The Alaska State Medical Board took the first step Friday toward restricting access to gender-affirming care for minors in the state. In a unanimous vote, the board passed a draft regulation that would allow medical providers to be sanctioned by the board for providing the care, and would put their licenses at risk. The draft will be open for further public comment for 30 days after it’s reviewed by the state law department. A spokesperson for the board said the next public comment period will be announced on the state’s online public notice system, but she could not estimate a date.
According to experts, if finalized, the regulation would severely restrict gender-affirming care for anyone under age 18 in Alaska, although nurses and nurse practitioners are not subject to the board’s regulations.
Dr. David Paulson, a neurosurgeon and member of the board, explained that the regulation is meant to prevent minors from making irreversible medical choices.
“While compassion requires us to care for the youth in distress, we must recognize our duty to protect them from medical and surgical interventions that risk permanently altering their bodies or futures before they're fully capable of mature consent,” Paulson said.
The change in regulation would consider medical or surgical intervention to treat gender dysphoria in minors as unprofessional conduct, according to the board.
More than half of states have effectively banned or restricted gender affirming care for minors. And a U.S. Supreme Court decision this year found such bans don’t violate the U.S. constitution. Opponents of the care for minors cite the permanence of intervention, and potential for negative, long-term consequences. Supporters cite the high suicide rates for transgender youth, especially for those without access to gender affirming treatment.
Some medical interventions, like puberty blockers, are considered reversible. And all major medical associations support access to gender affirming care for minors, including options for medical interventions. WPATH, the World Professional Association for Transgender Health, which often guides acceptable practice, endorses access to gender-affirming care like hormone blockers and hormones for minors in some circumstances, but not surgeries. The American Medical Association has called state bans on gender-affirming health care for minors “a dangerous intrusion into the practice of medicine.”
Dr. Lindsey Banning, who identified herself as a parent of a transgender child, spoke during the public comment period before the vote.
“It's quite simply the standard of care for trans folks that's accepted by all major medical organizations in this country,” Banning said. “Blocking access to this care has devastating consequences on the health and well being of trans kids dramatically raising rates of depression, anxiety and suicide.”
Tom Pittman, executive director for Identity Alaska, which provides gender affirming care, calls the move politically motivated and said the changes would impact a very small number of vulnerable Alaskans.
Dr. Matt Heilala, a podiatrist who is running for governor, suggested the regulation change. The medical board was appointed by Gov. Mike Dunleavy and Heilala noted that the board has the governor’s support for this change.
But Dave Wilson, a pilot on the medical board, said that the move is not politically motivated and emerged in response to public concern.
