In Arkansas, trans teens await an uncertain future

FAYETTEVILLE, Ark. – For years, Zara Banks had been looking forward to her 14th birthday – the moment, last June, when her life would no longer be on pause.

Ever since Zara, a transgender girl, turned 8, she’s been sure she wants to grow up to be a woman. After conversations with her parents and sessions with a therapist, she began a social transition: she changed her name to Zara and her pronouns to her. At the age of 9, she began treatment with puberty blockers, drugs that would put her physiological development in limbo until she was old enough – 14 according to her doctor – to start a estrogen therapy and developing a female body.

But last spring, Arkansas enacted a law, the first of its kind in the country, prohibiting doctors from administering hormones or puberty blockers to transgender people under the age of 18. The bill, titled the Save Adolescents from Experimentation (SAFE) Act, overruled a veto by Gov. Asa Hutchinson and was set to take effect July 28, about a month after Zara’s birthday. It is now on hiatus due to a legal challenge from the American Civil Liberties Union.

Zara was able to get hormones during the trial, but worries about what the future holds. “I was really happy, after finally waiting so long, to get something that I needed for a very long time,” she said, sitting in her suburban garden with her parents, Jasmine and Mo Banks. , amid the buzz of cicadas.

In recent years, an increasing number of American teenagers have come out as transgender and have sought medical care to better align their bodies with their gender identity. Even as the medical community debates how best to provide this care, states across the country have introduced legislation banning it outright; medical groups have condemned these laws as dangerous.

Major medical associations, including the Endocrine Society and the American Academy of Pediatrics, recommend that this care be made available to patients under the age of 18. Yet clinicians remain divided on best practices. Last month, an international group of experts focused on transgender health published draft new care guidelines recommending a more cautious stance towards minors, who generally cannot give full legal consent until the age of 18.

Puberty blockers and hormone therapy, the two treatments primarily given to minors, are most effective around age 8 to 14, as they can prevent the need for future surgeries in adulthood; for example, a transgender boy who took puberty blockers might not need a mastectomy later. Drug treatments carry risks, including slowed bone growth and loss of fertility, but evidence suggests that denying care to adolescents who need it increases the risk of depression and suicide.

The push to ban such care altogether grew last year as Republicans across the country embraced the issue. Arkansas and Tennessee are the only states to have passed such laws — Tennessee has banned gender-affirming care for children who have not yet reached puberty, a population that currently does not receive such care — and 19 other states have considered them, according to the Williams Institute at UCLA Law School.

If confirmed, Arkansas law would also prohibit doctors from referring patients to other healthcare professionals for medications or surgeries as part of gender-affirming care, even outside of the State. Any physician providing such care could lose their license or face civil action. The law would also allow private insurers to deny coverage for such care to transgender patients of all ages.

A week before the law took effect, however, it was temporarily blocked by a federal judge in response to the ACLU’s legal challenge. The trial is scheduled for July. Transgender adolescents and their families now live in uncertainty.

“It’s pretty excruciating as a parent to be told by the state that it will become illegal to give your child what she needs to exist,” Jasmine Banks said.

Zara added: “It’s not the decision of others who I am and what I’m not.”

A year on the defensive

Sabrina Jennen, 16, who lives in Fayetteville, pondered ghosts – whether they exist and what it would be like to encounter one.

“People are a lot scarier than ghosts,” she said on a windy day in Gulley Park, a sloping green space near her neighborhood.

Transgender adolescents are typically prescribed gender-affirming hormones after undergoing mental health assessments and exhibiting persistent distress due to the disconnect between their body and their gender identity.

Sabrina came out to her family in July 2020 at the age of 15. She saw a therapist, was diagnosed with gender dysphoria, and had many conversations with her parents, Lacey and Aaron Jennen. Last January, she felt ready to start hormone therapy. Then the SAFE law was passed.

“I felt like my life was undone,” Sabrina said. She lay awake at night imagining her future. “If this fell into place, it would truly be Sabrina’s death,” she said. “I couldn’t live and be myself.”

When the bill passed, her parents asked her if she wanted to be a plaintiff in the ACLU lawsuit. She did it. “If it’s not me, it will be someone else,” she said. “And if it’s not someone else, it won’t be anyone.”

In March 2021, Representative Robin Lundstrum, one of the bill’s sponsors, compared gender-affirming surgery to “mutilation” during a committee hearing on the bill. Representative Alan Clark, another of the bill’s sponsors, described hormone therapies as “experimental.” (Ms. Lundstrum and Mr. Clark did not respond to numerous interview requests.)

(The latest suggested standards of care recommend 15 as the minimum age for thoracic surgery and 17 for genital surgery, with each patient’s case considered individually. No physicians in Arkansas currently perform affirmation surgery. gender on minors.)

Dylan Brandt, 16, of Greenwood, is another complainant. He and his mother, Joanna Brandt, were at the State House during a hearing on the bill.

“It was hard to listen to because they were still saying horrible things about me and so many other people,” he said.

Dr. Michele Hutchison, a pediatric endocrinologist who treats transgender teens in Arkansas, was one of several medical experts who testified against the bill. She told lawmakers that several of her young patients attempted suicide after learning about the bill.

Ms Brandt, who also spoke at the hearing, described the experience as “heartbreaking”. Dylan stood behind her; while she was testifying, Ms. Lundstrum approached and began talking to her, he said.

“She looked me in the eye and shook my hand, and then 10 minutes later the House voted to strip me of my rights,” Dylan said. “We’re kids just trying to live our lives, and they’re trying to make it harder, and I don’t quite understand.”

Better and better

Last spring, the Reverend Clint Schnekloth, pastor of the Good Shepherd Lutheran Church in Fayetteville, began hearing from young members of the congregation who feared what the SAFE law might bring. Several parents of gender non-conforming children reached out.

“One of the families said, ‘My child has suicidal ideation stemming from anxiety about these laws,'” Pastor Schnekloth said. “So I thought, what can we do?”

He launched Queer Camp, welcoming 86 children for a week in July. It offered camp activities involving birds, bugs and sports, as well as a name change clinic and a “transition closet”, where children could donate clothes that no longer matched their gender presentation and choosing new outfits, said Conner Newsome Doyle, the camp director. .

Sabrina, who attended camp, picked out a black prom dress from the closet. She recalled that the camp was the first time she was around queer and transgender people her age. “It was definitely safe,” she said.

At school in Greenwood, Dylan said he was bullied so much that he eventually left and spent several years home schooling. Last fall, he returned with great anxiety.

“I walked into the building for the open house and I just felt like I couldn’t breathe,” he said.

But things were different this time. One day in art class, he recalls, a classmate said something transphobic to him, and a girl at the back of the class chimed in. “I don’t know who she is, but she threw herself at him,” he said.

During Pride weekend last summer in Fayetteville, Zara spoke out against the bill in front of hundreds of people at Arkansas’ first Trans March. She practiced her lines at home and in the car ride there. “I don’t like public speaking normally,” Zara said. “It’s just the fact of, like, the state we’re in right now.”

The upcoming trials

Some Arkansas families have considered leaving the state to ensure their children will have access to gender-affirming health care. Last summer, George and Emily Spurrier, who lived in the state for 16 years, moved to New Mexico to ensure their 17-year-old son Cas would be able to continue hormone therapy. In August, Camille and Homero Rey moved in with their young transgender son, Leon, from Texas – who considered, but did not pass, a bill that would have classified gender-affirming care for minors as child abuse. children – in Maryland.

For other families, moving is not an option.

Zara’s parents grew up in the South and run a mutual aid organization that distributes funds to those in need in Arkansas, including caregivers and parents of transgender children. “My family doesn’t have a lot of money,” said non-binary Mo Banks. “We can’t leave the state.”

Zara would like to leave; as a black transgender girl, she is disproportionately vulnerable to violence and discrimination. When she sees media coverage of transgender teens, she sees white children whose experience is fundamentally different from hers. Given how hard these teens are struggling to be accepted, she wondered, “What hope do we have for black trans kids?”

She dreams of moving to a more tolerant place after high school. “I know one thing,” she said. “That when I can, I won’t be here anymore.