Watch a previous NBC4 report on House Bill 68 in the video player above.
COLUMBUS, Ohio (WCMH) — Ohio lawmakers advocating for a bill banning medical care for transgender and nonbinary youth are clashing with the Ohio State University Wexner Medical Center and every leading medical association in the United States.
House Bill 68 — the “Save Adolescents from Experimentation Act” — would bar healthcare professionals from providing treatment known as gender-affirming care to trans children in the state. Violating physicians would be disciplined by the state medical board and could face legal action from the state’s attorney general.
“What we’re just simply saying is, let kids grow up,” said Rep. Gary Click (R-Vickery), who reintroduced the bill in February. “Children are incapable of providing the informed consent necessary to make those very risky and life-changing decisions.”
The bill states mental health professionals must screen patients for abuse and comorbidities before diagnosing gender dysphoria. In addition, mental health professionals are required to report data outlining the number of minors treated for a “gender-related condition” each year.
However, Nationwide Children’s Hospital, the American Academy of Pediatrics and other major medical providers said gender-affirming care is an evidence-based practice with a proven track record of improving health outcomes for trans youth. The Ohio Children’s Hospital Association previously called the bill a “misguided effort” that could exacerbate harm to LGBTQ+ youth.
“When I read the news, it’s heartbreaking,” said Nima Baradaran, a reconstructive urologist who performs gender-affirming surgeries at Ohio State University Wexner Medical Center. “I cannot imagine any other medical condition being under such a large magnifying glass of scrutiny.”
A diagnosis of gender dysphoria
Stephani Brockway, a trans woman and former patient of Baradaran, said she began experiencing gender dysphoria when she was 4 and continued wrestling with her identity throughout childhood. Growing up during the 1980s, Brockway was unable to access affirming mental health services, and the suppression of her identity caused her to suffer from depression for years.
Decades passed, yet the feeling never wavered. After several marriages and enlisting in the military in a “last effort to be what society expected,” Brockway knew she needed to receive gender-affirming care.
“It wasn’t till I was, I think, 45 years old that I realized if I don’t live my life for me now, then I’m never going to,” said Brockway.
Gender-affirming care encompasses a range of social, psychological, behavioral and medical interventions provided to a patient after receiving a diagnosis of gender dysphoria, said Baradaran. He described the feeling as a sense of dissatisfaction because of a mismatch between a patient’s biological sex and their gender identity.
“[Gender dysphoria] impacts a patient’s social life, relationships, mental health and can have catastrophic consequences,” said Baradaran. “Gender-affirming care is all the treatments that are available to address that.”
Nonsurgical and surgical treatment
Treatment for gender dysphoria typically begins with a nonsurgical option. After beginning mental health services and receiving a diagnosis of gender dysphoria, Brockway began taking medication known as hormone replacement therapy to increase her levels of estrogen to develop sex characteristics aligned with her identity.
A similar medication known as “puberty blockers” can be prescribed to trans individuals under the age of 18 who have not completed puberty, suppressing sex hormones like testosterone and estrogen, explained Baradaran. Trans patients can also pursue other non-surgical options like speech therapy to help match vocal characteristics with their gender identity.
After taking hormones for several years, Brockway said she was ready to pursue gender-affirming surgeries. Gender-affirming surgeries change the look and function of a trans patient’s assigned sex to match their gender identity, including facial surgery, voice surgery and top and bottom surgeries to align a patient’s chest or genitalia with their gender identity.
Baradaran performed two procedures on Brockway to address her dysphoria: an orchiectomy and a vaginoplasty. An orchiectomy is the surgical removal of one or both testicles, while a vaginoplasty creates external genitalia that resembles and functions as close to cisgender female genitalia as possible. Since receiving her surgeries, Brockway said her depression is gone and she no longer lives in fear.
“Gender used to be the overwhelming, all-encompassing factors of the day and it isn’t anymore,” said Brockway. “The freedom that I have now to pursue whatever I want to pursue without that weight is phenomenal.”
‘The demand is high’
While Baradaran treats patients ranging from young adults to patients in their 80s, he said Brockway represents a trend of older trans individuals receiving treatment now who were unable to pursue care when they were younger.
Baradaran’s surgical schedule is booked out for the next six to seven months, a majority for gender-affirming surgeries. In addition, new patients have to wait weeks, if not months, before an initial appointment. Now, Baradaran said patients are also coming from out of state.
“The demand is high,” said Baradaran. “It’s unfortunate because even patients who otherwise would have felt comfortable waiting or postponing surgery for a variety of reasons, because of the political climate, they feel the pressure that if they don’t get it now, they might never be able to get it.”
Brockway said the last few years have been difficult for the trans community as state legislators nationwide are proposing a record-breaking number of anti-LGBTQ+ laws in 2023. She encourages LGBTQ+ youth to find a support system to aid them through the emotional challenges of living out their identities.
“This isn’t what trans is about and, to me, they’re hurting all of us when they do something like that,” said Brockway. “I have no regrets, none at all. But, it is life changing and you have to have a support structure.”