Texas bill would ban nearly all gender-affirming care, including for trans adults

[PissedOffAmericanWoman]

As a Texas born Woman I'm on the fence about this one. On one hand I'm glad they are doing something about it all. Doing something is definitely better than nothing! On the other hand this feels a bit like an overreaction... Assuming that CBS Is not lying or exaggerating the situation. 🤔

I feel like adults should be able to transition with certain checks and balances in place of course! The situation with Michelle Zacchigna is living proof that not all adults should be transitioned and need different care.

www.cbsnews.com/amp/news/texas-bill-ban-gender-affirming-care-transgender-adults/

What do you ask think? Also is CBS a reliable truthful news source? If not is there a better news source that covers this story?

I don't understand what "gender affirming care" means if it isn't experimental drugs and surgery.

CBS is not reliable or trustworthy as a news source IMO. That article interviews and quotes only advocacy organizations and individuals, and relays their worst. most apocalyptic, fears without question or qualification. Banning mastectomies or hysterectomies for cancer patients? I doubt it. "Lawmakers are playing politics with the very lives of transgender people in our state... The mental health toll and harm that even debating this bill would cause is catastrophic." Sure.

Reading between the lines, and of course that makes it so much harder because both sides seem on a mission to obfusticate, it appears to be saying:

• you need to pay for it yourself - we don't want public funds being used for what we see as unnecessary interventions
• If something goes wrong then it's on the surgeon/prescriber etc - which I read as a recognition that these are high-risk interventions, often experimental, with high risks of failure and regret, and with higher rates of litigation because of this.

But the US medical system is complex so it could well be that this legislation attacks the right of people to pay for interventions, and over exposes medics to litigation even when the risks have been adequately explained to the patient.

No one should be bound to perform sexist stereotypes, modes of behaviour or dress because of their sex.

Anyone can do this without medical intervention or a falsified birth certificate.

I think the sooner we accept that nobody can change sex, and the drugs used cause excruciatingly horrific long term effects on humans, and that this experiment is a catastrophic failure the better.

I don't believe that wrong sex hormones and surgeries to remove healthy body parts can ever be the answer to psychological distress.

Do american doctors cut off healthy arms and legs for people who want to be amputees? I see it the same way.

Might be worth watching, or listening to this...describing the atrocious effects of the drugs given in 'gender affirming care'

"and increase legal liability through malpractice suits for medical professionals or health care providers that offer gender-affirming care."

Presumably it's not so much that it will be "banned" (for adults) but more that if it goes tits-up people will be able to sue more easily.

Yes this is my interpretation too. Would be nice to read something vaguely neutral wouldn't it?

Whilst I don't believe it is at all helpful, healthy or effective to take cross sex hormones and have these surgeries I do worry that a totalitarian approach may create too much reactionary division to enable effective reasoning and education around why one might take this approach.

Ultimately we need to have an approach and understanding of fully informed consent around reasoning against transition and for exploratory therapy. Across all of society.

At the same time it will make it a hell of a lot harder to damage children which I'd support.

Generally speaking, it seems to be the case that one side is continuously using the word "ban" when it is not in fact a ban.

For example, all the transwomen being "banned" from sport.

Actual real bans on medical procedures are a blunt tool, and very common - even things like lobotomies aren't outright banned, they're just very restricted.

Most of this sort of thing is harmful, but not fatal, cosmetic procedures, and if someone of age really wants to do that sort of thing privately, and someone is willing to do it, and the person is prepared to face any compensation charges, then I think, as a liberal, we can't really stop them. Although you do have to worry about the long-term costs if the state is going to pick up the costs for after-care from complications.

As someone said above, whatever covers "chopping people's limbs off on demand" really should cover it. It's not any different.

Actual real bans on medical procedures are a blunt tool, and very common

NOT very common, of course...

There will be an avalanche of malpractice suits in the States eventually over 'gender affirming care', this is just getting ahead of it. The concept of treating a body dysmorphic disorder with drugs and surgery is crazy, and everyone else having to play along with it is dystopian.

Here's the actual text:

capitol.texas.gov/tlodocs/88R/billtext/html/SB01029I.htm

Reading through it, the main points are liability, and coverage in state plans.

If you do offer it:

STRICT LIABILITY FOR HEALTH COVERAGE. A health benefit plan issuer is strictly liable to a patient for the patient's medical, mental health, and pharmaceutical costs, including costs associated with reversing a gender modification procedure or treatment, incurred for the life of the patient as a result of a gender modification procedure or treatment covered by the issuer's plan.

Plus also liability for the physician or health care provider.

The actual ban is on certain forms of insurance from covering it - there's a list of "chapter XXX" health coverage plans, including Medicaid, so presumably these are ones getting some sort of state subsidy. They are not allowed to cover it in the first place.

So you can do it, but it mustn't be state-funded, and if you do you're liable.

I think there's a particular issue in the US that it's very, very hard to sue doctors for malpractice, due to some changes in the last decade or so, following some previous waves of successful group claims, and subsequent health industry lobbying. This seems to be trying to punch through that - in particular US detransitioners have said that they can't do anything more than 1 year after treatment, because there's a tight time limit.

Doesn't the Irish Teenage Breast Removal Doctor not actually have insurance so that she cannot be sued?

Although you do have to worry about the long-term costs if the state is going to pick up the costs for after-care from complications.

Yes, it is bad enough that NHS has to pick up the pieces from botched cosmetic surgery done on the cheap abroad, the public are not overly happy about that.

I found it interesting regarding the 'Turkey Teeth' debacle that Private Dentists in the UK have refused to carry out corrective work and of course NHS Dentists are few and far between.

The idea of the surgeons/endocrinologists being heavily sued in litigation USA will, I would imagine, mean there won't be many prepared to carry out this type of medical work which is possibly part of the intention of the new law, cut off the source of supply.

I believe so which is something I found very strange, maybe the aw in Texas is making them personally liable?

Absolutely agree that those harmed by poorly explained, experimental surgery that was provided without thorough and careful exploration of other options first to alleviate distress should have a legal come back that those surgery providers cannot hide from.

It's been said for years that eventually, inevitably, this would end up being uninsurable. Insurers don't like big risk of massive payouts.

Doctors who undertake “gender affirming” medical treatments should have absolutely no problems with the enactment of a lifelong liability policy with no statute of limitations, given their brazen confidence in the “life saving” work they are doing right now.

Yes, Dr "Yeet the Teet" doesn't have medical malpractice insurance. I'm sure she can still be sued but it would be pointless if she does not have the cash to pay out.

I hate any incursion of the government into the provision of health care and decisions that should be made between a patient and doctor. Texas did the same with abortion. I feel the same about any government outlawing so-called "conversion" therapy (as if attempting to turn a boy into a girl isn't the worst kind of conversion therapy)

To me, this entire banning "gender-affirming" care by states is because of the total failure of organisations like the american academy of pediatrics or endocrinology or even psychiatry to tackle this alarming rise in children identifying as trans and the medical response to it. There should be at least some basic guidelines out there for what is medical best practice. There should be at least some loud discussion of the effects of puberty blockers and cross-sex hormones.

I don't want the state of Texas telling any doctor what she can and can't do for a patient. But I don't want doctors rendering children infertile and aorgasmic either - I want the guidance to come from the medical profession not some republican dog-whistler. But it seems like I'll be waiting a long time for that.

And another thing. I wish to god the phrase "gender affirming care" was banned. It sounds so lovely and benign. I wish journalists would describe what that care actually is and how it affects a human body.

It wouldn't be pointless if it bankrupted her and shut her down... Though little/no personal benefit to the claimant of course, and they probably wouldn't get costs paid so would probably have to crowdfund or something I guess?

I don’t love this politics in medicine and there’s no question that the us approach is coming from a gay people are bad, trans people are bad. Along with the book banning which i have no truck with either. I don’t mind insurance covering these for adults as there is no medicine without insurance in the us and gender dysphoria is a condition that many people think has helped them to have surgery for (satisfaction rates much higher in well earning adults, unsurprisingly, as presumably they have robust mental health on average); I just want them properly administered with counselling and evidence of time.
I do think it should not be easier and more special to get your breasts removed than it is to get them reconstructed following cancer, that’s just active misogyny in medicine.

Yes. Sadly rich people losing money tends to be what stops disasters, not any sense of ethics.