by CHARLESTON, W.Va. — West Virginia’s Republican-majority House of Representatives quickly approved a proposal to add mental health exemptions to a bill that would bar certain health services for transgender youth on the final day of its 60-day legislative session on Saturday.
The House approved changes made by the state Senate late Friday that would allow some transgender youth to continue receiving medical interventions, including hormone therapy, if they are at risk of self-harm or suicide.
The bill now returns to the Senate for final approval, which it is likely to receive Saturday before going to Gov. Jim Justice’s desk. The Republican governor has not taken a public position on the measure.
Lawmakers in West Virginia and other states pushing bans on transgender health care for youth and young adults often characterize gender-affirming treatments as medically unproven, potentially dangerous in the long term and a symptom of “woke” culture.
But every major medical organization, including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association, supports gender-affirming care for youth.
House members — who voted for a much more restrictive version of the proposal last month that did not include mental health exemptions — voted for the amendment in a unanimous voice vote with little debate. The amended bill subsequently passed 88-10, with all the “no” votes coming from the chamber’s shrinking Democratic delegation.
The only lawmaker to speak on the floor before the vote was Democrat Del. Rick Griffiths, who cited evidence from peer-reviewed medical journals showing that hormone therapy and other interventions can dramatically reduce psychological distress and suicidal ideation for transgender adolescents.
“We talk a lot about ‘Parents know what’s best for their kids,'” he said. “That’s a pretty limited allowance when a child might be potentially suicidal.”
The rate of suicidal ideation or suicidal thoughts or ideas for transgender youth in Virginia is three times higher than the rate for all youth in the state, according to research conducted by WVU Medicine physicians using data from the West Virginia Youth Risk Survey.
The West Virginia bill would ban people under 18 from being prescribed hormone therapy and fully reversible medication to halt the physical changes of puberty.
But the change approved by House lawmakers on Saturday — proposed by Senate Majority Leader Tom Takubo, a physician by training — would allow young people to access puberty blockers and hormone therapy if they experience severe gender dysphoria, under certain circumstances .
Gender dysphoria is defined by medical professionals as severe psychological distress experienced by those whose gender identity differs from the sex they were assigned at birth.
Takubo cited 17 peer-reviewed studies showing a significant reduction in rates of suicidal ideation and suicide attempts among youth with severe gender dysphoria who have access to drug treatment.
“These kids are struggling, they have incredible hardships,” he said.
He found a supporter in another trained physician, Sen. Mike Maroney, chairman of the Senate Health and Human Services Committee. Maroney said lawmakers would set “a dangerous precedent” by ignoring medical research in favor of political gain.
“Who are we, to win elections, to tell people how to practice medicine? Should we change treatments? It’s unbelievable,” the Republican said, adding that lawmakers would not apply the same standard to drugs for cancer or mental illness.
The legislation includes a ban on gender-affirming surgeries for minors, something medical professionals stress is not happening in West Virginia.
Under Takubo’s change, a person under the age of 18 would have to be diagnosed with severe gender dysphoria by at least two doctors or mental health providers to gain access to drug treatment. One would have to be a mental health provider or a specialist in adolescent medicine.
According to the bill, the dosage should be the lowest possible for “treatment of the psychiatric condition and not for gender reassignment purposes.”
Providers must be specifically trained to diagnose and treat severe adolescent gender dysphoria and must provide written testimony that medical interventions are necessary to prevent or limit self-harm or the potential for self-harm. The minor’s parents or guardians must give written consent for the treatments.
Hormone therapy could not be given to minors before the age of puberty, which West Virginia doctors say is not the case anyway.
The bill includes exemptions from the House version for people born with a “medically verifiable disorder,” including people with ambiguous “external biological sex characteristics,” and for people receiving treatments for an infection, injury, disease, or disorder “caused by or aggravated by the performance of gender transition procedures’.
People can also access treatment if they are in “imminent danger of death or impairment of an important bodily function, unless surgery is performed”.
The House vote came two days after a throng of protesters descended on the state Capitol, where chants of “trans kids matter” could be heard from the Senate chamber as lawmakers debated bills. The Democratic Del. Danielle Walker, the only openly LGBTQ member of the Legislature, led chants of the state’s slogan: “Climbers are always free.”
