[Editor’s note: Make sure to read Joseph Klein’s masterpiece contributions in Jamie Glazov’s new book: Barack Obama’s True Legacy: How He Transformed America.]
An Obama-appointed federal district court judge in Arkansas, District Court Judge James M. Moody Jr., struck down Arkansas’s ban on “gender transition procedures” performed on any individual under eighteen years of age. In an opinion that Judge Moody issued on June 20th he held that the state ban was unconstitutional because, he claimed, it violated the Fourteenth Amendment’s Equal Protection and Due Process Clauses and the First Amendment.
Transgender activists refer to gender transition procedures, including puberty blockers, hormonal therapy, and gender reassignment surgery, as “gender-affirming” medical care. However, in reality, such life-changing treatments amount to cruel experimentation on impressionable children who are pressured into thinking that their confusion and unhappiness can be fixed with puberty blockers, hormones, and going under the knife.
Here is a brief description of what the gender transition medical procedures entail that Arkansas sought to prohibit from being performed on minors. It is not pretty.
For biological girls, radically transformative surgeries, preceded by testosterone replacement therapy, can include double mastectomy and what transgender activists like to call “bottom surgery.” The latter could entail removal of the uterus, removal of the vagina, and changing the clitoris into a penis. These surgical procedures often entail serious, long-term complications and are irreversible for the rest of the girl’s life.
For biological boys, radically transformative surgeries, preceded by chemical castration, can involve breast augmentation and penile inversion vaginoplasty.
Commenting on Judge Moody’s ruling, Arkansas Governor Sarah Huckabee Sanders said that he was “pushing a political agenda at the expense of our kids.” She added that “Only in the far-Left’s woke vision of America is it not appropriate to protect children.”
Arkansas’s Attorney General Tim Griffin vowed to appeal Judge Moody’s decision. “I am disappointed in the decision that prevents our state from protecting our children against dangerous medical experimentation under the moniker of ‘gender transition,'” he said. Attorney General Griffin added that “There is no scientific evidence that any child will benefit from these procedures, while the consequences are harmful and often permanent.”
The Tenth Amendment to the U.S. Constitution states that “the powers not granted to the federal government by the Constitution, nor prohibited to the States, are reserved to the States or the people.” A state has the reserved power under the Tenth Amendment to enact legislation protecting the public safety, health, and welfare of the state’s residents.
“It is evident beyond the need for elaboration that a State’s interest in ‘safeguarding the physical and psychological well-being of a minor’ is ‘compelling,’” Justice Byron White wrote in a majority opinion for the Supreme Court back in 1982. “A democratic society rests, for its continuance, upon the healthy, well-rounded growth of young people into full maturity as citizens. Accordingly, we have sustained legislation aimed at protecting the physical and emotional well-being of youth even when the laws have operated in the sensitive area of constitutionally protected rights.”
Arkansas passed such a law, entitled the “Save Adolescents From Experimentation (SAFE) Act,” to protect young people from gender transition medical procedures for health and safety reasons. Other states have also either banned or sharply restricted gender transition medical procedures on the same grounds.
Nevertheless, Judge Moody decided that Arkansas does not have a compelling enough interest to protect minors in its state from being subjected to radically transformative medical procedures that could well impede their healthy growth “into full maturity.”
States have the power to prohibit the sale of alcohol to individuals under the age of 21 and to ban or limit the tattooing of minors. Yet Judge Moody drew an arbitrary line when it comes to allowing states to use their reserved powers to regulate, or in Arkansas’s case to ban, gender transition medical procedures performed on minors.
Judge Moody based his decision on the fallacious premise that “the State has failed to prove that gender-affirming care for minors with gender dysphoria is ineffective or riskier than other medical care provided to minors.”
Of course, it is riskier – far riskier. There is no rigorously developed scientific evidence upon which to determine one way or the other the extent of long-term adverse consequences that could affect young people for the rest of their lives.
Judge Moody closed his eyes and ears to any findings that contradicted his pre-conceived notions about so-called “gender-affirming care.” He cavalierly dismissed testimony by Arkansas’s expert witnesses who called into question such procedures, claiming that the testimony was “grounded in ideology rather than science.”
Judge Moody also cavalierly dismissed medical guidelines issued by various European countries that have recommended sharply curtailing such procedures. While it may be true, as Judge Moody said, that “none of these guidelines have prohibited gender-affirming medical care for minors,” this is misleading. Contrary to blue states in the United States, the presumption in these countries is not to perform gender transition procedures except in extremely limited, controlled circumstances.
For example, following a comprehensive review of available evidence, the Swedish National Board of Health and Welfare (NBHW) concluded in February 2022 that:
“[T]he evidence base for hormonal interventions for gender-dysphoric youth is of low quality, and that hormonal treatments may carry risks… In light of above limitations in the evidence base, the ongoing identity formation in youth, and in view of the fact that gender transition has pervasive and lifelong consequences, the NBHW has concluded that, at present, the risks of hormonal interventions for gender dysphoric youth outweigh the potential benefits.”
“As a result of this determination, the eligibility for pediatric gender transition with puberty blockers and cross-sex hormones in Sweden will be sharply curtailed. Only a minority of gender dysphoric youth—those with the ‘classic’ childhood onset of cross-sex identification and distress, which persist and cause clear suffering in adolescence—will be considered as potentially eligible for hormonal interventions, pending additional, extensive multidisciplinary evaluation. For all others, including the now-prevalent cohort of youth whose transgender identities emerged for the first time during or after puberty, psychiatric care and gender-exploratory psychotherapy will be offered instead.”
In December, Sweden’s National Board of Health and Welfare said mastectomies for teenage girls wanting to “transition” should be limited to a research setting.
According to The Daily Signal, citing a report in The Telegraph, England’s National Health Service (NHS) is planning “a ban on prescribing young people puberty blockers outside of strictly-conducted clinical trials.”
In June 2020, the Council for Choices in Health Care in Finland adopted “a recommendation on medical treatment methods for dysphoria associated with variations in the gender identity of minors.” The Council recommended a cautious, case-by-case approach with respect to hormonal therapy for minors:
“Based on thorough, case-by-case consideration, the initiation of hormonal interventions that alter sex characteristics may be considered before the person is 18 years of age only if it can be ascertained that their identity as the other sex is of a permanent nature and causes severe dysphoria. In addition, it must be confirmed that the young person is able to understand the significance of irreversible treatments and the benefits and disadvantages associated with lifelong hormone therapy, and that no contraindications are present.”
The Council added that “the initiation and monitoring of hormonal treatments must be centralized at the research clinics on gender identity” and that “Surgical treatments are not part of the treatment methods for dysphoria caused by gender-related conflicts in minors.”
The French National Academy of Medicine issued a press release on February 25, 2022 regarding medicine and “gender transidentity”in children and adolescents. It said that “there is no test to distinguish a ‘structural’ gender dysphoria from transient dysphoria in adolescence. Moreover, the risk of over-diagnosis is real, as shown by the increasing number of transgender young adults wishing to ‘detransition.’” It noted the potential serious adverse side effects of the use of hormone blockers or hormones of the opposite sex such as “impact on growth, bone fragility, risk of sterility, emotional and intellectual consequences and, for girls, symptoms reminiscent of menopause.” Thus, the French Academy recommended that “the greatest reserve is required in their use.” As for surgical treatments, “their irreversible nature must be emphasized.”
A government watchdog agency in Norway, the Norwegian Healthcare Investigation Board, stated in its March 2023 report that “research-based knowledge for gender-affirming treatment (hormonal and surgical), is insufficient and the long-term effects are little known.” The Board recommended “that puberty delaying treatment [puberty blockers] and hormonal and surgical gender confirmation treatment for children and young people are defined as experimental treatment.” (Emphasis added)
Joshua Cohen, a contributor to Forbes on healthcare issues, summarized the trend in Europe this way:
“In essence, progressively the message emanating from European gender experts is that until there is reliable long-term evidence that the benefits of youth gender transition outweigh the risks, it is prudent to limit most medical interventions to rigorous clinical research settings.” (Emphasis added)
Arkansas’s law that Judge Moody arbitrarily struck down was designed to protect vulnerable minors from gender transition medical interventions for these very reasons.
Gender transition medical practitioners, gender clinics, and big pharma are pushing their over-hyped medical panaceas without solid science to back up their claims. They are experimenting on young people without the rigorous guardrails and controls that would be required in a clinical research setting.
Judge Moody’s decision must be overruled to allow states like Arkansas to exercise their constitutional authority to protect the health and safety of their young residents in such a manner as the states deem to be reasonable based on expert scientific advice.