Apr 8, 2021

Arkansas bans transgender youth treatments.

Arkansas bans transgender youth treatments.

What will the bill do?

Today’s read: 10 minutes.

We’re skipping today’s reader question and focusing entirely on the bill that just became law in Arkansas. Also, we’ve got a fresh new Blindspot Report, an interesting survey for you and some fascinating numbers.

The Governor speaks to the crowd gathered for the Chaffee Crossing ribbon cutting in Ft. Smith. Photo: Gov. Hutchinson

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Quick hits.

  1. In some of his most definitive comments yet, Sen. Joe Manchin (D-WV) penned a Washington Post op-ed stating that he will not “vote to weaken or eliminate the filibuster,” meaning Democrats should continue to need 60 votes in order to pass major legislation. (The Washington Post, subscription)
  2. State jobless claims rose again, with 741,000 workers filing first-time claims for jobless benefits last week. (The New York Times, subscription)
  3. President Biden will unveil executive action on guns today, including a tightening of regulations on so-called “ghost guns” — or firearms that are assembled from kits and hard to trace. (Axios)
  4. The mayoral race in New York City is ramping up, and everyone is ganging up on Andrew Yang. (Politico)
  5. The U.S. Chamber of Commerce has called Joe Biden’s proposed corporate tax hikes “dangerously misguided” as big businesses coalesce to oppose them. (The Washington Examiner)

The big story.

Arkansas. Earlier this week, Republican Arkansas Governor Asa Hutchinson vetoed a bill that would have banned gender confirming treatments and surgery for transgender youth. But on Tuesday, Hutchinson’s fellow Republican lawmakers overturned that veto, enacting the bill, dubbed the Save Adolescents From Experimentation (SAFE) Act, with a 72-25 veto-proof majority.

The bill prohibits doctors from providing hormone treatment, puberty blockers or gender-related surgery to anyone under the age of 18 years old. If a doctor does provide such treatment to a minor, they can lose their medical license and face fines. The bill also prevents trans youth from being referred to other providers for treatment. Proponents of the bill have argued that there should be age minimums to these treatments similar to laws prohibiting drinking or smoking. Opponents of the bill, including pediatricians in Arkansas and the American Academy of Pediatrics, said it could increase rates of suicide, depression and self-harm amongst transgender youth.

Around the same time the Arkansas bill was passed, a similar bill was introduced in North Carolina. One particularly contentious part of that bill, Senate Bill 514 (which went viral online), would compel state employees to notify parents in writing if their child displays “gender nonconformity” or expresses a desire to be treated or addressed as a gender that is not what they were assigned at birth. Transgender advocates say the provision would lead to state employees outing transgender youth to their parents without their consent.

Arkansas Gov. Asa Hutchinson, who initially vetoed the bill, said it went too far in limiting the decision-making of parents, doctors and children, and also noted that it would cut off treatment currently happening for trans youth because it lacked a “grandfather” clause.

The law could take effect by late July. Several groups, including the ACLU, have already vowed to sue.

What the right is saying.

The right supports the bill, saying that these treatments are unproven and trans youth shouldn’t be on the front lines of medical experimentation.

The National Review editors said Asa Hutchinson made a “foolish mistake” by vetoing the bill.

“The bill bans the use of drugs and surgeries on children as part of ‘gender reassignment’ therapy, a euphemism to describe the abusive prescription of hormonal drugs by gender clinicians, and the mutilation of healthy sexual organs and their replacement with nonfunctioning facsimiles by surgeons,” they wrote. “This is the right decision, and every state should follow Arkansas’ example.

“A raft of studies and books, such as Abigail Shrier’s Irreversible Damage, show that these experimental hormone therapies and surgeries do more physical and psychological damage to those suffering gender dysphoria, and they increase rates of suicide among people who identify as transgender,” the editors wrote. “These so-called therapies are driven, at bottom, by psychological, sociological, and anthropological superstitions. These include a belief in a ‘true identity,’ hidden in the psyche or the will, that is at odds with our given biology. Or the assertion that, because cultures and history shape how men and women interact and behave, human nature is essentially plastic and can be remade at will.”

In The Washington Examiner, Zachary Faria said Gov. Hutchinson can’t hide behind limited government to justify his veto.

“It's a noble sentiment, but it has no business being applied here,” he wrote. “This is not the more invasive North Carolina bill, which would compel state employees to inform parents if their children display ‘gender nonconformity.’ The Arkansas Legislature, which has since voted to override Hutchinson’s veto, focused only on the irreversible damage done to children through the use of puberty blockers, hormone therapy, and gender reassignment surgery… Roughly 80% of children who experience gender dysphoria grow out of it without any intervention. Even some adults who go through the process of chemically or physically altering their bodies end up regretting it, and it is no easy thing for them to de-transition.”

In Hot Air, Jazz Shaw wrote that if “the law had applied to adults I would be 100% onboard with the governor’s reasons for vetoing it.”

“No matter what your views on the entire transgender issue may be, adults are entitled to make decisions as to what they do with their own bodies, provided they are willing to take responsibility for the consequences if they wind up regretting those decisions later,” he wrote. “I would not support any sort of blanket government ban on these procedures.

“But when it comes to the safety of children, there is more than ample precedent to say that such state protections are called for. The state bears a responsibility to ensure the proper care for those who are too young to provide informed consent and it’s traditionally not seen as government overreach. For example, a school nurse who gives an aspirin to a minor student without parental permission can lose their job. A tattoo artist who inks someone that’s age 17 or younger can go to jail. Nobody argues with those rules.”

What the left is saying.

The left is opposed to the bill, saying it will cause harm to the transgender community and could increase depression, anxiety and suicides.

In Vox, Emily VanDerWerff, a trans woman, wrote that “these bills will effectively force trans teens through a puberty that will cause them immense emotional and psychological harm.”

“Numerous studies have shown that trans teenagers are more at risk of death by suicide than their cisgender peers,” she wrote. “A 2018 study by the American Academy of Pediatrics found that trans boys showed a 50.8 percent rate of attempted suicide (compared to 9.8 percent for cis boys), while trans girls showed a 29.9 percent rate (compared to 17.6 percent for cis girls). Nonbinary teens reported a 41.8 percent rate and gender-questioning teens a 27.9 percent rate.

“But when trans children receive gender-affirming health care and the support of family and peers, their risk of death by suicide declines substantially. (I don’t like to talk about it, but I spent most of my life consumed by suicidal thoughts until I began transition.),” she said. “What’s more, trans children who are affirmed in their gender have less risk of anxiety and depression than trans kids who are not, and a 2014 study of trans youth showed that allowing them to transition as children led to positive outcomes.”

In The New York Times, Jennifer Finney Boylan wrote that “keeping trans kids from medicine” doesn’t make them disappear.

“In issuing the veto, Mr. Hutchinson had said the bill banning medical treatment was a step too far. He called it ‘government overreach’ into a difficult health care question, and said that the proposed legislation was the ‘product of the cultural war in America,’” she wrote. “But it was his own Republican Party doing the overreaching. This skirmish is one in which conservatives have gone to battle against research backed by the Endocrine Society and the American Academy of Pediatrics — not to mention the lived experience of doctors around the country — showing that early medical interventions, including the prescription of puberty blockers for younger trans people, are both beneficial and safe.”

The Washington Post editorial board said “Republicans have turned to culture wars to unite the GOP and boost their political standing.”

“Mr. Hutchinson is not a notable ally of the LGBTQ community,” they wrote. “He said that he would have signed the bill if its restrictions were not quite as extreme. The bill does not just ban gender transition surgery for minors. It also ends hormone therapy for young people, even for those already undergoing it, a potentially shocking disruption to their treatment. Moreover, denying gender transition services short of surgery does nothing to prevent surgical ‘experimentation’ on transgender youth, which is what the bill’s advocates say they oppose. Rather, it encourages depression, hopelessness and suicide among young Arkansans struggling with their gender identities.

“State lawmakers promote an oblivious view of transgender youth and their treatment as some kind of Dr. Frankenstein fantasy,” it added. “The protests of people who are actually transgender and those who care for them — that gender transitioning is not experimental, that people undergo intensive therapy and screening before transitioning is considered, that hormone therapy is introduced carefully in stages that reflect patients’ age and development, that those who undergo the transition process emerge relieved to feel more themselves — did not deter majorities in the Arkansas legislature from picking on a small, often misunderstood portion of the population.”

Isaac’s take.

One of the big challenges with trans issues in America is that there are still a lot of unknowns, along with fear, ignorance and limited exposure. Many Americans, and I presume many people in Arkansas, don’t know any transgender people. Many lawmakers are acting out of concern for the control they want to have over their own children’s decisions, and many people who support this legislation might view it as a common sense bill that prevents kids from doing irreparable harm to themselves.

I think there is a great deal of evidence — and logic — to suggest that this is not the case.

No matter how you feel about transgender people or more specifically transgender youth, you must first accept that they are human beings. Like you and me, that means they should have certain rights to access care and resources that are specific to their needs. The only way to come to the conclusion that a broad, government-enacted bill can deny a group of human beings specific kinds of health care they want is by first taking away their status as human beings capable of making their own decisions. That’s it. It requires an internal narrative that says, “I know what is best for you, so I’ll make that call because you are unequal to me.” This legislation is not protecting transgender youth — it is removing the basic humanity they (and their parents) are supposed to be guaranteed in our country to make decisions about their own health care.

The contradictions by conservatives on this specific issue are numerous and important to point out. You cannot stand on conservative principles of limited government and freedom of choice while also presuming that the government is entitled to broadly ban widely practiced medical treatments for specific groups of people — especially against the objections of the medical community and patients themselves. Asa Hutchinson, a bonafide Republican and firebrand conservative, is right to point this out, and I agree with him.

On an issue like abortion, conservatives can avoid this kind of contradiction by pointing to the fact an unborn child has no say in the matter. And that does make the issue of rights more complex and nuanced. But what is the logic in this case? You have a youth, a parent, a team of doctors, psychologists, clinicians and a body of scientific evidence to support certain actions — yet you deny all of them the power to decide on their own? It flies in the face of common sense to think that a broad government mandate would be more effective than a team of doctors and patients making case-by-case decisions.

Earlier this week, I wrote about my opposition to vaccine passports and how uneasy it would make me feel if the government were to create a centralized plan that effectively limits who can go where. I was embracing “the right’s” argument and the conservative principles that exist in my own political worldview. Even if I were to remove the dehumanization of trans people from the argument here, despite the fact that I believe it should be the central point, opposing vaccine passports or gun regulations or laws that narrow free speech but supporting a bill that allows the government to make a blanket decision about what health care someone can receive is deeply inconsistent.

What are the potential long-term positives and negatives of this kind of treatment and therapy? They are somewhat inconsistent but appear to be mostly positive. There are studies that show negative long-term outcomes for people who undergo sex reassignment surgeries. Sometimes, trans youth regret their transition as adults. There are also studies that show positive outcomes for trans youth who receive hormone treatment or puberty blockers. Specific medical interventions aside, there is an abundance of evidence that supporting transgender youth in their self-identification yields positive mental health results. This is why every single major American medical body recommends giving trans youth a choice to transition.

Two weeks ago, I interviewed a top transgender youth clinician on the Tangle podcast and asked her about these difficult questions, and shared some of my own reservations and concerns about what I’ve heard and read regarding trans youth treatment. One of the things she made clear is that puberty blockers are not a long-term solution but used to buy time, and hormone treatment is not something that happens overnight, but slowly, and after months and years of evaluation. Youth sex reassignment surgery is extremely rare.

At the absolute worst, the results of these interventions have been inconsistent depending on where a patient is being treated, but appear to be getting better every year. That is not cause for the government to implement an outright ban on these kinds of interventions, and it is certainly not cause to compel state employees to flag parents in writing anytime a child expresses gender nonconformity, as the North Carolina bill would do. Obviously, allowing these treatments to be legal does not mean every kid who explores their gender should have a sex reassignment surgery either, yet the discourse on the right is proceeding as if this were the case.

Medical interventions of all kinds carry all sorts of risks. We wouldn’t deny individuals access to other medical treatments because they don’t always work or sometimes have negative outcomes. We understand that doctors, parents and patients are the actual experts on what is best for them, and we trust that they will do their best to achieve a positive result for a given individual.

That should be the consistent, logical throughline. The bill is indefensible. If you're worried about trans youth in Arkansas, this bill could cause the difference between fulfillment and misery — life and death. If you're only worried about protecting minors who may regret their decision, the bill is still overreaching in its intervention. And if your primary concern is government interventionism, that alone should be enough. Conservative writers like Zachary Faria who can oppose the North Carolina bill as government overreach yet draw a line between it and what is happening in Arkansas leave me dumbfounded. Asa Hutchinson was right to veto this bill, and the state legislature that overruled him shows an infuriating and dangerous level of hubris about what they purport to know better than doctors, patients and parents across the state of Arkansas.

Blindspot report.

Tangle has very few partners because we are very careful about who we work with. But one of them is Ground News, an exceptional app and website that tracks the political bias in news reporting. I feature parts of Ground News’s “Blindspot Report” in Tangle. The Blindspot Report tells you what you were likely to miss based on your political leanings and the news feed bubble you’ve created for yourself.

If you’re on the left, you probably missed a story about how the Biden administration may restart border wall construction to plug ‘gaps.’

If you’re on the right, you probably missed a story about how more than 50 major U.S. corporations paid no federal taxes last year.

Want to check out Ground News’s bias ratings, blindspot reports or other news sources? Click here.

A story that matters.

Online scammers have a new offer for you: vaccine cards. Hundreds of sellers are offering false and stolen vaccine cards, typically forgeries or falsified copies of the Centers for Disease Control and Prevention vaccination cards you get when you receive the vaccine. “The coronavirus has made opportunists out of many people, like those who hoarded bottles of hand sanitizer at the start of the pandemic or those who cheated recipients out of their stimulus checks,” The New York Times reports. “Now online scammers have latched onto the latest profit-making initiative: the little white cards that provide proof of shots.” The cards could become particularly valuable if companies begin instituting vaccine passports. 45 state attorneys general have called on Twitter, Shopify and eBay to stop the sale of the cards on their platforms.


  • 49%. The percentage of U.S. adults who identify with the Democratic party or said they are independents who lean toward the Democratic party, according to Gallup.
  • 40%. The percentage of U.S. adults who identify with the Republican party or said they are independents who lean toward the Republican party, according to Gallup.
  • 9%. The partisan advantage for Democrats, the largest measured since 2012.
  • 44%.The percentage of Americans who identify as political independents.
  • 38%. The percentage of Americans who identified as political independents in the fourth quarter of 2020.
  • 156 million. The estimated number of stimulus checks the Biden administration has sent out as of Wednesday.
  • $372 billion.The estimated total cost of those stimulus checks.

Have a nice day.

In 1964, Brian Robson signed a contract to travel from Cardiff, Wales, to Melbourne, Australia and work on Victorian Railways as part of an assisted immigration program. But soon after arriving, he became desperately homesick, then hatched a plan to escape his contract and be sent back in a wooden crate from Melbourne to London. Except his plane went to Los Angeles. Robson barely survived the ordeal, which lasted five days, and now he is out with a book called “The Crate Escape” and trying to reconnect with the friends who helped make it happen. (CBC)

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