{"id":22814,"date":"2021-06-09T13:20:24","date_gmt":"2021-06-09T18:20:24","guid":{"rendered":"https:\/\/arknews.org\/?p=22814"},"modified":"2021-06-09T16:24:16","modified_gmt":"2021-06-09T21:24:16","slug":"kids-feel-like-theyre-being-erased-inside-the-clinic-targeted-by-arkansass-new-anti-trans-law","status":"publish","type":"post","link":"https:\/\/arknews.org\/index.php\/2021\/06\/09\/kids-feel-like-theyre-being-erased-inside-the-clinic-targeted-by-arkansass-new-anti-trans-law\/","title":{"rendered":"\u2018Kids feel like they\u2019re being erased\u2019: Inside the clinic targeted by Arkansas\u2019s new anti-trans law"},"content":{"rendered":"<figure id=\"attachment_22816\" aria-describedby=\"caption-attachment-22816\" style=\"width: 640px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-22816\" src=\"http:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-edit-1170x731.jpeg\" alt=\"\" width=\"640\" height=\"400\" srcset=\"https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-edit-1170x731.jpeg 1170w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-edit-700x438.jpeg 700w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-edit-768x480.jpeg 768w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-edit.jpeg 1440w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption id=\"caption-attachment-22816\" class=\"wp-caption-text\">WAITING: Brandi Evans and her son, Andrew Bostad, are among the many families anxiously awaiting a federal court ruling on the new law (Credit: Matt White)<\/figcaption><\/figure>\n<p><span style=\"\">A new state law puts Arkansas doctors who work with transgender youth in a difficult bind: They must either stop providing what they consider to be life-saving medication to their young patients or risk losing their medical license.<\/span><\/p>\n<p><span style=\"\"><a href=\"https:\/\/www.arkleg.state.ar.us\/Bills\/Detail?id=hb1570&amp;ddBienniumSession=2021%2F2021R&amp;Search=\">House Bill 1570<\/a>, now Act 626, the \u201cSave Adolescents From Experimentation (SAFE) Act,\u201d prohibits physicians and other professionals from providing gender-affirming health care to patients under the age of 18. Sponsored by state Rep. Robin Lundstrom (R-Elm Springs), it passed the House on March 10 and the Senate on March 29, both by large majorities. <a href=\"https:\/\/www.cnn.com\/videos\/politics\/2021\/04\/05\/arkansas-gov-asa-hutchinson-veto-transgender-health-care-bill-1570-sot-vpx.cnn\">Gov. Asa Hutchinson vetoed the bill on April 5<\/a>, calling it a \u201cvast government overreach,\u201d but the legislature overrode his veto the next day. It could go into effect as soon as July 28.<\/span><\/p>\n<p><span style=\"\">The law, which is the first of its kind in the country, will ban Arkansas health care providers from prescribing cross-sex hormones for trans people under 18, including estrogen for patients transitioning from male to female and testosterone for patients transitioning from female to male. The law prohibits doctors from prescribing puberty-blocking drugs as part of a gender-affirming regimen. And, it prevents doctors from referring patients to other providers, though doctors say it is unclear whether that ban would include referrals for counseling and mental health care related to gender dysphoria. (The bill also bans gender reassignment surgeries for minors, but doctors who work with trans youth say such operations aren\u2019t performed on patients under 18 anywhere in Arkansas.)<\/span><\/p>\n<p><span style=\"\">On May 25, the American Civil Liberties Union <a href=\"http:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/brandt_et_al_v_rutledge_et_al_-_complaint.pdf\" target=\"_blank\" rel=\"noopener\">filed a lawsuit in federal court<\/a> seeking to block the measure from taking effect. Holly Dickson, the executive director of the ACLU of Arkansas, <a href=\"http:\/\/\u2018Kids feel like they\u2019re being erased\u2019: Inside the clinic targeted by Arkansas\u2019s new anti-trans law\">said in a press release<\/a> that the bill would be \u201cdevastating to transgender youth and their families, forcing many to uproot their lives and leave the state to access the gender-affirming care they need.\u201d<\/span><\/p>\n<p><span style=\"\">One provider in particular is in the crosshairs of the new ban: The Gender Spectrum Clinic at Arkansas Children\u2019s Hospital. Dr. Michele Hutchison, a pediatric endocrinologist who helped found the clinic in 2018 and is a plaintiff in the lawsuit, said the \u201cvast majority\u201d of trans children in Arkansas receiving medical care to help affirm their gender identities are doing so at the Gender Spectrum Clinic. After years of building a health care practice that caters to the unique needs of Arkansas\u2019s trans youth, much of Hutchison\u2019s work may soon be deemed illegal.<\/span><\/p>\n<p><span style=\"\">The clinic\u2019s fate is unclear if the court declines to block the new law, and Arkansas Children\u2019s Hospital has avoided commenting on its future. \u201cWhile Arkansas Children\u2019s is not party to this litigation, our patients and families continue to seek care and we will continue to provide allowable services,\u201d said Brent Thompson, executive vice president and chief legal officer for the hospital, in an emailed statement.<\/span><\/p>\n<p><span style=\"\">Hutchison said that if the law goes into effect, some clinic employees could lose their jobs. Hutchison herself would still be employed, she said, because she also works at the Endocrine Clinic and the Diabetes Clinic at Children\u2019s. But, she said, it would be a devastating blow.<\/span><\/p>\n<p><span style=\"\">\u201cOn an emotional level, it would just take the gas right out of me,\u201d she said. \u201cI don\u2019t know how I could keep running. I\u2019d still have a job, I\u2019d still have a paycheck, but I\u2019d be pretty miserable.\u201d<\/span> <span style=\"\">Hutchison emphasized that she was speaking as a private citizen and concerned physician, not as a representative of Children\u2019s.\u00a0<\/span><\/p>\n<p><span style=\"\">Andrew Bostad, 15, is one patient of the Gender Spectrum Clinic who could lose access to treatment should the law stand. He said the legislation sends a dangerous message to him and his peers.<\/span><\/p>\n<p><span style=\"\">\u201cTrans teens are [at] very high risk for suicide, so this legislation is just basically telling people like me that they don\u2019t want them to exist,\u201d he said. \u201cThey\u2019re not helping anyone with these bills. They\u2019re killing kids.\u201d<\/span><\/p>\n<p><span style=\"\">Hutchison said that in the three years the Gender Spectrum Clinic has been open, before passage of the bill, two or three patients had attempted suicide. Since early April, she said, staff have been alerted to seven attempted suicides, four by patients of the clinic. (The other three were trans children who were not patients but were treated at the emergency room at Children\u2019s.) Dr. Stephanie Ho, a family medicine physician and a Fellow with Physicians for Reproductive Health at Vector Health and Wellness Clinic in Fayetteville, is one of the few other providers in Arkansas to administer cross-sex hormones to patients under 18. She said one of her patients has also attempted suicide.<\/span><\/p>\n<p><span style=\"\">Andrew\u2019s mother, Brandi Evans, said Andrew came out as trans when he was 12 years old. She learned about the clinic through a support group for parents of trans children, then got a referral from her son\u2019s primary care provider. Andrew started going to the clinic shortly after he came out and began taking testosterone injections at age 14.\u00a0<\/span><\/p>\n<p><span style=\"\">Evans said that when she found out about HB 1570, \u201cto say I was livid would be an understatement.\u201d<\/span><\/p>\n<p><span style=\"\">\u201cNot only are they taking these kids\u2019 right to have affirming health care away from them, which is detrimental in and of itself, but they\u2019re telling me as a parent that I no longer have control over my child\u2019s medical care,\u201d Evans said.<\/span><\/p>\n<p><span style=\"\">Willow Breshears, 18, began transitioning when she was 13 years old. She works as a community organizer and founded the <a href=\"https:\/\/www.facebook.com\/youngtranswomensproject\">Young Transwomen\u2019s Project<\/a>, which provides resources for Arkansas trans women and girls between the ages of 16 and 28. She said the new law will have a profoundly detrimental impact on trans children.<\/span><\/p>\n<p><span style=\"\">\u201cJust imagine if you got something that you wanted so bad \u2014 something that was so life-changing for you \u2014 and then all of a sudden that was taken away,\u201d Breshears said. \u201cHow would you feel?\u201d\u00a0<\/span><\/p>\n<p><b>Expectation management and family-conscious care<\/b><\/p>\n<p><span style=\"\">Though debate around health care for trans youth has focused on hormone therapy and puberty-blocking drugs, Hutchison said the Gender Spectrum Clinic does far more than simply provide medications. The clinic is \u201cholistic,\u201d she said, \u201cin the sense that we can\u2019t work with just the child: It has to involve the entire family.\u201d\u00a0<\/span><\/p>\n<p><span style=\"\">\u201cA lot of what we do is expectation management, both for the parents and for the kids,\u201d Hutchison said. \u201cA lot of these teenagers come hoping that they\u2019re going to get their cross-sex hormones on the very first visit, and that\u2019s not going to happen.\u201d<\/span><\/p>\n<p><span style=\"\">Before a patient visits the Gender Spectrum Clinic for the first time, the clinic\u2019s social worker will interview the patient by phone, Hutchison said, primarily to gauge whether the child is \u201cactively suicidal\u201d and needs to be connected with appropriate mental health resources. The interview also helps the clinic better understand the child\u2019s family environment.<\/span><\/p>\n<p><span style=\"\">\u201cFor example, maybe mom is accepting and affirming, but dad is not. Well, we need to know that ahead of time,\u201d Hutchison said. \u201cIs this child living with their grandmother, but mom has custodial rights?\u201d<\/span><\/p>\n<figure id=\"attachment_22817\" aria-describedby=\"caption-attachment-22817\" style=\"width: 640px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-22817\" src=\"http:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Hutchison-3-edit-1170x731.jpeg\" alt=\"\" width=\"640\" height=\"400\" srcset=\"https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Hutchison-3-edit-1170x731.jpeg 1170w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Hutchison-3-edit-700x438.jpeg 700w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Hutchison-3-edit-768x480.jpeg 768w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Hutchison-3-edit.jpeg 1440w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption id=\"caption-attachment-22817\" class=\"wp-caption-text\">DOCTOR AND PLAINTIFF: Much of Dr. Michele Hutchison's work at the Gender Spectrum Clinic could be banned under the new law (Credit: Matt White)<\/figcaption><\/figure>\n<p><span style=\"\">Hutchison said part of the clinic\u2019s role is to help families with the often difficult task of adjusting to a child\u2019s transition.<\/span><\/p>\n<p><span style=\"\">\u201cThe best way that I\u2019ve tried to reach out to some parents who are struggling \u2026 is to say, \u2018Imagine if you woke up in someone else\u2019s body. \u2026 And nobody saw you. Nobody recognized you. Your wife doesn\u2019t recognize you, your boss doesn\u2019t recognize you, people on the street don\u2019t recognize you, or they see you as somebody else. How terrifying would that be?\u2019\u201d she said.<\/span><\/p>\n<p><span style=\"\">\u201cAll these kids want is to be seen as who they are,\u201d she said. \u201cAnd they have to live that every single day.\u201d<\/span><\/p>\n<p><span style=\"\">Brandi Evans said Hutchison is a \u201cvery hands-on\u201d doctor who wants her patients and their families to \u201cunderstand the entire process.\u201d<\/span><\/p>\n<p><span style=\"\">\u201cShe wants everyone involved to know what her expectations are [and] what our expectations should be,\u201d Evans said. \u201cWe shouldn\u2019t have these grandiose expectations of, \u2018He\u2019s gonna take one [testosterone] shot, his voice is going to drop and he\u2019s going to grow a full beard.\u2019 \u201d<\/span><\/p>\n<p><span style=\"\">In addition to the social worker, the team at the clinic includes nurses, a gynecologist and other doctors, a psychologist, a chaplain and an attorney. Hutchison said the attorney may help with a variety of legal matters, from name changes to parental custody issues to situations in which a child\u2019s school refuses to let them use the appropriate bathroom.<\/span><\/p>\n<p><span style=\"\">Other medical providers say the expert guidance provided by the Gender Spectrum Clinic is a vital resource. Dr. Natalie Burr, a pediatrician with the Little Rock Pediatric Clinic, said she refers her transgender patients to Hutchison and her team, rather than prescribing them medication herself. Being prohibited from doing so, she said, \u201creally ties my hands.\u201d<\/span><\/p>\n<p><span style=\"\">\u201cTo me, this is just in opposition to the Hippocratic Oath that I take,\u201d she said. \u201cI really and truly never imagined that it would be illegal for me to refer a patient to care that is evidence-based.\u201d<\/span><\/p>\n<p><span style=\"\">In her four years of practice at the Little Rock Pediatric Clinic, Burr said, she has learned that trans children \u201care still kids [who] need to be supported just like any other kid.\u201d<\/span><\/p>\n<p><span style=\"\">\u201c[Trans children] still might get strep throat like a lot of the other kids do. They have those common childhood concerns that you see, just as they have their unique concerns,\u201d Burr said. \u201cAcceptance and respect for who they are as people goes a long way. I may not be the one prescribing gender-affirming medications, but just using a correct pronoun or name means so much to them.\u201d<\/span><\/p>\n<p><b>\u2018Like switching on a light\u2019<\/b><\/p>\n<p><span style=\"\">Proponents of the new law claim it is intended to protect kids. When presenting the bill on the floor of the state House of Representatives in March, Rep. Lundstrum said minors shouldn\u2019t be able to receive hormone treatment, even with parental consent.\u00a0<\/span><\/p>\n<p><span style=\"\">\u201cSome of them may choose to be transgender when they\u2019re older,\u201d Lundstrum said. \u201cThat\u2019s okay, that\u2019s their choice. But when they\u2019re under 18, they need to grow up first. That\u2019s a big decision. There\u2019s no going back.\u201d (Lundstrum did not respond to repeated requests for comment for this story.)<\/span><\/p>\n<p><span style=\"\">But the Gender Spectrum Clinic extensively vets patients before beginning medication, Hutchison said. The clinic requires patients to be 14 years old before they begin cross-sex hormones. Hutchison said the clinic also requires that a patient see a therapist for at least six months before they\u2019re considered for hormones.<\/span><\/p>\n<p><span style=\"\">According to Hutchison, around 50 patients at the Gender Spectrum Clinic are taking cross-sex hormones and would be forced to stop (or go out of state for care) if the new law goes into effect. She said 40 more patients are \u201cin the pipeline\u201d to begin hormones within the next year, and around 30 patients are waiting to be seen at the clinic.<\/span><\/p>\n<p><span style=\"\">The clinic also sees a number of patients who are too young to begin cross-sex hormones, as well as patients with mental or emotional issues that must be addressed before starting treatment. For example, Hutchison said she recently learned that a patient who was preparing to begin hormones has an eating disorder, so the clinic will work on helping the patient address that problem before starting hormones.\u00a0<\/span><\/p>\n<p><span style=\"\">Patients\u2019 mental and emotional health often improve further once hormone treatments begin. After Andrew began puberty and before he started taking testosterone injections, Evans said, her son was a \u201cclosed off, very angry, depressed child.\u201d<\/span><\/p>\n<p><span style=\"\">\u201cHis brain this whole time is saying \u2018I\u2019m a boy, I\u2019m a boy,\u2019 but he\u2019s getting this flood of estrogen that makes him [feel] \u2018no, this isn\u2019t right, I don\u2019t like it,\u2019 so it just really shut him down,\u201d Evans said. \u201cHe just wanted to stay in his room. He didn\u2019t want to talk to anybody; he was just mad at the world.\u201d\u00a0<\/span><\/p>\n<p><span style=\"\">Evans said that Andrew would literally faint every time he started his menstrual cycle. She took him to see neurologists and gynecologists to determine why he was losing consciousness every time he got his period. But once Andrew came out as trans, she said, \u201cthe passing out made sense, because this wasn\u2019t supposed to be happening.\u201d\u00a0<\/span><\/p>\n<p><span style=\"\">Andrew has now been taking testosterone for almost two years. Evans said that a couple of months after he began treatment, \u201cI started to see [my] happy-go-lucky kid come back.\u201d<\/span><\/p>\n<p><span style=\"\">\u201cHe was talking to us, he wanted to go out and do things, he wanted to hang out with friends again,\u201d Evans said. \u201cAll of the things [that make you say], \u2018Right there, that\u2019s the kid I remember.\u2019\u201d<\/span><\/p>\n<figure id=\"attachment_22818\" aria-describedby=\"caption-attachment-22818\" style=\"width: 640px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-22818\" src=\"http:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-2-edit-1000x1000.jpeg\" alt=\"\" width=\"640\" height=\"640\" srcset=\"https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-2-edit-1000x1000.jpeg 1000w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-2-edit-700x700.jpeg 700w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-2-edit-150x150.jpeg 150w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-2-edit-768x768.jpeg 768w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-2-edit.jpeg 1281w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption id=\"caption-attachment-22818\" class=\"wp-caption-text\">Brandi Evans and Andrew at their home in Bauxite (Credit: Matt White)<\/figcaption><\/figure>\n<p><span style=\"\">Andrew said his testosterone injections have helped him \u201cpass,\u201d or be perceived as his affirmed gender.<\/span><\/p>\n<p><span style=\"\">\u201cChanges really started a couple months in,\u201d he said. \u201cMy voice started to drop, my skin got oilier, [I got] body hair everywhere. I used to not pass at all, previously to starting testosterone, and now I pass all of the time. It\u2019s pretty liberating.\u201d<\/span><\/p>\n<p><span style=\"\">Andrew said the new friendships he\u2019s made during his transition have been an important part of the process.\u00a0<\/span><\/p>\n<p><span style=\"\">\u201cI\u2019m not friends with the same people I was friends with when I first started testosterone,\u201d he said. \u201cBut meeting new people who are more supportive and more like me is probably the best thing that has happened.\u201d<\/span><\/p>\n<p><span style=\"\">Ho, the Fayetteville doctor, said she sees about a dozen minor trans patients, nine of whom are taking cross-sex hormones.<\/span><\/p>\n<p><span style=\"\">The change in behavior and emotional well-being for trans youth after beginning cross-sex hormones can be profound, she said. \u201cIt\u2019s like switching on a light,\u201d Ho said.<\/span><\/p>\n<p><span style=\"\">Hutchison said the new law makes inaccurate claims about the risks of puberty blockers. HB 1570 states that doctors are prescribing puberty blockers \u201cdespite the lack of any long-term longitudinal studies evaluating the risks and benefits of using these drugs,\u201d but Hutchison said such medications have been routinely used in pediatric practices for the last 40 years. Puberty blockers are regularly prescribed to children who are not trans but are experiencing early puberty, she said, and the effects are \u201ccompletely reversible.\u201d<\/span><\/p>\n<p><span style=\"\">For example, a pediatrician may prescribe a puberty-blocking drug to a young girl who has begun to go into puberty and is poised to start menstruation at the age of five, Hutchison said.\u00a0<\/span><\/p>\n<p><span style=\"\">She said that within one week at the Endocrine Clinic at Arkansas Children\u2019s Hospital, she saw four children taking puberty blockers and diagnosed a fifth patient with early puberty, who will soon start taking the drugs. She added that the Endocrine Clinic follows between 150 to 200 patients with early puberty.<\/span><\/p>\n<p><span style=\"\">For trans youth, puberty blockers serve a different purpose. For a child with gender dysphoria, puberty can be a jarring experience, as their body changes in ways that don\u2019t feel aligned with their gender identity. Taking puberty blockers can, according to Burr, provide a young trans patient with \u201ctime to work through their gender identity.\u201d<\/span><\/p>\n<p><span style=\"\">If a patient stops taking a puberty blocker and does not start taking a cross-sex hormone afterwards, that patient will go through puberty in accordance with the sex they were assigned at birth.\u00a0<\/span><\/p>\n<p><span style=\"\">Hutchison said the Gender Spectrum Clinic currently has only two or three patients taking puberty blockers. Most patients are already well into puberty by the time they\u2019re seen at the clinic, she said. Hutchison also said puberty blockers are \u201cprohibitively expensive\u201d \u2014 costing around $20,000 per year out of pocket \u2014 and the use of such medication for gender-affirming purposes is usually not covered by insurance. Even when a young child in the Endocrine Clinic is prescribed puberty blockers, \u201cwe really have to prove that the child is in early puberty for the insurance to pay for it,\u201d Hutchison added.<\/span><\/p>\n<p><span style=\"\">(Ho said she does not prescribe puberty blockers for her trans patients and refers families who are interested in the medication to the Gender Spectrum Clinic.)<\/span><\/p>\n<p><span style=\"\">\u201cIn terms of numbers, epidemiologically, the [puberty blockers] prohibition doesn\u2019t affect a large number of children,\u201d Hutchison said. \u201cBut, it has a dramatic effect on those individual children.\u201d\u00a0<\/span><\/p>\n<p><span style=\"\">The new law also prohibits \u201cgenital and nongenital\u201d gender reassignment surgery for minors, but Hutchison said genital gender reassignment surgery is not performed on any patients under the age of 18 in the state of Arkansas. Hutchison said she would support legislation that prohibited genital reassignment surgery on minors.<\/span><\/p>\n<p><span style=\"\">Should HB 1570 go into effect, Hutchison predicted the prohibition on doctors referring young people to other providers for gender-affirming care would cause a great deal of confusion. Though the law would not prohibit psychological counseling for minor trans patients, Hutchison said pediatricians have been left confused about whether referring a minor patient to a therapist might be considered a \u201cgender transition procedure.\u201d <\/span><span style=\"\"><br \/>\n<\/span><span style=\"\"><br \/>\n<\/span><span style=\"\">\u201cWhat\u2019s the difference between a referral versus just giving somebody information? That\u2019s one of the things that I have asked for some guidance on,\u201d Hutchison said.<\/span><\/p>\n<p><span style=\"\">According to Burr and Hutchison, trans youth experience high rates of anxiety and depression because of the cultural stigma associated with being gender nonconforming and the emotional pain of experiencing gender dysphoria. Evans said the new law will further this stigma and have devastating consequences.\u00a0<\/span><\/p>\n<p><span style=\"\">\u201cThis isn\u2019t just costing health care providers. This isn\u2019t just costing affirming care. This is costing lives,\u201d Evans said. \u201cThese kids are losing hope.\u201d<\/span><\/p>\n<figure id=\"attachment_22820\" aria-describedby=\"caption-attachment-22820\" style=\"width: 960px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-22820\" src=\"http:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Chilson-rally-1.jpeg\" alt=\"\" width=\"960\" height=\"640\" srcset=\"https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Chilson-rally-1.jpeg 960w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Chilson-rally-1-700x467.jpeg 700w, https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Chilson-rally-1-768x512.jpeg 768w\" sizes=\"auto, (max-width: 960px) 100vw, 960px\" \/><figcaption id=\"caption-attachment-22820\" class=\"wp-caption-text\">Protestors rallied against HB 1570 at the state Capitol in March (Credit: Brian Chilson)<\/figcaption><\/figure>\n<p><b>An uncertain future<\/b><\/p>\n<p><span style=\"\">The ACLU lawsuit argues the new Arkansas law abridges the constitutional rights of doctors, patients and their parents in several ways. The plaintiffs contend the law discriminates against transgender people, violating the equal protection clause of the 14th Amendment. The plaintiffs also claim it violates the rights of parents to make decisions concerning the care of their children, as guaranteed by the 14th Amendment\u2019s due process clause. And, the plaintiffs contend the new law violates the First Amendment\u2019s guarantee of freedom of speech by prohibiting doctors from making referrals and preventing patients and their families from hearing those recommendations.<\/span><\/p>\n<p><span style=\"\">Even if the court declines to block the law, much remains uncertain about how it will be implemented. For example, the law says any health care provider who refers a minor trans patient for \u201cgender transition procedures\u201d would be \u201csubject to discipline by the appropriate licensing entity or disciplinary review board.\u201d But Hutchison said she and other doctors are unclear as to how they would be sanctioned if they violated the law.<\/span><\/p>\n<p><span style=\"\">The <\/span><a href=\"https:\/\/www.armedicalboard.org\/Professionals\/pdf\/mpa.pdf\"><span style=\"\">Arkansas Medical Practices Act<\/span><\/a><span style=\"\"> states that physicians who are found guilty of \u201cunprofessional conduct\u201d \u2014 the definition of which ranges from conviction of a felony to committing an \u201cethical violation\u201d as determined by the Arkansas State Medical Board \u2014 may have their medical license revoked or suspended, be issued a reprimand, be placed on probation, or have to pay a fine of up to $1,000 per violation.<\/span><\/p>\n<p><span style=\"\">The medical board, which is responsible for licensing and disciplining physicians, may need to establish rules to enforce the law and flesh out its details. Meg Mirivel, a spokeswoman for the state Department of Health, said the medical board is still determining whether and how they would craft new rules to implement the legislation.<\/span><\/p>\n<p><span style=\"\">Regardless of what the courts decide, advocates for transgender youth said they will continue to speak out against the ban on gender-affirming care.<\/span><\/p>\n<p><span style=\"\">\u201c[Arkansas legislators] are politicians. They\u2019re not medical doctors,\u201d Ho said. \u201cThere have been medical doctors all over the state and all over this country who have adamantly opposed [this] ban.\u201d<\/span><\/p>\n<p><span style=\"\">\u201cIt\u2019s incredibly rewarding to take care of these kids, and I can\u2019t imagine why anybody would want to take away their care or to bully them,\u201d Ho said.<\/span><\/p>\n<p><span style=\"\">Should the law take effect, Hutchison suspects some patients will find their medications on the black market and take them without the oversight of a physician.\u00a0<\/span><\/p>\n<p><span style=\"\">That could be dangerous, she warned. The Gender Spectrum Clinic conducts a blood test before any patient begins cross-sex hormones to check liver function, cholesterol levels, blood counts and other metrics. Hutchison then monitors her patients\u2019 body functions throughout their hormone therapy.\u00a0<\/span><\/p>\n<p><span style=\"\">\u201cThe fear is that if a child were to have an unexpected event and nobody was there to catch it, you could then go on to develop liver disease or a stroke,\u201d Hutchison said. \u201cThe [other] concern is that if you have a child who\u2019s taking a higher dose than they should \u2026 that\u2019s going to give them problems, and nobody is there to regulate it or give advice.\u201d<\/span><\/p>\n<p><span style=\"\">Nonetheless, she said, \u201cit would be very naive to think that these incredibly resourceful and intelligent children are simply going to stop taking their medication because the legislature tells them to.\u201d\u00a0<\/span><\/p>\n<p><span style=\"\">\u201dKeep in mind that this is not kids sneaking around to buy illicit drugs,\u201d Hutchison added. \u201cThese are kids whose parents have already agreed with the therapy and support it, so this is a situation where the parents are going to go find a way for them to get their testosterone or estrogen.\u201d<\/span><\/p>\n<p><span style=\"\">Evans said she\u2019s spoken with other parents of trans children about what their options will be if the law goes into effect. They\u2019ve discussed going across state lines to access gender-affirming care, or even reaching out internationally, as telehealth options have expanded during the pandemic. They would also have to find an out-of-state pharmacy to mail them any medications, as in-state pharmacies would be prohibited from filling the prescriptions.<\/span><\/p>\n<p><span style=\"\">\u201cThere would be the expense of traveling, the expense of prescription costs out of state, and we would have to pay the doctors\u2019 offices out-of-pocket because his in-state insurance won\u2019t pay for it,\u201d Evans said. \u201cIt just would be a tremendous financial burden on everybody that is in this position.\u201d<\/span><\/p>\n<p><span style=\"\">Other families may leave Arkansas altogether. Hutchison said the families of at least twenty of her patients have called to ask which state they should move to in order to access care, and two families have already moved.\u00a0<\/span><\/p>\n<p><span style=\"\">\u201c[Parents are] saying they\u2019re leaving because they don\u2019t want to live somewhere where their child is not accepted,\u201d Hutchison said. \u201cIt\u2019s a lot more basic than just getting medication: It\u2019s this feeling of, \u2018I\u2019m not wanted here, my child\u2019s not wanted here, so we\u2019re going to go somewhere where my child can feel wanted, accepted and loved.\u2019\u201d<\/span><\/p>\n<p><span style=\"\">\u201c[These] kids feel like they\u2019re being erased; that\u2019s a word that keeps coming up,\u201d Hutchison said. \u201cThe patients feel as if society is trying to erase them, trying to make it as if they don\u2019t even exist. As an adult, I think that would be a tragic situation to have to encounter \u2026 So imagine being a teenager and feeling that way.\u201d<\/span><\/p>\n<p><span style=\"\">Evans said she wants to emphasize that Andrew, who is a sophomore at Bauxite High School, is, above all else, a typical teenage boy.<\/span><\/p>\n<p><span style=\"\">\u201cWhile he is a trans person, that is just a label or a box they want to put my child in,\u201d Evans said. \u201cHe has friends, he plays in the band, he does theater, he makes good grades. Outside of being transgender, [he] is a typical teenage boy who just wants to live his life.\u201d\u00a0<\/span><\/p>\n<p><i><span style=\"\">This story is courtesy of <\/span><\/i><a href=\"http:\/\/arknews.org\/\"><i><span style=\"\">the Arkansas Nonprofit News Network<\/span><\/i><\/a><i><span style=\"\">, an independent, nonpartisan news project dedicated to producing journalism that matters to Arkansans.<\/span><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A new state law puts Arkansas doctors who work with transgender youth in a difficult bind: They must either stop providing what they consider to be life-saving medication to their young patients or risk losing their medical license. House Bill 1570, now Act 626, the \u201cSave Adolescents From Experimentation (SAFE) Act,\u201d prohibits physicians and other [&hellip;]<\/p>\n","protected":false},"author":37,"featured_media":22816,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[111],"tags":[362,361,365,360,69,363,364],"class_list":["post-22814","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-care","tag-andrew-bostad","tag-brandi-evans","tag-lgbtq-rights","tag-michele-hutchison","tag-robin-lundstrum","tag-stephanie-ho","tag-transgender-rights"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v17.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u2018Kids feel like they\u2019re being erased\u2019: Inside the clinic targeted by Arkansas\u2019s new anti-trans law - Arkansas Nonprofit News Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/arknews.org\/index.php\/2021\/06\/09\/kids-feel-like-theyre-being-erased-inside-the-clinic-targeted-by-arkansass-new-anti-trans-law\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u2018Kids feel like they\u2019re being erased\u2019: Inside the clinic targeted by Arkansas\u2019s new anti-trans law - Arkansas Nonprofit News Network\" \/>\n<meta property=\"og:description\" content=\"A new state law puts Arkansas doctors who work with transgender youth in a difficult bind: They must either stop providing what they consider to be life-saving medication to their young patients or risk losing their medical license. House Bill 1570, now Act 626, the \u201cSave Adolescents From Experimentation (SAFE) Act,\u201d prohibits physicians and other [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/arknews.org\/index.php\/2021\/06\/09\/kids-feel-like-theyre-being-erased-inside-the-clinic-targeted-by-arkansass-new-anti-trans-law\/\" \/>\n<meta property=\"og:site_name\" content=\"Arkansas Nonprofit News Network\" \/>\n<meta property=\"article:published_time\" content=\"2021-06-09T18:20:24+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-06-09T21:24:16+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-edit.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"1440\" \/>\n\t<meta property=\"og:image:height\" content=\"900\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Rebekah Hall Scott\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"19 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Organization\",\"@id\":\"https:\/\/arknews.org\/#organization\",\"name\":\"Arkansas Nonprofit News Network\",\"url\":\"https:\/\/arknews.org\/\",\"sameAs\":[],\"logo\":{\"@type\":\"ImageObject\",\"@id\":\"https:\/\/arknews.org\/#logo\",\"inLanguage\":\"en-US\",\"url\":\"https:\/\/arknews.org\/wp-content\/uploads\/2021\/04\/annn_logo.png\",\"contentUrl\":\"https:\/\/arknews.org\/wp-content\/uploads\/2021\/04\/annn_logo.png\",\"width\":1200,\"height\":900,\"caption\":\"Arkansas Nonprofit News Network\"},\"image\":{\"@id\":\"https:\/\/arknews.org\/#logo\"}},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/arknews.org\/#website\",\"url\":\"https:\/\/arknews.org\/\",\"name\":\"Arkansas Nonprofit News Network\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/arknews.org\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/arknews.org\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"ImageObject\",\"@id\":\"https:\/\/arknews.org\/index.php\/2021\/06\/09\/kids-feel-like-theyre-being-erased-inside-the-clinic-targeted-by-arkansass-new-anti-trans-law\/#primaryimage\",\"inLanguage\":\"en-US\",\"url\":\"https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-edit.jpeg\",\"contentUrl\":\"https:\/\/arknews.org\/wp-content\/uploads\/2021\/06\/Andrew-Bostad-and-Brandi-Evans-edit.jpeg\",\"width\":1440,\"height\":900,\"caption\":\"WAITING: Brandi Evans and her son, Andrew Bostad, are among the many families anxiously awaiting a federal court ruling on whether the new law will be enjoined (Credit: Matt White)\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/arknews.org\/index.php\/2021\/06\/09\/kids-feel-like-theyre-being-erased-inside-the-clinic-targeted-by-arkansass-new-anti-trans-law\/#webpage\",\"url\":\"https:\/\/arknews.org\/index.php\/2021\/06\/09\/kids-feel-like-theyre-being-erased-inside-the-clinic-targeted-by-arkansass-new-anti-trans-law\/\",\"name\":\"\\u2018Kids feel like they\\u2019re being erased\\u2019: Inside the clinic targeted by Arkansas\\u2019s new anti-trans law - 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