Kansas Ban on Transgender Surgeries for Children Fails to Survive Veto

Kansas Gov. Laura Kelly gives her inaugural address for her second four-year term on the south steps of the Statehouse in Topeka, Kan., on Jan. 9, 2023. John Hanna/AP Photo

An attempt by Kansas state lawmakers to override Gov. Laura Kelly’s veto of a bill banning transgender procedures for children failed after two Republicans joined Democrats to uphold the veto, clearing the way for the use of puberty blockers, cross-sex hormones, and transgender surgeries for kids.

The Kansas Senate voted 27–13 to override Ms. Kelly’s veto on April 29, which was the exact margin necessary to keep the bill alive and preserve the transgender procedure ban. However, the 82–43 vote in the Kansas House was just two votes shy of the necessary two-thirds majority to overcome the veto, after two Republicans broke ranks to side against the measure.

The two Republicans whose votes scuppered the veto override were Kansas Reps. Susan Concannon and Jesse Borjon, who both expressed concern that the measure took away from the ability of parents to decide about health-related procedures for their children.

“We hear about mental health, about suicide, and ask why. We’re not listening to the impacted youth. Government involvement is not the answer,” Ms. Concannon said from the House floor.

Mr. Borjon told The Kansas City Star that he supports prohibiting gender reassignment surgery for minors and backs limiting the use of puberty blockers but that he believes the bill’s restrictions go too far.

Kansas Sen. Mark Steffen, a Republican who voted to override the veto, told The Kansas City Star that a “woke” health care system was pushing gender transition on vulnerable children.

“Today I voted to protect our children from being mutilated,” said Dr. Steffen, who’s also a physician.

More Details

When it first cleared the Kansas Senate and House earlier this year before meeting with the governor’s veto, Substitute Bill for Senate Bill 233 prohibited health care providers from performing transgender surgeries and procedures such as hormone treatment and puberty blockers on children.

It also allowed a civil cause of action against providers offering such treatments, while restricting the use of state funds to promote so-called “gender-affirming” procedures on minors. The measure also prohibited professional liability insurance firms from covering damages for health care providers offering gender-transition procedures to children and barred state employees who work with children from promoting transitioning for children struggling with gender dysphoria.

When Ms. Kelly, a Democrat, vetoed the bill in mid-April, she said her decision prevented the trampling of parental rights.

“This divisive legislation targets a small group of Kansans by placing government mandates on them and dictating to parents how to best raise and care for their children. I do not believe that is a conservative value, and it’s certainly not a Kansas value,” she said at the time.

Republicans who backed the bill argued that the ban would protect vulnerable children from what they said were risky experimental procedures whose outcomes are poorly understood and have the potential to result in long-term health problems.

For instance, a recent study suggests that puberty blockers may cause permanent damage to boys’ reproductive organs and irreversibly impair their fertility, undercutting the viewpoint expressed by many advocates of “gender-affirming” care that their use is a harmless way to explore gender identity.

While Kansas Republicans who backed overriding the governor’s veto opposed gender-transition procedures for minors, hundreds of health care providers in the state signed an open letter in support of so-called “gender-affirming” care for those under 18.

“Banning access to essential health care not only denies transgender youth the support they desperately need but also sends a damaging message that their identities are invalid and unworthy of acceptance. This rejection can lead to profound psychological consequences, including increased rates of depression, anxiety, self-harm, and suicidality,” they wrote.

While advocates of “gender-affirming” care have often raised the argument that supporting gender transition lowers the likelihood that people experiencing severe gender dysphoria will commit suicide, the science regarding this premise remains unsettled, according to a review of 23 studies, with one long-term study showing “substantially higher rates” of suicide and suicide attempts in sex-reassigned individuals than in a healthy control population.

Gender-reassignment “treatments” have become a prominent issue in state legislatures nationwide, as Democratic and Republican lawmakers advocate for bills that either advance or restrict such procedures.

At least 19 states have passed laws that shield minors from transgender surgeries and related procedures.

No Confirmed Benefit

While some advocates of “gender-affirming” therapies and surgeries claim that they can help people suffering from gender dysphoria, there is little evidence for this.

A national organization of pediatricians recently put out a policy statement saying that gender-transition procedures such as puberty blockers and cross-sex hormones provide no mental health benefit to youth with gender dysphoria.

“There are no long-term studies demonstrating benefits nor studies evaluating risks associated with the medical and surgical interventions” provided to adolescents with gender dysphoria, the American College of Pediatricians said in a Feb. 7 statement.

The group prepared the statement after reviewing more than 60 studies.

“There is no long-term evidence that mental health concerns are decreased or alleviated after ‘gender-affirming therapy,’” they wrote.

Many individuals who have undergone it “later regret those interventions and seek to align their gender identity with their sex,” they said.

“Because of the risks of social, medical, and surgical interventions, many European countries are now cautioning against these interventions while encouraging mental health therapy,” the group added.

A 2020 report from Finland raised concerns about the possibility that puberty blocker use “alters the course of gender identity development” and “may consolidate a gender identity that would have otherwise changed in some of the treated adolescents.”

A May 2022 report from the Florida Agency for Health Care Administration stated that there were no studies comparing outcomes between those using puberty blockers and those not using puberty blockers among individuals with gender dysphoria.

“Therefore, it is unknown whether people with gender dysphoria who use puberty blockers experience more improvement in gender dysphoria, depression, anxiety, and quality of life than those with gender dysphoria who do not use them. There is very low certainty about the effects of puberty blockers on suicidal ideation,” it said.