Author: Ashleigh Barber

State and Federal Legislation on Gender-Affirming Care for Minors

Posted on by Ashleigh Barber

In the past six years, the introduction of bills in state legislatures to ban gender-affirming care for transgender and gender diverse youth has increased exponentially. In 2018, two such bills were introduced. In 2023, there were 185. Arkansas became the first state to ban gender-affirming care for youth in 2021; now, there are 26 states with bans on gender-affirming care for transgender youth. In response, other states have begun passing laws protecting access to gender-affirming care. It is estimated that 110,000 transgender teenagers, about 40 percent of transgender youth, live in states with bans on gender-affirming care.

What is Gender-Affirming Care?

Gender-affirming care consists of an array of services, including both medical and non-medical interventions for transgender and gender diverse people. Medical services can include hormone therapy, surgery, and mental health services. Non-medical services can include adopting gender-affirming hairstyles, clothing, names, gender pronouns, and restrooms and other facilities.1

Gender-affirming medical care for youth most often consists of puberty blockers that stop the onset of puberty. Doctors say the goal of puberty blockers is to give young people time to mature enough mentally and emotionally to make informed decisions about whether to pursue permanent treatment. Once someone stops taking them, puberty starts again as normal. Gender-affirming medical care for youth can also include hormone therapy and, rarely, surgical intervention.2

What Kinds of Bills Have Passed?

The details of state bans on gender-affirming care vary, but in general, the laws prevent transgender minors from accessing puberty blockers, hormones, and surgery. More than 20 states have passed laws that punish health care professionals for providing gender-affirming care to their minor patients. Five states have made it a felony, and in eight states it is illegal for providers to offer minors referrals for care outside their state or otherwise aid and abet access to gender-affirming care.3

Sixteen states and the District of Columbia have shield laws that protect access to gender-affirming care for transgender and gender diverse youth. Shield laws vary by state but generally preserve minors’ access to gender-affirming care and protect patients, guardians, and medical professionals from prosecution for seeking or providing care.4

What Do Opponents of Gender-Affirming Care for Minors Say?

Opponents of providing gender-affirming care point to examples of people who began their transition and later expressed regret or decided to de-transition later in life. They argue that minors are not mature enough to make such life-altering decisions.

“We need to just pause, we need to understand what these emerging therapies actually may potentially do to our kids. My heart goes out to them. … This is an extremely uncomfortable position for me to be in. I don’t like it. But I have to do what I believe right now is in the best interest of the kids,” said Iowa Gov. Kim Reynolds when signing the state’s ban on gender-affirming care for minors.5

Opponents also point to increasing restrictions abroad. The National Health Service in England recently ended the practice of prescribing puberty blockers to children, citing a lack of evidence of the safety and effectiveness to make them a part of routine treatment.6 Many other European countries do not allow the use of cross-sex hormones until age 16, and only then allow them after a patient has completed several psychotherapy sessions. In addition, most European countries ban gender-affirming surgery until age 16.7

What Do Supporters of Gender-Affirming Care for Minors Say?

Nearly all major U.S. medical associations support youth access to gender-affirming care, including the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association. In particular, these groups point to evidence demonstrating that medically necessary gender-affirming care enhances mental health outcomes for transgender youth, including by reducing suicidal ideation.8

The AMA released this statement after Arkansas passed its ban: “Decisions about medical care belong within the sanctity of the patient-physician relationship. … We believe it is inappropriate and harmful for any state to legislatively dictate that certain transition-related services are never appropriate and limit the range of options physicians and families may consider when making decisions for pediatric patients.”9

Supporters also argue that transgender and nonbinary minors are not the only youth seeking gender-affirming care. A Harvard T.H. Chan School of Public Health study examined 2019 data for 22,827,194 youth with health insurance. It found that most gender-affirming surgeries for both transgender and cisgender (someone whose gender identity matches their sex at birth) youth were chest-related surgeries, and 97% of breast reduction surgeries were for cisgender males. Breast augmentation surgery for cisgender females is likewise considered gender-affirming medical care.10 Supporters point to this data and note that the same surgeries that are being banned for transgender and gender diverse youth are relatively unregulated for their cisgender counterparts.

Are There Any Federal Bills in Congress?

Like in state legislatures, there have been bills introduced in Washington, D.C., that would ban gender-affirming care for youth and others that would protect it. Rep. Marjorie Taylor Green (R-Ga.) introduced H.R.1399, the Protecting Children’s Innocence Act, which would make it a felony to perform any gender-affirming care on a transgender minor, prohibit the use of federal funds for gender-affirming care or for health insurance that covers such care, and prohibit universities from offering instruction in gender-affirming care.11 Sen. Ed Markey (D-Mass.) introduced S.2246, the Gender-Affirming Care Access Research for Equity (CARE) Act, which would provide $25 million in funding for the National Institutes of Health and the Centers for Disease Control and Prevention to research barriers to gender-affirming care and the impact of those barriers on the health of transgender teens.12

Discussion Questions

  1. Do you think gender-affirming care should be banned until an individual turns 18?
  2. Does your state have laws about gender-affirming care? If so, do you agree or disagree with those laws? Why?
  3. Should more temporary medical interventions, like puberty blockers, be treated differently than more permanent treatments, like hormone therapy or surgery?
  4. What authority, if any, should the government have over medical care decisions for citizens?

Additional Resources

Related Blog Posts

As always, we encourage you to join the discussion with your comments or questions below.

Close Up is proud to be the nation’s leading nonprofit civic education organization, working with schools and districts across the country since 1971. If you would like to partner with us or learn more about our experiential learning programs, professional development, or curriculum design and consulting, contact us today! 

 

Sources

Featured Image Credit: KFF. Policy Tracker: Youth Access to Gender Affirming Care and State Policy Restrictions
[1] Office of Population Affairs: https://opa.hhs.gov/sites/default/files/2022-03/gender-affirming-care-young-people-march-2022.pdf
[2] CNN: https://www.cnn.com/2024/03/15/health/puberty-blockers-explained-nhs-wellness/index.html#:~:text=%E2%80%9CThe%20use%20of%20puberty%20blockers,started%2C%20bone%20mineralization%20normalizes.%E2%80%9D
[3]  Association of Medical Colleges, https://www.aamc.org/news/states-are-banning-gender-affirming-care-minors-what-does-mean-patients-and-providers; NPR: https://www.npr.org/sections/shots-health-news/2024/07/03/nx-s1-4986385/trans-kids-health-bans-gender-affirming-care
[4] UCLA Law: https://law.ucla.edu/academics/centers/center-reproductive-health-law-and-policy/shield-laws-reproductive-and-gender-affirming-health-care-state-law-guide#:~:text=Currently%2C%20through%20legislation%20or%20executive,to%20gender%2Daffirming%20health%20care.
[5] Des Moines Register: https://www.desmoinesregister.com/story/news/politics/2023/03/21/kim-reynolds-says-iowa-should-pause-gender-affirming-care-to-trans-kids/70034427007/
[6] The Guardian: https://www.theguardian.com/society/2024/mar/12/children-to-stop-getting-puberty-blockers-at-gender-identity-clinics-says-nhs-england
[7] Forbes: https://www.forbes.com/sites/joshuacohen/2023/06/06/increasing-number-of-european-nations-adopt-a-more-cautious-approach-to-gender-affirming-care-among-minors/
[8] Endocrine Society: https://www.endocrine.org/news-and-advocacy/news-room/2023/ama-gender-affirming-care
[9] American Medical Association: https://www.ama-assn.org/press-center/press-releases/ama-states-stop-interfering-health-care-transgender-children
[10] JAMA Network Open: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820437
[11] H.R. 1399 Protecting Children’s Innocence Act: https://www.congress.gov/bill/118th-congress/house-bill/1399
[12] Gender-Affirming Care Access Research for Equity Act: https://www.congress.gov/bill/118th-congress/senate-bill/2246?q=%7B%22search%22%3A%22care+act+gender%22%7D&s=1&r=1

 

What Young Americans Seek in Political Leaders

Posted on by Ashleigh Barber

On September 17, the Sine Institute of Policy and Politics at American University released results of a poll that focused on the views of Americans ages 18-34. The survey was designed by the Sine Institute in partnership with Future Caucus and Close Up Foundation and was based on interviews conducted by Generation Lab, a data intelligence company that gathers and interprets the views and behavior of young adults. Last week, we explored young Americans’ levels of optimism and hope. In this post, we will explore the question of what young Americans are looking for in their political leaders.

When poll participants were asked to list the three most important qualities they look for in a political candidate, they listed a motivation to serve others as the highest priority. They also said they want leaders who actively listen to and consider the perspectives of others and who are willing to compromise to get results. Interestingly, they ranked all three of those attributes above the priority of a leader supporting the policies that the poll participants support.

One element of this survey that distinguishes it from many other political surveys is that it asked respondents to listen to eight short, AI-generated audio clips of a hypothetical candidate’s pitch to voters. The text of those clips, along with their labels, is shared below. Survey respondents did not see the labels.

  • Competence: “I’m running to work hard and get the job done for the American people. I have real-world experience and a track record of delivering results. If we stay focused and determined, we can solve even our most complex challenges.”
  • Compassion: “I’m running because I care about people. Good leaders are compassionate, active listeners. I want to make people’s lives better by truly understanding your concerns and focusing on what we have in common as human beings.”
  • Integrity: “I’m running because we need honest leaders with integrity who will serve others, not themselves. I’ll always do what’s right for the people I’m elected to represent, whether you voted for me or not.”
  • Authenticity: “I’m running because we need leaders who are willing to tell hard truths and be real with people. I won’t just say what you want to hear. I’ll give you my honest opinion, even if it’s unpopular, and if I make a mistake I’ll own up to it.”
  • Idealism: “I’m running because I want to be part of building a brighter future. We can accomplish anything if we put our minds to it. We’re facing a lot of tough problems, but I believe we can find solutions and achieve our potential.”
  • Inclusive: “I’m running to make sure our government serves everyone equally. Every voice matters. America works best when it works for all, with no one left out or left behind.”
  • Decisive: “My vision for America is clear and it won’t waiver. I am running because America deserves a strong leader who will protect our country and enforce our basic rules and values.”
  • Compromise/Unity: “I’m running to end the disunity and division tearing us apart. Bringing people together will require compromise. But there is more that unites us than divides us. We’re all in this together, and we will rise or fall together.”

Respondents were asked to rate, on a scale of 1-10, how appealing they found each campaign pitch.

Next week, we will take a final look at the results from this Sine Institute survey of young Americans to explore their views about the 2024 presidential election.

Discussion Questions

  1. Which of the eight excerpts above (competence, compassion, integrity, etc.) speak most directly to you? Least directly? Why?
  2. What is something that a political candidate could say that would help them appeal to you? Are you looking for the same things in political leaders as the people who responded to this survey?
  3. In your own words, how would you describe what you are looking for in a candidate for the presidency?

Related Blog Posts

As always, we encourage you to join the discussion with your comments or questions below.

Close Up is proud to be the nation’s leading nonprofit civic education organization, working with schools and districts across the country since 1971. If you would like to partner with us or learn more about our experiential learning programs, professional development, or curriculum design and consulting, contact us today! 

 

Sources

Featured Image Credit: Sine Institute of Policy & Politics

 

America in One Room: Data and Impact on First-time Voters Ahead of the Election

Posted on by Ashleigh Barber

Check out the unveiling of the America in One Room: The Youth Vote impact report! Learn about key findings, hear from participants about their experience, and discover how Close Up and DDL are spreading a culture of deliberative dialogue this election year through virtual deliberations with youth nationwide.

WATCH VIDEO >

 

 

 

 

 

 

Close Up and A Starting Point Host Students for White House Q&A

Posted on by Ashleigh Barber

WASHINGTON—The Close Up Foundation partnered with A Starting Point (ASP) to bring students from Maryland and Virginia to the White House on January 30 for a wide-ranging discussion with administration officials about youth civic engagement and policy priorities relating to energy, the environment, and the economy.

Approximately 60 students and teachers took part in the event, which included remarks by White House Press Secretary Karine Jean-Pierre and a Q&A with Secretary of Energy Jennifer Granholm and Deputy Secretary of the Treasury Wally Adeyemo. ASP’s co-founders, actor and director Chris Evans and actor and director Mark Kassen, moderated the discussion.

“It means a lot to us to be here,” said Kassen. “There’s a lot of people who will be coming of the age where it’s their first chance to participate in democracy officially, and our goal of making sure we can help … demystify government, making people feel it’s a little more accessible, is really important to us.”

Close Up is the official education partner of ASP, a website, app, and media distribution platform that seeks to be an unbiased resource for information and civic engagement. Together, the two organizations created ASP Homeroom to educate students on pressing current issues, bring lawmakers into the classroom, and create interactive learning opportunities.

“We have been working with students for more than 50 years and creating opportunities for them to become informed and engaged citizens,” said Close Up President Mia Charity. “So, a platform like A Starting Point is a great resource for young people to get their first bites of what’s going on in politics and the issues that are impacting their lives and communities.”

Participating in the White House event were 11th- and 12th-graders in two Washington-area school districts: Virginia’s Prince William County Public Schools (PWCS) and Maryland’s Prince George’s County Public Schools (PGCPS).

As the second-largest school division in Virginia, PWCS is partnering with Close Up to implement student voice committees in all 14 of its high schools, giving students a place at the table where decisions are made. As part of that effort, Close Up has worked with PWCS students to build community, conduct facilitation training, and lead deliberations about important issues impacting their communities.

Close Up is also a longtime partner of PGCPS, one of the nation’s 20 largest school districts. In 2023-2024, Close Up is facilitating a congressional simulation series for PGCPS high school students, giving them the chance to engage with peers across the county on critical policy issues. Close Up is also partnering with PGCPS to conduct week-long summer civic engagement programs that include meetings with elected officials, workshops on political values and current issues, and college readiness seminars.

Contact us today for more information about partnering with Close Up.

Sinema Meets Arizona High School Students Visiting Nation’s Capitol with Congressional Hispanic Caucus Institute

Posted on by Ashleigh Barber

WASHINGTON – Arizona senior Senator Kyrsten Sinema met with Arizona high school students from Xavier College Preparatory and Brophy College Preparatory visiting Washington D.C. as part of the Close Up program, sponsored by the Congressional Hispanic Caucus Institute.

READ FULL ARTICLE>

 

 

 

 

The National Network of Schools in Partnership Merges with the Close Up Foundation

Posted on by Ashleigh Barber

Arlington, VA – The Close Up Foundation is pleased to announce that it has merged with the National Network of Schools in Partnership (NNSP), with NNSP becoming a division of Close Up effective July 1, 2023. The new division will be overseen by NNSP’s longtime executive director, Blake Kohn, and the entirety of Close Up will remain under the purview of Close Up CEO Eric Adydan.

READ FULL NEWS RELEASE>

 

 

 

Cardinals Again Emphasize How Civics Matter Through D.C. Trip

Posted on by Ashleigh Barber

Franchise teams with Close Up to send high school students on team plane…Johnson’s essay was what got him to Phoenix Sky Harbor Airport on Wednesday morning, one of 260 students chosen — based on their essays — to take part in the second annual Civics Matter Arizona trip to Washington D.C. Pairing with the Close Up Foundation…

READ FULL ARTICLE>