Topeka, KS— Puberty blockers, mastectomies, surgeries that remove “any body part or tissue” and prescribing estrogen to males or testosterone to females to treat gender dysphoria could be essentially unavailable in Kansas to people under 18.

A bill in the Statehouse would cost doctors their licenses or subject them to lawsuits if they prescribe such treatments. That, in turn, could put the brakes on that treatment in Kansas.

The bill drew both praise and anger at a legislative hearing on Tuesday. People pushing for the new law see it as a way to protect children from life-altering treatments they might later regret. Advocates for transgender rights say restricting access to these procedures could kill people.

“People will die. Families will suffer,” said D.C. Hiegert, a lawyer and the LGBTQ+ legal fellow with the ACLU of Kansas.

More deaths would come from increased rates of suicide, opponents of the bill said. The Harvard T.H. Chan School of Public Health found that gender-affirming surgeries reduced psychological distress by 42% and dropped suicidal ideation by 44% when compared to people who wanted the surgery but didn’t get it. It even found people given the surgeries were less likely to smoke tobacco.

Beth Oller, a doctor with the Rooks County, Kansas, Health Clinic, said many patients need the care — even in her rural part of the state.

“What do you think legislation like this says to them?” she asked legislators. “It validates their fears that not only are they not accepted, but they are not even worth basic medical care.”

Opponents of the bill warn it would harm trans youth. Multiple trans people told lawmakers at the hearing that surgeries can change someone’s life for the better.

They also argue that hormone therapies are reversible and not everyone with gender dysphoria needs these procedures.

The Senate Public Health and Welfare committee was preparing to tackle a different bill Tuesday morning, SB 12, that would have criminalized gender-affirming care. But it’s been put back on the shelf and another hearing for it has not been scheduled this week.

Trans health care was still front and center when the committee worked through the bill that would allow citizens to fight doctors through the court system.

Festus Krebs III, a retired doctor, supported limiting trans-friendly medical care. He said the surgeries don’t guarantee good outcomes for patients and said suicide rates remain high, even after surgery. Krebs cited a study published in the National Library of Medicine that found suicide attempts and mortality rate remained high after gender-affirming treatment.

That same study said the surgeries should not treat gender dysphoria alone and called for better medical care to help people.

“Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group,” the study said.

Chloe Cole had puberty blockers and a double mastectomy, but she sided with Krebs and said the surgeries do more harm than good. She said she was told about the risks but she was too young to think about how it could affect her long term.

Cole now worries she can’t have kids and wouldn’t be able to breastfeed a child.

“We can’t allow anybody under 18 to make these decisions,” she said.

Her concerns echoed that of others who spoke in support of the bill. They worry puberty blockers or major surgery can’t be undone and that kids are too young to make these decisions.

2022 study published by the American Association of Pediatrics found that 7.4% of children re-transitioned, or reversed the effects, within five years of their initial switch.

Oller, the doctor in Rooks County, said every story is important and cases like Cole should not be ignored. But she said gender-affirming care has more success stories than bad endings.

Oller said patients should be trusted to know what is best for them.

“I don’t know everything and I don’t claim to,” she said, “but I do know that the person who best knows my patient is my patient. And I know that I believe them, I trust them … they should be able to make decisions regarding their health without government infringement.”

Blaise Mesa reports on criminal justice and social services for the Kansas News Service in Topeka. You can follow him on Twitter @Blaise_Mesa or email him at blaise@kcur.org.

The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.