An effort to ban gender-affirming health care for transgender youth, such as surgeries, hormones and puberty-blocking drugs, died Wednesday before a Louisiana Senate panel in a victory for activists fighting a wave of legislation targeting LGBTQ+ rights.
Attempts to limit access to transgender health care had been filed in Louisiana before. But the latest effort, House Bill 648, got more traction than earlier bills, sailing through the conservative state House amid a national climate where Republican-controlled legislatures have pushed bans or restrictions on that care.
Louisiana’s latest version of that legislation met its end in a tense hearing of the Senate Health and Welfare Committee, which voted 5-4 along mostly party lines to sideline the bill. Committee Chairman Sen. Fred Mills, R-Parks, clashed repeatedly with the bill’s Republican sponsor in discussion and ultimately sided with Democrats in voting to kill the measure.
“I always, in my heart of hearts, have believed that a decision should be made by a patient and a physician,” Mills said.
The result means that Louisiana, for now, is the only southeastern state where most forms of gender-affirming health care remain legal. Alabama, Mississippi, Texas, Oklahoma, Arkansas, Georgia, Florida and other nearby states have each passed laws restricting the services in recent years.
Legislatures including Louisiana's have also increasingly moved to curtail access to books with LGBTQ+ themes and discussion of sexuality in schools.
The target of Pollock Republican Rep. Gabe Firment’s bill is a swath of health care options for children experiencing gender dysphoria. Few providers in Louisiana offer the care; those who do generally advise counseling for younger children and only advise treatments that alter a patient’s body, such as puberty blockers or hormones, in their late teenage years, said Clifton Mixon, a pediatric psychiatrist who opposed the bill.
Firment and other conservative supporters, including some physicians, said the bill would protect children from life-altering medical procedures. Dr. Quentin Van Meter, who works for a conservative advocacy group called the American College of Pediatricians that opposes same-sex marriage and has referred clients to conversion therapy, testified that gender-affirming care is experimental — an argument refuted by mainstream U.S. medical organizations.
Highlighting a schism in the Republican party over whether such health care bans infringe on parents’ rights, Firment has said the bill would give parents more say in children's health care decisions. Parents’ rights have historically been a priority of conservative lawmakers.
Firment also said that while he holds parents’ decision-making in high regard, gender-affirming care is so harmful that government has a duty to intervene.
“This bill is about protecting innocent children. No one in Louisiana has the right to harm a child,” Firment said.
Democratic Gov. John Bel Edwards whipped members of the Health and Welfare Committee to vote against the bill in the hours before the hearing, according to multiple people involved in the discussions. A spokesperson for the governor did not immediately provide a comment. The governor has previously said that anti-LGBTQ+ bills distract from more pressing issues facing the state.
Opponents of Firment’s legislation cited studies showing that gender-affirming care helps improve the mental health of youth experiencing gender dysphoria, including by reducing rates of suicide. They said a small percentage of people who identify as transgender and undergo such treatment decide to detransition — between 1% and 13%, studies show. The bill’s supporters cited a higher percentage, without evidence, in an earlier hearing.
Some opponents told the committee that misinformation was clouding the benefits of gender-affirming care. While Firment maintains that his bill was not a hateful effort, others said transgender people struggle not because of who they are but because of laws such as the one Firment sought to pass.
One opponent told the committee that her wife, who is trans, tried taking her own life several times as a child.
“She never tried to end her life because of who she was, but because of the world she was living in,” Kaycee Filson told the committee.
Gender-affirming care among youth, including treatment via hormone therapy and puberty blockers, is rare in Louisiana, at least among low-income populations, according to a report by the Louisiana Department of Health. Just a few dozen people under 18 receive those kinds of care annually, according to the report, which reviewed Medicaid-enrolled youth between the years 2017 and 2021.
There were no gender-reassignment surgeries performed on Medicaid-enrolled youth in Louisiana during that period, the report found.
Mills, the committee chairman, later became the target of social media blowback from conservative activists, including far-right personality Matt Walsh, for casting the lone Republican vote against the measure.
“He’s going to be infamous and disgraced by his own base,” Walsh wrote on Twitter. “We’ll make sure of that.”
Mills’s term in his Acadiana-area Senate seat expires in 2024.
Committee members voting to kill House Bill 648:
Sen. Regina Barrow (D-Baton Rouge)
Sen. Gerald Boudreaux (D-Lafayette)
Sen. Gary Carter (D-New Orleans)
Sen. Jay Luneau (D-Alexandria)
Sen. Fred Mills (R-Parks)
Members voting to keep the bill alive:
Sen. Bob Hensgens (R-Abbeville)
Sen. J. Rogers Pope (R-Denham Springs
Sen. Patrick McMath (R-Covington)
Sen. Beth Mizell (R-Franklinton)