Richard Nelson: ‘Do No Harm Act’ protects Kentucky’s children from life-altering decisions

The Do No Harm Act (HB 470) passed the Kentucky state House amid raucous opposition last week. Opponents positioned the bill as anti-transgender, hateful in fact, and in some cases verbally accosted legislators for their beliefs. In reality, HB 470 was pro-child protection for children who cannot rightly make such life-altering decisions. Essentially the bill protects minors suffering from gender dysphoria from untested hormone therapy and sex “change” surgery.

A representative from the ACLU asked me while passing in the annex hallway if we were happy with the victories. My response was that I saw a lot of brokenness on both sides. There was anger and sadness in the Judiciary Committee room. Transgender identified people believed they were being erased. On the other side was compelling testimony of a young woman who had a double mastectomy at 16 and was given strong doses of testosterone so her external appearance would appear male. She testified that she ‘felt completely abandoned by what the medical professionals did to me… I will have to live with this the rest of my life.”

It’s important to understand that many minors are suffering from what is known as gender dysphoria. This is where one’s mind is not in accord with their biological sex. Gender ideology says the body should be changed to align with the mind. In the past, medical professionals advised that when there is mental incongruency with the body, it is the mind that should change. For example, people with anorexia, believing themselves to be overweight, were told that wasn’t true. So counselors and psychiatrists worked to bring their patient’s minds into accord with the reality of their bodies. Any less counsel would threaten their well-being. Why would we treat a fellow human being suffering from gender dysphoria any differently? Instead of recommending hormones or surgical reconstruction, why not address the mental incongruency of minors and help counsel them to accept their biological reality?

The strongest argument against HB 470 is that professional medical organizations have endorsed “gender, affirming care.” Interestingly, the science does not bear this out. There are no longitudinal studies that show that hormone therapy for gender dysphoric minors has the desired results of achieving happiness. Paul McHugh, former Chair of Psychiatry at Johns Hopkins University, said as much when he closed down their sex change clinic in 1979. He found that upwards of 80 percent of minors experiencing gender dysphoria eventually embraced their biological sex as they grew into adulthood. McHugh said that the gender transition of minors “borders on child abuse.” In fact, the largest youth gender clinic in the world — Great Britain’s Tavistock Centre in London — shut down last year because of the emerging deep harm caused to young people’s health. It now faces a class-action lawsuit from transgender minors who are experiencing secondary health issues caused by various “transition” procedures. It’s this existential harm that HB 470 seeks to prevent.

So what do we make of the positions of groups like the American Academy of Pediatrics (AAP), which have endorsed “gender-affirming care”? An influential study by AAP in 2020 purports the benefits of hormone therapy for minors. Yet the study was flawed, according to James Cantor, clinical psychologist, sexologist, and former scientist with Canada’s Centre for Addiction and Mental Health. Cantor found the study was filled with misrepresentations and ignored the clinical and professional consensus that the best approach to care for minors struggling with gender dysphoria is the “watchful waiting approach,” which waits to see if the symptoms persist into adulthood before attempts are made to “transition” them.

The endorsements by professional organizations of the invasive medicine approach to minors with gender dysphoria appear to be political maneuvers by the leadership in these groups to placate political pressure. This is how “gender identity disorder” was downgraded from a mental illness to dysphoria when the APA updated its Diagnostically and Statistical Manual (DSM-5) in 2013. The politics of mainstreaming transgender identity began on the world stage in 2017 when Denmark became the first country to remove transgender people’s classification as “mentally ill”—not by health authorities relying on sound medicine and research, but by politicians moved by prevailing political currents.

Such is not the first time that the medical community has been swayed by political ideology. Nor is it the first time they’ve been wrong on important issues. In the first half of the 20th century, America’s medical community promoted eugenics, the debunked science of selective breeding to weed out genetic anomalies and perfect the human race. Several states adopted eugenics laws based purely on racist motives. According to a 2020 report by the University of Michigan’s Center for Healthcare Policy and Innovation, by the end of the 20th century, some 60,000 people were sterilized in 32 states under these laws.

This is similar in some ways to what’s happening with young people suffering from gender dysphoria; questionable science, political ideology, and cultural winds often converge toward bad results. In this case, it could very well lead to another wave of sterilization of our young people. And when this happens, it will be too late to reverse choices made at a time when minors did not have the mental capacity to assent to such life-changing decisions.

State Rep. Pam Stevenson (D-Louisville) argued that gender transitions of minors should be left to parents and children. Yet state law regularly protects children from harm in many ways. We legislate that parents buckle up their children when they get into a car. Kids cannot get a tattoo until age 16. They can’t vote until they’re 18. And they can’t drink beer until they’re 21. These laws are in place to protect the health and well-being of children. After all, the parent-child relationship is not absolute.

Unfortunately, children have become political pawns in a sexual revolution beholden to an ideology that’s discarded moral boundaries and biological realties for human sexuality. This revolution downplays and minimizes brokenness resulting from harmful ideologies. But the results cannot be hidden, as de-transitioners like Luka Hines share their stories with the public.

Dozens of states have introduced similar bills to HB 470. Utah and South Dakota have enacted similar laws. A Tennessee bill is awaiting Gov. Lee’s signature. The laws make clear that it is not “gender-affirming” care to tell young females they can transcend their biological sex through hormones and “sex reassignment” surgery. It is real harm to tell biological boys they can have a vaginoplasty and breast reconstruction to give them the appearance of a female. In Kentucky’s case, the law, as it is now proposed, will hold accountable medical professionals who practice gender transitions on minors. There will also be a 30 year statute of limitations of claims for children whose lives have been harmed by gender mutilation or hormone therapy.

Biological categories that one is born either male or female, and that children need protection from ideologies that could gravely impair future possibilities afforded by their sex are objective truths. Such truths transcend political affiliation. If this is the case, can we not objectively agree that it’s right and proper for lawmakers to protect children from potential harms they may regret later in their adulthood?

This bill shouldn’t divide us politically. Rather, protecting the health and well-being of our children and their future should unite us.

Richard Nelson is executive director of the Commonwealth Policy Center.

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