Bill 1388 would exclude gender-related care for children and teenagers under the state’s CHIP program, a jointly funded state and federal program that provides health insurance coverage to low-income children. The measure bans CHIP funding for all “gender or sex reassignment surgery or gender or sex transition services, including, but not limited to, physician’s services, inpatient and outpatient hospital services, prescribed drugs or counseling services related to such surgery or services.”
The bill’s sponsor, Republican state Sen. Donald White, defended the restriction, claiming in a statement: “It is completely inappropriate to use state funds to pay for sex change operations for children.”
But White’s statement distorts both the expansive nature of his proposal and the medical necessity of the care he seeks to block. The proposed amendment goes far beyond restricting access to surgical care for children and could bar all health care for transgender youth—including counseling services, hormone therapy, and puberty blocking care, all of which can be medically necessary for youth with gender dysphoria. And while surgical care is often not prescribed for youth with gender dysphoria, some surgical intervention can also be medically necessary for youth under age 19. (CHIP provides coverage up to a young person’s 19th birthday.)
The proposed amendment threatens the lives of young people in Pennsylvania who rely on health care–related to gender dysphoria. The care in question is not experimental or cosmetic: It is routinely provided basic health care under prevailing medical and scientific protocols for treating young people with gender dysphoria.
White is deliberately tapping into public fears about, and resistance to, the idea of affirming transgender young people through medical interventions to treat gender dysphoria. His incendiary language evokes the idea of complex surgeries on young children—but no one is performing genital surgeries on young transgender children. What this proposal does is restrict funding for all medically necessary care that a vulnerable population of youth relies on to survive including therapy and hormones, as well as surgical care for older adolescents.
The data is unequivocal: Failure to treat gender dysphoria can lead to depression, anxiety, and suicidality. Barring coverage for care will lead to negative health outcomes for vulnerable youth, including death. And singling out a group of people for disfavored treatment is plainly illegal no matter the smoke and mirrors White puts up to confuse the issue. Proposals to ban coverage for health care for transgender people are not grounded in medicine or science, but rather, reflect the animus and discomfort that many feel towards the transgender community. But thankfully our laws and our movements will not tolerate these desires to harm politically unpopular groups.
The health care that I have been able to receive to treat my gender dysphoria has saved my life. I was forced to pay for much of this care out of pocket and I am still paying off those debts. For so many, the costs are simply out of reach without insurance coverage. Low-income youth cannot pay for their hormone therapy, or their counseling, or their surgical care. If we restrict coverage for that care, young people will die. If we fear the bodies of transgender children and pass sweeping laws that demonize them, we will contribute to the many epidemics of bullying, harassment, violence, and self-harm that threaten our communities.
White’s amendment to a critical piece of health care legislation is deadly. Lawmakers, doctors, families, and voters across Pennsylvania should stand up and say no to this cruel, dangerous, and anti-science proposal. Lives depend on it.