Iowa Bans Transgender Procedures on Minors

Iowa Gov. Kim Reynolds speaks at a campaign event for Sen. Joni Ernst (R-Iowa) at Dahl Auto Museum as part of Ernst's RV tour of Iowa, in Davenport, on Oct. 31, 2020. Mario Tama/Getty Images

Iowa has become the latest state to ban transgender procedures on minors after Gov. Kim Reynolds signed a bill into law on March 22.

Reynolds also signed into law a second bill banning transgender students from entering school bathrooms or changing rooms that do not correspond with their biological genders.

Under the first bill, SF 538 (pdf), health care professionals are prohibited from prescribing under-18s puberty blockers, hormones, and surgeries including sterilizations, vasectomies, or hysterectomies.

There are exceptions to the law, however, such as in cases where a minor is “born with a medically verifiable disorder of sex development,” or been “diagnosed with a disorder of sexual development by a physician when the physician has determined through genetic or biochemical testing that the minor does not have a normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a biological male or biological female.”

Exceptions are also made in cases of treatment of any infection, injury, disease, or disorder that has been “caused or exacerbated by the performance of gender transition procedures,” or when a minor “suffers from a physical disorder, physical injury, or physical illness that is certified by a physician and that would place the minor in imminent danger of death or impairment of a major bodily function unless surgery is performed.”

Safeguarding Children

A second bill signed into law by Reynolds (pdf) bans transgender students from using single and multiple occupancy restrooms or changing areas and other facilities in elementary and secondary schools that do not correspond with their biological sex.

“A student who, for any reason, desires greater privacy when using single or multiple occupancy restrooms or changing area, or other facility and whose parent or legal guardian provides written consent to school officials, may submit a request to such officials for access to alternative facilities,” the bill states.

“The school official to whom a request is submitted shall evaluate such request and shall, to the extent reasonable, offer options for alternative facilities,” it adds.

However, no accommodation will be made to allow access to multiple or single occupancy restrooms or changing areas designated for use by students of the opposite sex while students of the opposite sex are present.

Both laws are effective immediately, although health care professionals who are already administering transgender procedures to patients under the age of 18 will have 180 days until they are forced to end treatment.

Supporters of the new laws argue that they are necessary to safeguard children and prevent them from undergoing potentially life-changing surgeries that could have serious impacts.

‘In the Best Interest of the Kids’

A spokesperson for Reynolds told the Des Moines Register that the governor met with some parents of transgender minors to discuss both of the bills before signing them into law on Wednesday.

“My heart breaks,” Reynolds, a Republican, told reporters during a press conference on Tuesday. “I’ve sat down and met with them. It’s not easy. It’s not easy for me either. It’s not easy for our elected officials to make these decisions. So I just... I hope they know that.”

“We need to just pause, we need to understand what these emerging therapies actually may potentially do to our kids,” Reynolds said. “My heart goes out to them. I’m a parent, I’m a grandmother. I know how difficult this is. This is an extremely uncomfortable position for me to be in. I don’t like it. But I have to do what I believe right now is in the best interest of the kids.”

However, opponents of the new laws, including LGBTQ advocates, argue they attack transgender children.

“The Iowa Legislature has repeatedly targeted the most vulnerable students with rhetoric and legislation designed to suppress, out, target, ban, and censor Iowa’s LGBTQ+ student communities,” Iowa State Education Association (ISEA) President Mike Beranek said in a statement on Monday. “Despite these shameful attacks, the ISEA continues to stand with and fight for all our students.”

A string of major medical organizations like the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association, have all voiced support for gender transition care among minors, arguing that it is safe and effective.

However, guidance (pdf) from the World Professional Association for Transgender Health states that genital surgery should not be carried out until the individual has reached the age of 18 and has lived continuously for at least 12 months in the “gender role that is congruent with their gender identity.”

Iowa is among a number of states to ban transgender procedures on minors following Alabama, Arizona, Arkansas, South Dakota, Tennessee, Utah, Mississippi, and Florida.