Oklahoma lawmakers are weighing a bill that would ban gender-affirming care for minors and prohibit insurers from covering transgender care for people of all ages. Oklahoma’s House Bill 2177 is a nearly word-for-word copy of legislation Arkansas enacted in 2021 that has since been introduced in several other states.
The Oklahoma House of Representatives voted 80-18 in favor of the bill on Feb. 28 after a two-hour debate. The Frontier fact-checked lawmakers’ remarks before the vote by reviewing the language of the bill, policy statements from major medical associations and available scientific studies.
The bill now awaits a vote in the Senate.
Editor’s note: Transgender youth seeking advice or counseling can speak with a counselor at The Trevor Project by calling 1-866-488-7386 or text messaging 678-678. The Trans Lifeline is also available by calling 877-565-8860.
Claim: House Bill 2177 won’t restrict access to gender-affirming services for adults.
Rep. Kevin West, R-Moore, one of the HB2177’s authors said: “In the state of Oklahoma this just puts a moratorium on, you can’t do it until you’re 18. Once you’re 18, you’re free to do it.”
Fact Check: True but misleading
The bill would only ban gender-affirming care for minors, but would also ban insurers in Oklahoma from covering services for people of all ages. This would limit the number of people who are able to access gender-affirming care in the state.
Claim: Some nations have already taken steps to limit access to gender affirming care for minors.
West said: “The countries at the forefront of these procedures, Sweden, Finland, the UK, France, Australia, and New Zealand have in recent years put roadblocks in place to prevent minors from receiving these procedures.”
Fact check: Mostly True
Sweden’s National Board of Health and Welfare updated its recommendations in 2022 to urge restraint for physicians providing hormone therapy for minors, citing uncertainty in the “effect and safety” of the treatments. “The risks outweigh the benefits at this point,” the board said, according to a translated statement.
Finland’s Council for Choices in Health Care recommended in 2020 that minors should only be treated with cross-sex hormones on a case-by-case basis after thorough evaluation. England has recently pledged to overhaul its transgender care for minors and has restricted gender-affirming care.
France’s National Academy of Medicine also issued new guidance in 2022, urging medical professionals to use more psychological treatment for minors considering transitioning. It appears there have been few major changes to the process in Australia, which requires consent from parents or an order from family court. While New Zealand has mostly supported gender-affirming care for youth, A position paper recently issued by the Royal Australian and New Zealand College of Psychiatrists specifically does not endorse such care for minors. The group also called for more research on the long-lasting effects of treatments. But none of those other countries have enacted a blanket government ban on gender-affirming care for minors like the one Oklahoma is considering.
Claim: Drugs prescribed to help delay the onset of puberty in transgender youth as well as cross-sex hormones carry a wide variety of medical risks including brain cancer and infertility.
Rep. Jim Olsen, R-Roland, one of HB 2177’s authors said: “This is about protecting children from the risk of puberty blockers such as sexual dysfunction, infertility, disrupting normal brain and bone development. It’s also about protecting children from the risks of cross-sex hormones such as heart attack, strokes, gallstones, liver dysfunction, brain cancer and type-2 diabetes.”
Fact check: Mixed
Research on the long-term effects of puberty blockers and cross-sex hormones is still in its infancy, but some studies have found the potential for harm.
The American Pediatrics Association recommends that youth who identify as transgender have access to “comprehensive, gender-affirming, and developmentally appropriate health care.” But the organization also noted that the use of drugs used to delay puberty are not without risks and has called for more research. A 2020 study found lower bone mineral density in early adolescents taking puberty blockers and noted there is little data on the long-term effects.
Cross-sex hormone treatment has been found to cause temporary or permanent infertility.
A French study found that transgender women taking the synthetic hormone cyproterone acetate had an increased risk of brain tumors, but the drug isn’t currently approved in the United States. Some research has found evidence that transgender women who use estrogen have an increased risk of heart attack and stroke.
Claim: Every major medical association in the United States supports gender-affirming care.
Rep. Andy Fugate, D-Del City, said: “Does it surprise you that every single major doctor association and medical association in the United States, pediatric, psychiatric, family doctors, American Medical Association, all support the care you and others might claim causes adverse effects.”
Fact check: Mostly true
Most major U.S. medical associations have recognized the harmful effects of denying access to gender-affirming care and the medical necessity of providing that care to youth, according to the Kaiser Family Foundation, a national health policy and communication nonprofit.
In a 2021 statement, the American Medical Association held that restricting gender-affirming care “can have tragic consequences for transgender individuals.” Studies have shown that people who are transgender are at a higher risk for anxiety, depression and suicide and that gender-affirming care can help alleviate some of those struggles.
The American Psychological Association, the Endocrine Society, the American Psychiatric Association and other groups have also released statements of support for gender-affirming care.
Claim: The medical community’s support of gender-affirming care is not based on actual research.
Olsen said: “Statements by medical associations (such as the American Medical Association that are in support of gender-affirming care) are not tied in with actual studies.”
Fact check: False
A two-page statement the American Medical Association issued in March 2021 in response to a spate of anti-transgender bills cites eight scientific studies on outcomes of gender-affirming care.
Claim: Oklahomans in the process of transitioning will have to de-transition if they cannot afford to pay for their care if HB 2177 becomes law.
Rep. Mauree Turner, D-Oklahoma City, said: “Folks are forced to de-transition if they … cannot afford (gender-affirming care) out of pocket to provide the healthcare they need to survive … (this bill is saying) they cannot stay in Oklahoma.”
Fact check: True
West agreed with Turner, D-OKC, that the bill would bar adults from receiving gender-affirming care if they could not pay for it out of pocket. West said his bill was “100 percent focused on protecting children,” but he also said he wanted to “(protect) state dollars from being used on this.”
The bill would also ban any facility that receives public funds from providing gender-affirming for minors and adults. Violations would result in a loss of public funding for one year, and facilities would be ineligible for further public funding until they ceased providing gender-affirming services. The bill, which would take effect immediately if signed into law, grants a six-month grace period for transgender Oklahomans to “taper off” hormone treatments or puberty blockers.
True: A claim that is backed up by factual evidence
Mostly true: A claim that is mostly true but also contains some inaccurate details
Mixed: A claim that contains a combination of accurate and inaccurate or unproven information
True but misleading: A claim that is factually true but omits critical details or context
Mostly false: A claim that is mostly false but also contains some accurate details False: A claim that has no basis in fact