NOEL KING, HOST:
Twenty state legislatures have introduced bills that would prohibit gender-affirming medical care for transgender children. One of the toughest bills is in Alabama. It would make it a felony to provide transition-related medical treatment like puberty blockers or hormones to trans kids. Here's NPR's Melissa Block.
MELISSA BLOCK, BYLINE: Meet Syrus Hall, who lives in Mobile, Ala., with his twin sisters, his mom and her fiance and his pet fish...
SYRUS: Good morning, buddy.
(SOUNDBITE OF SHAKING FISH FOOD)
SYRUS: It's time to eat.
BLOCK: ...A brilliant blue crowntail betta.
SYRUS: His name is Florence.
BLOCK: Syrus is 17, a high school junior, who hopes to study forensics in college.
SYRUS: I'm thinking about being either, you know, like, a forensics investigator or a forensic psychologist.
BLOCK: Syrus was assigned female at birth, but around fifth grade, when he hit puberty...
SYRUS: That's when I started to fully get uncomfortable with, like, the way that I looked or the way that I felt. Like, in my head, I looked a different way than I looked in the mirror.
BLOCK: Even though he was feeling this way, Syrus says he didn't know how to explain it.
SYRUS: I didn't find out the words for, like, who I am. Like, I didn't know that trans people existed until I was about 12 or 13. Like, I had never heard of trans people.
BLOCK: That's where the Internet comes in. Syrus says he spent long nights online doing research to figure out who he is. And ultimately, he came out as trans to his family. Last August, with his mother's permission and after lengthy psychological counseling, he was prescribed testosterone, weekly shots. On a recent Zoom call with his pediatrician, Dr. Morissa Ladinsky, Syrus sounded bubbly as they talked about the changes he's started to see.
SYRUS: The first thing I noticed was hair. Just...
MORISSA LADINSKY: You started growing so much hair.
SYRUS: And I was, like, excited because, you know, I was like, oh, something's happening; this is so cool. And then I started noticing, you know, my voice changing a little bit.
LADINSKY: That voice, I'm loving it.
LADINSKY: See that laugh? I love that laugh.
BLOCK: The physical changes are one thing; the emotional transformation has been dramatic, too. As Syrus' mom Carla Saunee describes it, her son used to be reclusive, would mostly stay in his room. Now that he's transitioning, he's more confident and social, has good friends.
CARLA SAUNEE: He's more himself. He's happy, you know? He's like a big kid. He'll still sit on my lap and cuddle up with me, you know? And those are things he wasn't doing before.
BLOCK: So Carla and Syrus and their medical team have watched with alarm as the Alabama Legislature advances a bill that would outlaw his hormone treatment. It's called the Vulnerable Child Compassion and Protection Act. It passed overwhelmingly in the state Senate and could go to the full House as early as this week. Here's a sampling of arguments in favor of the bill - first, from retired Alabama pediatrician Bill Whitaker...
(SOUNDBITE OF ARCHIVED RECORDING)
BILL WHITAKER: The truth is that there are only two sexes based on biology, female and male - that it's impossible to change one's sex.
BLOCK: ...Also, pediatrician Den Trumbull...
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DEN TRUMBULL: Medical procedures intended to alter or delay the normal sexual development of a gender-confused (ph) child is child abuse.
BLOCK: ...And the bill's sponsor, state Senator Shay Shelnutt.
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SHAY SHELNUTT: Bottom line is we have a responsibility to protect Alabama's children. Minors are not mentally capable to make a decision of this caliber.
BLOCK: Those who treat transgender youth say remarks like these are not just factually wrong; they also stigmatize an already marginalized population. This month, the American Academy of Pediatrics called bills that prohibit trans medical care or other bills that ban trans girls from women's sports teams dangerous. The academy warned the bills threaten the health and well-being of transgender youth.
LADINSKY: There is a lot of viscerally repugnant language in those bills that really evoke pain and evoke fear and couldn't be farther from the truth.
BLOCK: That's Dr. Ladinsky, Syrus' pediatrician, who points out that in her clinic, no minor child is making the decision for treatment on their own. The child, parents and entire medical team have to agree through a lengthy, informed consent process. And Ladinsky emphasizes that their hospital never performs gender-affirming surgery on minors. But if the Alabama bill becomes law, she and her medical team could be charged with felonies for prescribing puberty blockers or hormones. That means they could face 10 years in prison.
LADINSKY: The idea of this precedent scares the living crap out of me.
BLOCK: Ladinsky is part of a pediatric gender health team at the University of Alabama in Birmingham, a team that also includes an endocrinologist, psychologists and a chaplain.
LADINSKY: Throughout the last few weeks, you know, almost every clinic visit have ended with either a parent or a child choking back tears, saying, where do you think those bills are going? Is it really going to happen?
BLOCK: The bill's sponsor, Senator Shelnutt, has acknowledged he has never spoken to a transgender youth, which boggles the mind of Syrus Hall's mom, Carla Saunee.
SAUNEE: I would ask him just to spend the day with us. Let's have a conversation. It doesn't even have to be us. You know, find you a transgendered youth and be around them and experience who they are. You can't write a bill when you have zero experience with the transgender population.
BLOCK: And there's another part of the Alabama bill that infuriates Saunee. She's a public high school teacher and the bill would force school staff to out transgender children to their parents.
SAUNEE: Who are you to tell me as an educator that I have to go break trust with a student to out them to their parents when that is not my place at all?
BLOCK: As for 17-year-old Syrus, he says it's simple; people who support this legislation would deny something essential - the person he knows himself to be.
SYRUS: I've been told that before. Like, people are like, oh, it's just a phase; you're going to grow out of it - blah, blah, blah, blah, blah. And it makes me mad because, like, it hurts people. Like, when people who know who they are can't access the things they need to make themselves feel better, it's awful.
BLOCK: LGBTQ advocacy groups are gearing up for immediate court challenges if any of the medical care bans bubbling up around the country become law.
Melissa Block, NPR News.
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