On Tuesday, Ohio’s 10th District Court of Appeals overturned part of a 2023 law that prohibits minors from accessing cross-sex hormones and puberty blockers. However, the plaintiffs did not challenge the portions of the law prohibiting surgical care or restrictions on participation in school sports. The three-judge panel overturned a lower court ruling allowing the law into effect because they determined that the court erred in evaluating the case under a “rational basis review,” because the law impacts parents’ fundamental right to direct the care and upbringing of their children, including the right to make medical decisions. The court also determined that the plaintiffs would be harmed by the bans and often deferred to the “standard of care” established by medical associations, including the activist organization the World Professional Association for Transgender Health (WPATH). Although the claims are not supported by the findings of systematic reviews, the court accepted that “affirming care” can reduce dysphoria, psychiatric illness, and improve quality of life. “This is a no brainer — we are appealing that decision and will seek an immediate stay. There is no way I’ll stop fighting to protect these unprotected children,” Ohio Attorney General Dave Yost said in a statement.
On Monday, the Department of Veterans Affairs (VA) announced that “gender affirming” treatments would no longer be available to trans-identified veterans. To be consistent with Trump’s EO defunding “gender ideology,” the VA intends to rescind a 2018 directive which made hormonal treatments, and pre and post operative care, available to veterans. Transition related surgeries were not part of the directive. The 2018 policy also allowed trans-identified veterans to use VA facilities that align with their “gender identity.” The VA clarified that trans-identified veterans “will continue to receive comprehensive VA health care, which includes preventive and mental health care.” Funds allocated for “affirming” care will be reallocated towards helping severely injured VA beneficiaries.
After conducting a compliance review, the U.S. Department of Health and Human Services Office of Civil Rights has determined that Maine’s Department of Education–and the Maine Principals’ Association and Greely High School–are in violation of Title IX by allowing males to compete in sports reserved for girls. OCR has sent letters to the offending entities and granted them a ten-day window to comply with Title IX, and Trump’s EO on “Keeping Men out of Women’s Sports,” or “risk referral to the U.S. Department of Justice for appropriate action.”
In the Archives of Disease in Childhood, Dr. Alison Clayton provides an overview of the current state of knowledge related to pediatric gender medicine and speculates about the way forward. While Clayton does not propose any hard proposals for how the field should progress, she maintains that more rigorous research studies are needed to improve the knowledge base and inform clinical decision making. Clayton also maintains that the current low certainty evidence for psychosocial benefits, and overall knowledge gaps, should already be informing clinical practice. Clayton also draws attention to how activists that support unbridled access to “affirming care” for minors are quietly shifting the goalposts by arguing that medical interventions should be made available based on a patient’s wishes and desires. She goes on to explore how this justification for treatment access diverges from medical ethical principles.
Last Friday, Kentucky House Republicans voted 67-19 to pass House Bill 495, which would undo an executive order that prohibits “conversion” practices on LGBTQ+ minors and prohibits Kentucky Medicaid from paying for cross-sex hormones and “affirming” surgeries. That same evening, Kentucky Republicans also passed SB2, which would prohibit trans-identified inmates in Kentucky jails from receiving “affirming” care while incarcerated. Although Gov. Beshear has signaled his displeasure with the bills, if it comes to it, Republicans have time to override a veto later this month.
Eight Michigan House Democrats have drawn the ire of their colleagues for breaking ranks with their party by supporting a resolution that urges the Michigan High School Athletic Association (MHSSA) to ban trans-identified boys from competing in girls' sports. The resolution, which was supported by every House Republican, calls on the MHSSA to comply with the Trump administration’s EO on “Keeping Men out of Women’s Sports.” In a statement, the MHSSA said it was “monitoring developments in this regard closely, including federal litigation challenging the recent Executive Order and potential changes to state law that have been introduced in the Michigan legislature. ... Until those matters are resolved, the MHSAA is not in a position to change its current rules or policies, which again comply with applicable state and federal law.”
In City Journal, Colin Wright, Samuel Stagg, & Christina Buttons challenge the “brain sex” argument that is often used to promote the notion that “gender identity” is immutable. In short, the “brain sex” argument is the idea that trans-identified individuals have brains like the sex they identify as. The authors argue, however, that “the notion that males can have ‘female brains,’ and vice versa, rests on a flawed interpretation of ‘brain sex’ studies that in no way demonstrate or even suggest a definitive biological basis for ‘gender identity.” Specifically, they argue that studies that claim trans-identified people have brains of the opposite sex are confounded by sexual orientation, which matters, because many trans-identifying people are gay, and same-sex attraction is itself linked to “neuroanatomical differences that reflect a cross-sex shift.” They go on to explore the implications of the misconception over “brain sex” for policy makers.
Australia’s National Health and Medical Research Council (NHMRC) “has been tasked with developing new independent, evidence-based guidelines” for the treatment of youth gender dysphoria. The project is set to take three years, while selection of the guideline development committee is expected to be completed by July. Although there is warranted cynicism that the review will work backwards from the predetermined conclusion that “affirming” care is medically necessary and safe for use in routine care–under influence from the transgender medical lobby–there are some promising signs that this guideline development process will follow the standards of evidence-based medicine. For one, the NHMRC has announced that it will issue brand new guidelines, rather than update controversial 2018 guidelines produced by Melbourne’s Royal Children’s Hospital, which did not assess the quality of evidence for their recommendations. Two, the new review will use the international GRADE system–common in systematic reviews–to rate the quality of evidence. The composition of the guideline development committee will be something to monitor going forward.
Joseph Figliolia
Policy Analyst
News
