Senate Judiciary Committee
February 13, 2023
Sen Stubblefield: The Chair sees a quorum. I’m going to go ahead and call this meeting of Judiciary to order. I recognize Senator Gilmore.
Sen Gilmore: Thank you, Mr. Chair. I know that I think we have quite a few people signed to speak for the bill that’s on the agenda. And if I could, I’d like to make a motion to limit debate to two minutes per person just to try to manage time in this Committee today. So with that, I make that motion.
Sen Stubblefield: All right, that’s a non-debatable motion, we have a second. All those in favor? Any discussion? All those in favor say aye. All opposed? Okay. Senator Rice, I’m going to ask you to come and take the Chair.
Sen Rice: Senator Stubblefield, you’re recognized to present Senate Bill 199.
Sen Stubblefield: Thank you, Mr. Chair. You know, if I came in here today and I advocated for the chemical castration, the sterilization, and mutilization of young adults, most of you would consider me to be crazy. And yet that’s exactly what a lot of our medical professionals, these activists, they’re promoting and defending gender affirmation care.
And the problem with these gender ideologies is that while it’s possible to identify as anything, it’s not possible for a man to become a woman or a woman to become a man. To obscure this fact these activists have manufactured a small dictionary of sweet-sounding terms like transgender, gender fluidity, and non-binary. Gender-affirming care, in the phrase activists have coined to describe sex change treatments such as puberty blockers, hormonal injections, and double mastectomies. I cannot even imagine – and I know I’m a little older than most of y’all – a doctor taking a scalpel, carving up a small child in order to put together sexual organs, and putting these children on puberty blockers and cross-sex hormones that haven’t even been approved by the FDA. And not only that, we don’t have enough data now to even know what the outcomes of many of these operations bring forth.
Shockingly, children’s hospitals are big players in these games. The Boston Children’s Hospital website has posted videos in which doctors describe as a full menu of medical treatments, including hysterectomies and gender-confused teens. The Gender Clinic at the Barbara Bush Children’s Hospital in Maine, offers instructions to little boys on how to tuck their boy parts to make them look more like girl parts. Yale University Pediatric Gender Program director said she medically assisted children as young as three years old on their gender journey.
And then you have Vanderbilt. Vanderbilt Medical Center has assessed gender care to be a new profit center. One of the doctors explained that attempting to change someone’s sex creates a permanent patient. And that is not hard to comprehend, when you’re talking about – and I’m not a doctor – there are doctors here but when you’re talking about capillaries and thousands of nerves that have to be tied back together. I told one of the doctors over here from UAMS, I had knee surgery three years ago, my knee is still numb. That’s a knee. Imagine having sexual organs tied back together. But these children’s hospitals are big players in this.
One of the doctors explained attempting to change someone’s sex creates a permanent patient. “And attempting to change someone’s sex creates a permanent patient.” Knowing patients will have to return for recurring treatments is a guaranteed money-maker. You know what that tells me? That tells me that they’re putting money ahead of our children. This is a lucrative, lucrative business, one of the largest American care establishments. The Tavistock Gender Identity Clinic in the UK has shut its doors along with Sweden and Finland. And you know why they shut their doors, colleagues? Because it wasn’t working out like they had planned. These children were not responding like they had planned, imagine that. So they shut their doors. And yet, in America, we continue to go over the cliff.
The UK has shuttered its state-run Tavistock Gender Identity Clinic, which was the largest pediatric gender clinic in the world, after a report found that the patients were at considerable risk due unquestioning affirmative approach. A more accurate description for this approach would be medical malpractice. In no other part of the medical world is it considered acceptable or even legal to damage the body of a healthy person irreversibly.
See, these kids can’t– when a little girl has this surgery she can’t have a baby. She can’t have an orgasm. Many can’t have sex. And when they grow up, this little 10-year-old girl grows up, and she decides that she wants to get married, how is that going to work out for her betterment? Because all this is irreversible, they can’t put her back.
If a mentally ill man who identifies as a double amputee asks a doctor to amputate his perfectly functioning arm to match his identity, every self-respecting surgeon would send him away. Or if a girl who is suffering from anorexia walks into a hospital and asks for liposuction no one in their right mind would grant her request. And that’s because physicians swear an oath. They swear an oath to do no harm, to preserve and protect and heal a person’s body as best they can in spite of any delusions the person may be experiencing. And yet, doctors violate that oath every time they promote gender-affirming care. Their motives, no matter how compassionate they might sound, relevant, but the idea that teenagers, let alone little children are capable of making such life-altering decisions is not only brand new but it’s absurd. A society that allows them to do this is a deeply broken society.
So how are you going to stop this? Stop going along with this language game that they’ve created, these ideologues want us to play. There are men, women, boys, and girls. And there are men and women, boys and girls who are confused about their gender. There is no such thing as having a place on a gender spectrum. With the rarest of exceptions, we are born one of two sexes, a male or a female. Sex is not a sign, it’s an integral part of who we are right from the moment of conception. It’s true for horses, it’s true for cows, it’s true for dogs, it’s true for every other species on the planet.
There’s no such thing as gender-affirming care, you cannot affirm something that does not exist. What does exist is chemical castration, sterilization, and surgical mutilation. What we need is legal accountability. Patients who have undergone physical medical gender treatments as minors should be able to sue doctors and hospitals that perform the treatment. The risk of serious financial responsibility will bring this act of barbarism to an end faster than any kind of protest you can have. This is a battle that we must win, not least because there’s an entire generation of boys and girls being made to believe that irreversibly changing their bodies will fix the social and emotional anxieties that they experience. Our children are counting on us to fix this and we can do this today. Mr. Chairman, I am closed and I would be glad to take questions.
Sen Rice: Questions from the Committee?
Sen Stubblefield: Mr. Chairman, I do have some people that I would like to come up.
Sen Rice: Okay, go ahead. Do you want them to speak before you take questions?
Sen Stubblefield: No. They said they’d just go and take questions.
Sen Rice: Okay. If you would take a seat at the table and we’ll ask you to go ahead and identify yourself and then we’ll go to the Committee for questions.
Cantrell (AG): Thank you, Mr. Chairman. My name is Michael Cantrell with the Attorney General’s office.
Broyles (AG): Good morning, my name is Jordan Broyles and I’m with the Attorney General’s office as well.
Sen Rice: Okay. Thank you both for being here and you can just pull that mic around wherever you need. Okay, questions from the Committee? Senator Clark, you recognized. Senator Clarke Tucker.
Sen Tucker: Thank you, Mr. Chair. So I have several questions I’d like to ask this morning. I just want to kind of start with the framework of what we’re talking about. Essentially this functions as a private civil enforcement of what the State did with the SAFE Act two years ago, is that fair?
Cantrell (AG): The question is whether the bill creates a private right of action, that’s correct.
Sen Tucker: Right. Essentially of the rights that the State was regulating in the SAFE Act two years ago so to speak?
Cantrell (AG): Well, that’s a different piece of legislation. I’m not sure.
Sen Tucker: It deals with gender-affirming care for teenagers. So that was a public enforcement, this is a private enforcement of the same right, correct?
Cantrell (AG): Yes. It creates a private right of action for medical malpractice concerning gender transition procedures.
Sen Tucker: Right. Yes. So from the testimony two years ago, the physicians in Arkansas who were performing this type of care said that there were approximately 20 kids per year who receive this type of care, and 100% of the time it was with their parents involved in the process and making the decision with them, along obviously, with medical advice of the professionals who are administering the treatment. Do you have any reason to dispute that?
Cantrell (AG): I apologize, Senator Tucker. I don’t– I’m not sure that I have any basis to dispute it. I’m not sure what the testimony was that you’re referring to. And I would prefer to be able to look at that more particularly if possible.
Sen Tucker: Sure. That’s just the basis for my understanding of a lot of the questions I’m going to ask and so I think it’s important to establish it. And one other fact is that during the course of the trial seeking to strike down that law, there was testimony from the American Medical Association, the American Academy of Pediatrics, and the Endocrine Society that have called these treatments safe if properly administered. Do you have any reason to dispute that?
Cantrell (AG): I believe that there was testimony from individuals to that effect, yes.
Sen Tucker: Okay. Thank you. Last one of these questions is, there was also testimony– I don’t know about the trial but two years ago when the SAFE Act was being proposed and deliberated on, that none of the procedures being administered, there were no surgeries being administered to teenagers, and from the physician’s perspective at least – and you may disagree with this – but at least from the physician’s perspective, there was no gender-affirming care being administered that would permanently affect a teenager’s life. That was their testimony at the table. So I just wanted to mention that. And you again may not recall that testimony or be as familiar with it as I am but I just wanted to kind of establish that baseline for the conversation that we’re going to have here today. With that, I would like to, I think go through a little bit of the language in the bill. I’m curious why– well, first of all, we already have laws on medical negligence in this state, correct?
Cantrell (AG): That is correct.
Sen Tucker: So what does this bill do that we don’t already have through our current medical negligence laws?
Broyles (AG): Sorry, a little awkward angle here. So this cause of action would extend the statute of limitations to be more consistent with this type of care. So the current act that we have, the statute of limitations is two years. And so based on treatment plans, things of that sort, this would extend the statute of limitations to make it more consistent and align with this type of medical treatment.
Sen Tucker: It extends the statute to 30 years, correct? How is that consistent with this type of care, to use your language?
Broyles (AG): Yeah, so because the care can last over an extended period of time, and again it goes to potential for a cause of action later in life, even after maybe the care has ended. So it would allow for that.
Sen Tucker: I have a few questions about the statute of limitations. Have you ever heard of another statute of limitations in a civil context that’s 30 years?
Broyles (AG): Child sex abuse, it was extended to 30 or– excuse me, 55.
Sen Tucker: To age 55 or 55 years?
Broyles (AG): Age 55.
Sen Tucker: And that’s a civil statute of limitations?
Broyles (AG): Yes, sir. In Arkansas.
Sen Tucker: Okay. What I’ve heard in other contexts is that a statute of limitations is tolled until the person can know about an injury. Did you consider that? And for example, in the medical context, sometimes a statute is tolled until you can know about an injury and then you have two years to bring the claim, which is what the current medical negligence statute of limitations is. Did you consider that approach?
Broyles (AG): It’s a little bit different in how it plays out in the courts on what’s discoverable and when you could or couldn’t have known. And so yes, it’s taken into consideration here but because the statute of limitations that exists in the main part of the Medical Malpractice Act again doesn’t necessarily allow for the circumstances that would apply to the care and treatment. It’s considered but that wouldn’t always work under the circumstances.
Sen Tucker: Okay. For the medical negligence laws that we already have in the state, whatever the type of treatment it is, whether it’s a surgery or anything, cancer diagnosis, there are standards of care established by the medical profession, correct?
Broyles (AG): Yes, sir.
Sen Tucker: And those standards of care, those are what is used in the course of a medical malpractice case to determine whether another physician or health care professional has violated the standard of care, correct?
Broyles (AG): Yes, sir.
Sen Tucker: Are you aware of another standard of care that’s established by the legislature rather than by the professionals in the industry?
Broyles (AG): I don’t know that this act as written establishes a per se standard of care. It includes safe harbor language but necessarily, I don’t necessarily read it to say that it establishes a quote, “standard of care” as it’s typically used. In the medical context what is the standard of care varies, that’s how you get different sides of the coin on an action but.
Sen Tucker: Well, malpractice by definition is violating the standard of care.
Broyles (AG): Are you asking me?
Sen Tucker: Yeah. Do you agree?
Broyles (AG): Yes.
Sen Tucker: So this law establishes liability for performing certain acts as a healthcare professional, and it has medical malpractice in the title of the bill, correct?
Broyles (AG): Yes, sir, it does.
Sen Tucker: So we’re establishing if this bill passes civil liability on a health care professional that’s established by something other than the standard of care in the industry?
Broyles (AG): I don’t know. Maybe could you rephrase that, I’m not sure I’m understanding.
Sen Tucker: Sure. I’ll just take it one piece at a time. We’re establishing civil liability for healthcare professionals through this bill if it passes, correct?
Broyles (AG): Yes, that would be correct.
Sen Tucker: And you just testified a moment ago that you’re not necessarily establishing a standard of care in this piece of legislation.
Broyles (AG): That would be true, yes.
Sen Tucker: So taking those two thoughts together, we’re establishing if this bill passes, civil liability for healthcare professionals based on something other than a standard of care established in the industry.
Broyles (AG): I don’t think that it can be read to be independent. I think it can take into consideration testimony of experts in the course of litigation on a case-by-case basis. So again, it has a safe harbor provision but I don’t know per se that it establishes a standard of care as we’re talking about that.
Sen Tucker: And that’s fine if you don’t want to say it establishes a standard of care but it does establish civil liability regardless of what the industry says. That’s my point. No matter what the other medical professionals have to say about it, it establishes civil liability if a healthcare professional violates the terms of this act, right?
Broyles (AG): Theoretically, since we’re talking, they could still– the case could still be defensible even if certain aspects of the safe harbor weren’t followed.
Sen Tucker: How’s that?
Broyles (AG): Well, with expert testimony, things of that sort as far as what would be consistent. Again, every case is so different it’s hard to play facts but again it’s not per se establishing a standard of care but.
Sen Tucker: I understand your point that it’s not establishing a standard of care, but you’re telling me that if a physician performs one of these procedures set out in the Act and that the safe harbor provision does not apply, that they still might be able to avoid liability?
Broyles (AG): Yes, sir. That would be up for a jury to decide, just like all of our other civil causes of action.
Sen Tucker: Then what is the purpose of the law?
Broyles (AG): The main purpose would be to create a cause of action that would allow for civil liability to protect children and their parents, creating– again it goes back kind of to the statute of limitations issue, that wouldn’t maybe, they wouldn’t otherwise have this cause of action under the law as it currently stands.
Sen Tucker: I just don’t understand how we have a bill to create civil liability if you do X but then if you do X you still may be able to avoid liability but we’ll just have to agree to disagree about that. You mentioned parents. Is a teen allowed under the law to make a decision about their health care like this without their parents to your knowledge?
Broyles (AG): I think the age is 16 as it’s written currently.
Sen Tucker: Did you consider– I understand that for the gender-affirming care, you have a number of types of care listed here, correct? Are you aware of any surgery taking place on a minor in Arkansas for gender-affirming care?
Broyles (AG): You want to go ahead?
Cantrell (AG): Could you repeat the question,sir?
Sen Tucker: Are you aware of any surgical procedure of a minor taking– surgical procedure for gender-affirming care taking place to a minor in the State of Arkansas?
Cantrell (AG): That’s a difficult question to answer. It’s hard to know the motivations for any particular procedure. I could not point you to one.
Sen Tucker: I don’t mean to suggest that y’all have universal knowledge of every surgical procedure that’s taken place. I’m just asking if you know of one and it sounds like the answer may be no.
Cantrell (AG): I could not point you to one that I could confidently say a surgery that was performed for the express purpose of a gender transition procedure in Arkansas.
Sen Tucker: In the last several pages of the bill it goes into great detail about the type of notice that healthcare professionals have to provide to parents and patients before they administer any gender-affirming care, correct?
Cantrell (AG): The bill does provide a safe harbor provision which would include notice, written notice to the minor, and the minor’s parent, yes.
Sen Tucker: I don’t know whose research you relied on and that’s not– I don’t want to get into that, that’s not my point but whoever it was, what if their thoughts on this changes in the next two years, are we going to come back in two years and change the notice, and are we going to do that every session if the research changes during the interim period?
Cantrell (AG): I cannot answer that question, Senator.
Sen Tucker: The question is why did we not leave this to be promulgated in a rule rather than putting it in the code?
Cantrell (AG): Again, I think that is a question for the Committee. That’s not a question that I can answer.
Sen Tucker: Bills that require this level of specificity– well, that’s not a question, so I’ll move to my next question.
Sen Stubblefield: Could I ask you a question, Senator Tucker?
Sen Tucker: Please.
Sen Stubblefield: All right. Why–
Sen Tucker: Your mic’s not on Senator.
Sen Stubblefield: Why would the largest–
Sen Rice: Senator Stubblefield, if you will pull your mic over to you.
Sen Stubblefield: Why would the largest state-run gender care unit in the UK, largest in the world, why would they shutter their doors on their gender-affirming care facilities?
Sen Tucker: I don’t know the answer to that and–
Sen Stubblefield: I just told you the answer. They gave the answers, so did Sweden and Finland. They said because it wasn’t working out like they had planned. They weren’t achieving the results that they thought they would achieve when they started these mutilations.
Sen Tucker: That’s fine, Senator. And I take exception to the word mutilations but I’m more concerned– I’m less concerned with the UK hospital than I am the American Medical Association, the American Academy of Pediatrics, and the Pediatric Endocrine Society in the United States.
Sen Stubblefield: You are concerned with the word mutilation? Have you ever witnessed one of these surgeries?
Sen Tucker: To my knowledge, there’s not been one of these surgeries take place on a teen and neither the Attorney General’s office.
Sen Stubblefield: Have you witnessed one anywhere in the United States?
Sen Tucker: I’m talking about the State of Arkansas, Senator because that’s who we’re making laws for here.
Sen Stubblefield: HIPPA law, you know we don’t know who gets services and who don’t a lot of times. I mean, I don’t know who’s getting a gallbladder removed this morning at UAMS, or having a heart transplant over there. So there’s a lot of things we don’t know.
Sen Tucker: I’m going to get back to the language in the bill. On page 5, in the notice it says “Puberty blockers may also cause diminished bone density for your child, increasing the risk of fracture and early osteoporosis. Puberty blockers may also prevent your child from ever being able to engage in sexual activity or achieve orgasm for the rest of your child’s life.” Is that true of puberty blockers? That’s why you put it in the bill?
Cantrell (AG): That is correct based on available information.
Sen Tucker: So is that also true of a child – to use the language you all have in this notice provision – is that also true of a child who has precocious puberty, those risks?
Cantrell (AG): I think the difference would be the timing at which the puberty blockers would be administered for precocious puberty. Again on available information, treatment for precocious puberty is given to children who have not yet reached the age at which puberty would be appropriate or typical for a child.
Sen Tucker: So by definition that’s going to be a pretty young child?
Cantrell (AG): Yes.
Sen Tucker: So I’m no physician but I would think that the risk of this type of medication would be greater for a younger child than for someone who’s 14 or 15. Do you have any reason to disagree with that?
Cantrell (AG): Based on available information, Senator, there is reason to believe that these medications given to a child who is 12, 13, 14 would create more of a risk of osteoporosis later in life than it would if it were administered earlier in life.
Sen Tucker: Okay. So to my knowledge, children have been taking puberty blockers for precocious puberty for multiple generations now, 50, 60 years, something in that range. Because of these risks of puberty blockers for osteoporosis and the others mentioned in the bill, do we not need to protect those children from their parents and their physicians as well?
Cantrell (AG): I think certainly, it’s appropriate to protect children from risks. As I indicated a minute ago, there is reason to believe that the risk of osteoporosis is greater when these drugs are administered later in life.
Sen Tucker: And why is that? Do you have a physician or a medical expert here to testify to that?
Cantrell (AG): No but I can point you if you would like, to literature.
Sen Tucker: It’s the same medication, correct?
Cantrell (AG): Yes.
Sen Tucker: And so you’re telling me the risk of osteoporosis is greater if it’s treating one condition rather than another, if it’s treating gender dysphoria instead of precocious puberty?
Cantrell (AG): I think the difference in risk comes with the timing of the–
Sen Tucker: Well, we established that the risk is greater for a younger child, and the child with precocious puberty will be taking it at a younger age than a child taking it for gender dysphoria.
Cantrell (AG): No, I believe that’s incorrect. The risk would be greater for a child who was older than the typical precocious puberty patient.
Sen Tucker: And what is that based on, what literature?
Cantrell (AG): There is– if you’ll give me a moment I can find it.
Sen Tucker: Please.
Cantrell (AG): Senator, I’m consulting a report from Dr. Paul Cruz, which provides a great deal of information that we would not be able to go through at this moment. But I would refer you to an article, let’s see, titled Bone mass in young adulthood following gonadotropin-releasing hormone analog treatment, and Cross-sex hormone treatment in adolescence with gender dysphoria, published in the Journal of Clinical Endocrinology and Metabolism. The author is Kilnk, K-I-L-N-K. And it indicates that emerging data shows that patients have a lower bone density which may lead to increased fracturing risk.
Sen Tucker: Okay. And that’s fine, I understand that. Right now I’m trying to establish the comparison between those who take puberty blockers for gender dysphoria and for precocious puberty. Now I understand we’re expected to vote on this piece of legislation today, right, that’s what you’re asking us to do? So in order to make an informed decision about this, I need to know why we’re not also protecting kids who take puberty blockers for precocious puberty from their parents and their doctors. And you’re telling me that the risk of osteoporosis is less for kids who take puberty blockers for precocious puberty and I want to know what the research is on that.
Cantrell (AG): I think the more fundamental point would be that there is a complete lack of long-term studies concerning the risk of administering the puberty blockers later and later and later.
Sen Tucker: Okay. Is there a plethora of studies about puberty blockers for precocious puberty?
Sen Rice: Senator Tucker?
Sen Tucker: Yes, sir?
Sen Rice: I’m giving wide latitude. I do have other members in that. I know you’re schooled on this, I’m giving as much latitude as I can but at some point.
Sen Tucker: Thank you. I don’t have a ton of more questions, Mr. Chair, but I do have a few more. But I’m very happy to let someone else have a turn.
Sen Rice: Okay. And if we’ll do that it may help you even in some of your presentation. Senator Gilmore, you’re recognized.
Sen Gilmore: Thank you, Mr. Chair. And thank you, Senator Tucker, for suspending briefly for questions. I don’t know exactly who this question might be for, perhaps Senator Stubblefield or the attorneys at the end of the table. Are you aware in any way, form, or fashion that the learned and educated healthcare community – and I think there’s about 11 or so countries in Europe – might be substandard to ours in their care? Are you aware of any factors that might indicate such as to the reason why they may have taken actions that we haven’t taken in this country? Senator Stubblefield, are you?
Sen Stubblefield: From what I read these–
Sen Rice: Please use your microphone. Senator Stubblefield, please use your microphone.
Sen Stubblefield: From the articles I’ve read, these Tavistock, they’ve been around a long time. And they’ve dealt with puberty blockers and cross-sex hormones for a long time. So they shuttered their doors because these things were not working on these kids. It’s about as simple as that. They weren’t getting the desired results that they expected.
Sen Gilmore: Okay, so it’s safe to say that in a lot of these procedures, Europe obviously made decisions ahead of us. Is that fair to say, in the sense of doing and allowing these procedures? Does that make sense? Perhaps I can clarify. Would you agree that in Europe some of these procedures were taking place before perhaps here in the US for an extended period of time and now they are ahead of us in seeing some of the effects would you–?
Sen Stubblefield: I would agree to that totally.
Sen Gilmore: So is it also safe to say that because they’re seeing some of these effects that they are taking now actions to correct some of that that we in the US should consider?
Sen Stubblefield: Absolutely.
Sen Gilmore: Thank you.
Sen Rice: Senator Hester, you’re recognized.
Sen Hester: Senator Stubblefield, we are aware that we do not allow minors to make decisions, specifically life-altering decisions. I mean, simple things, we don’t allow minors under 16 to drive, we don’t allow them to vote, we don’t allow alcohol and tobacco. Do you agree with that?
Sen Stubblefield: I agree with that. And I also agree with the fact that most doctors tell me that the human brain does not even fully develop till they’re 24, 25. So you could even go a little further out if you really wanted to but yeah, I would agree with that, absolutely.
Sen Hester: Would you also agree that – and we’ve seen the situation, horrific situations where there are parents that allow their children to be abused? So even a parent and a child would agree to some sort of abuse, and that happens routinely in the State of Arkansas and we call that a crime, can you imagine any of those scenarios?
Sen Stubblefield: Yes.
Sen Hester: Thank you.
Sen Rice: Not seeing other Committee members, Senator Tucker, I’m back to you.
Sen Tucker: Thank you, Mr. Chair. I’ll just follow up with where Senator Hester was. I’ve been hearing a lot of talk in this building the last couple of years that the government should not stand between parents and their children, whether it comes to a school board requiring a mask to go to school, whether it’s where a parent has an opportunity to send their child to school. But this is an example where you think the government should stand between parents and their children, is that true?
Sen Stubblefield: I would say living a life in bondage to one of these surgeries would not be freedom, Senator Tucker.
Sen Tucker: Right. But you think the government should step up and protect these kids from their parents?
Sen Stubblefield: I think you and I should protect kids, not from parents but protect kids.
Sen Tucker: From themselves or from who?
Sen Stubblefield: Well, a child is not capable of making this kind of– listen, I talked to a 10-year-old girl back in the fall, and you know where she got her idea to have one of these surgeries? Off of TikTok, because the Chinese were showing this little girl on TikTok, who said this has changed my life. So now we’re getting our information from the Chinese communist government on how to keep these surgeries going.
Sen Tucker: Fortunately, we have laws on the books that prevent that surgery for minors but. So this is– I’ll wrap here shortly, just kind of two more questions I want to ask. Never trust a lawyer when they say that by the way. But one is about the enforcement, the private enforcement. The SAFE Act was passed two years ago. Now, there’s been a case to strike– a lawsuit to strike that down. The trial on the merits has been held. They are awaiting Judge Moody’s final decision. However, Judge Moody granted a preliminary injunction to prevent the law from being enforced because it violates the Equal Protection Clause of the 14th Amendment to the United States Constitution. The Eighth Circuit affirmed the preliminary injunction. So we’re talking about a constitutional right, the right to equal protection.
Now, the state of Texas recently passed a law that said there was a private right of enforcement against a clinic that was administering abortion. Now, that case went to the Supreme Court of the United States, and two Justices of the Supreme Court, Justice Brett Kavanaugh, and Justice Amy Coney Barrett had questions for the State of Texas about that. Now, they said they may not personally be big fans of – they didn’t put it this way, I’m putting words in their mouth when I say this part – they may not personally be big fans of a hospital or a medical clinic administering abortions but they were big fans of constitutional rights being safeguarded and not being attacked through private enforcement. And Justice Kavanaugh, for example, specifically mentioned freedom of speech, freedom of religion, the Second Amendment.
So my question is if states start passing laws using private enforcement to prevent constitutional rights from being protected, in this case, the right to equal protection. What’s to prevent another state, not this state but what’s to prevent another state from passing a law that says every gun dealer who sells a gun is responsible and liable for all damages caused by that gun for a statute of limitations period of 30 years? Now that’s not infringing on the Second Amendment because the state’s not saying you can’t own a gun, it’s just a private right of action for liability that’s related to a constitutional right.
So that’s my question. If states start passing private enforcement that prevent constitutional rights from being protected, are we not as Justice Brett Kavanaugh pointed out, are we not opening Pandora’s Box for what states all over the country might be passing?
Sen Stubblefield: Every one of those rights you referred to has a duty connected with it. Just because you have the right to free speech doesn’t mean you have the right to run into a theater and yell fire. And it doesn’t mean just because you have the right to own a firearm to protect your property and your family doesn’t mean that you can go out and kill an innocent person. Those rights, when you took the oath and you put your hand on the Bible out here a few weeks ago, you took an oath to uphold the Constitution, is that correct?
Sen Tucker: Yes, sir. And I plan on it. Being consistent with that was my…
Sen Stubblefield: Did you take an oath to uphold some judge’s opinion of the Constitution or the Constitution?
Sen Tucker: The Constitution, including the Equal Protection Clause.
Sen Stubblefield: I rest my case
Sen Tucker: Yeah. So my vote today will be consistent with the Equal Protection Clause. My last question is about suicide rates. We know that suicide rates among transgender Americans are higher, and they’re even higher for teenagers, about four to five times as high. And we also know that there were reports of attempted suicide in the State of Arkansas of transgender teenagers when the SAFE Act was passing through the legislative process two years ago. And I’m just curious if that has any effect on your decision to move forward with this bill?
Sen Stubblefield: I don’t think we actually know all the figures that are related to suicide. I don’t think they’re all reported any more than they’re reported– we just came through COVID, I don’t think all those got reported. So we don’t have an accurate account and we don’t have any long-lasting data to look at and see if these things are really working other than the ones in Europe who have already shuttered them and closed them down because they weren’t getting the desired results.
Sen Tucker: So we have some data from Europe that we should listen to but the data from here in the United States is just not developed enough?
Sen Stubblefield: You mean like the data from the guy in Vanderbilt who said this is a lucrative business, we can’t let it go?
Sen Tucker: I mean the data about suicide rates for transgender Americans, especially teenagers.
Sen Stubblefield: We don’t know about that.
Sen Tucker: Okay so that’s not developed enough. Okay. Thank you, Mr. Chair.
Sen Rice: I have three Senators in the queue, Senator Gilmore first.
Sen Gilmore: I think this might have already been addressed but I heard my friend and colleague Senator Tucker make a statement about laws we have on the books and laws we have to protect children. But to Senator Stubblefield, I guess I’ll pose the question, as Chair of Judiciary, you see a lot of bills come through here that become law to protect people, correct?
Sen Stubblefield: Correct.
Sen Gilmore: Do you see this in any way as different than any of those bills that we are trying to protect minors, we are trying to protect children. And like I said, we have a lot of those laws on the books. Would this bill be any different than any of those in trying to protect children?
Sen Stubblefield: These are the most vulnerable among us.
Sen Gilmore: Your microphone, sir.
Sen Stubblefield: What we’re talking about here this morning is a category of the most vulnerable people among us. These are kids. Of all people we should protect, it’s kids. Listen, I just got a call a couple of weeks ago from a mom and dad who were both taking heroin. And the mom took the kid to school and almost ran over the crossing guard. So there comes a time when you have to step in. You asked about government, sometimes you have to step in to save the life of a child, Senator Tucker.
Sen Rice: Go ahead.
Sen Gilmore: Yeah, and with those laws, to that point, with those laws sometimes we even have to protect children from their parents, unfortunately.
Sen Stubblefield: That’s exactly right.
Sen Gilmore: I’ve sat in courtrooms and listened to abuse that’s taking place that have been imposed by parents regrettably. And so this would be – this case, this could be something that would help protect even more. Thank you.
Sen Stubblefield: Absolutely.
Sen Rice: Senator McKee, and then Senator Clark, the two of you are recognized.
Sen McKee: Senator Stubblefield, we know that there are Arkansans who believe you should be able to mutilate unborn babies. We know that there are Arkansans that believe you should be able to mutilate the genitalia of children. Does this law stop what they call gender-affirming care from occurring?
Sen Stubblefield: No. It wouldn’t stop it, it would simply put a– they would be liable for any problems.
Sen McKee: Which seems like a reasonable standard to have.
Sen Stubblefield: Because as I say, there’s not enough information we know the long-term effects of these.
Sen McKee: Suicides were brought up, the data shows that those in the transgender who are experiencing that kind of gender dysphoria, have higher rates of suicide but the data also shows that those who transition are consistent, that rate stays consistent. So does this bill affect that at all?
Sen Stubblefield: I would disagree with those statistics. I would say that the rate among children who are on drugs is higher than those who commit suicide from having one of these surgeries.
Sen McKee: But this law wouldn’t affect their ability to go through this what they call gender-affirming care?
Sen Stubblefield: No.
Sen McKee: It just makes sure that if there are negative impacts on that individual’s health or mental state in the future because of these treatments that they have recourse in the courts.
Sen Stubblefield: That’s correct.
Sen McKee: Thank you, Senator.
Sen Rice: Senator Clark, you’re recognized.
Sen Clark: Thank you Mr. Chair. And I don’t know what data y’all have and don’t have. But are you aware that Sweden, who has been allowing and doing these surgeries for decades has the most exhaustive study on the after-effects of transgender surgery of anyone?
Sen Stubblefield: I read a lot of those studies, Senator Clark.
Sen Clark: Okay. And especially addressing suicide, are you aware that in that study where they followed every person who had had the surgery, that of all the effects besides many times increased mental hospitalization rate above the normal population, it was also a much higher suicide rate of those who had had the transition surgery? Are y’all aware of that?
Sen Stubblefield: Yes.
Sen Clark: Thank you.
Sen Rice: Senator Hester, you’re recognized.
Sen Hester: So a follow-up from some of the things I’ve heard today. We do not have a constitutional right to abuse children, you agree with that? And I think what we’re talking about today is do we believe that this is abuse of a child or not. Some in this room think it is not abuse of a child, while the vast majority of people in this room and State of Arkansas and the country believe this is absolute abuse of a child. I would say what we are talking about is does this child, once they are not 8, 10, 14 years old, and they’re an adult one day, when they cannot perform as a natural human, if they feel like they were abused as a child at the hand of some doctor, do they have a cause of action at that point?
And I think the reason there’s concern is because almost everyone in this room believes there’s a legitimate chance that when a child that was put under this therapy or put under the knife will one day look back and say this was a mistake and I should not have been abused as a child and they’re going to have a cause of action. That’s the question that’s all about today. And the reason people have concern is they believe that later in life these children are going to look back and feel like they were abused and have a cause of action. Thank you.
Sen Rice: Okay, members. Not seeing any more questions from membership. We have 13 people signed up. Thank you at the end of the table for testifying. If you want to sit over to the side or whatever, you could be called back. I’ll remind you the Committee passed a motion for two minutes per person. First up we have Gwendolyn Herzis. You may want to correct my pronunciation of your name. Please come up, end of the table.
Sen Rice: Right there, yes. Please identify yourself. Make sure your button’s lit up and tell us who you are, who you’re with. You’re recognized to speak for two minutes.
Herzig: Good morning. My name is Dr. Gwendolyn Paige Herzig, owner and pharmacist at Park West Pharmacy in Little Rock Arkansas. I’ve lived my entire life in Arkansas, born in Newport, raised in northeast Arkansas, and have completed my doctoral degree at UAMS in Little Rock. I’m still happily married to my high school sweetheart, have two daughters, ages three and six, both rotten. And I’m also intimately familiar with disadvantaged communities and am myself a transgender female.
Before voting on this legislation I highly encourage you to first stop into my pharmacy, visit with me so I may dispel any unknowns, and share my experiences of those in my community. My staff and I are always readily available to serve, and we are conveniently located in West Little Rock. If anything, you can always stop at Trader Joe’s and say it wasn’t a wasted trip.
In my practice, I have not experienced a single instance of a patient regretting their transition or starting puberty-blocking medication. I have hundreds of patients currently on hormone replacement therapy that identify as being in the transgender community, each happy to have the opportunity to be themselves and stave off the chronic dysphoria that plagues them.
The biggest obstacle that the transgender individual faces is the lack of empathy, affirming care, and resources to help them succeed in life. Bills like SB199 are designed to hinder, not help Arkansans. By creating barriers to evidence-driven health care they deserve, under the guise of protecting young and innocent.
As a youth who experienced tremendous dysphoria since the age of 12, this is horrific. I was fortunate enough to develop a positive coping mechanism through my adult years to the age of 30 of insistent goal setting to distract myself, which turned into anxiety-ridden OCD. But many are not as fortunate as I have, many develop severely destructive ways of coping via substance abuse, social isolation, poor hygiene, and many more.
I would also like to point out that this bill references Sweden, Finland, France, and the United Kingdom with medical authorities. Those medical authorities are not defined in this bill and as much as I value collaboration, the United States of America have their own 20 medical authorities that I can list or are available for your reference at the transgender legal defense and education website. And I would probably go as far to say a vote for this bill is unpatriotic and casts doubts on our own health and research institutions who have worked through healthcare fields to improve the lives of Americans. In closing, I would like to circle back around to inviting you to my pharmacy.
Sen Rice: You need to wrap up. You’re over your time. I’ll let you go ahead and wrap up real fast.
Herzig: Sorry, it’s my closing. In closing, I would like to circle back around to inviting you to my pharmacy, a refuge for those who have too few resources. Again, I’d love to provide you a new perspective to the existing barriers that our patients are forced to overcome. Not only do I have lived experience but the knowledge and the compassion to know each person has their own life to live and want to make sure they have the tools to grow and thrive. What questions do you have for me?
Sen Rice: Are there any questions from the Committee? Not seeing any, thank you for your testimony. Just a minute, Senator Clark, you are recognized.
Sen Clark: Yes. I just want to know you said that you were not aware of anyone that was unhappy. Are you unaware that there is a large number of people in this country who are unhappy?
Herzig: I act with multiple social media sites for those who de-transition, and those who do de-transition – and I’ve not had any incidents in Arkansas. It’s generally because they have the lack of family support or resources, not necessarily because they’ve regretted the decision that they’ve made.
Sen Clark: You’re speaking for those people. That’s what you’re going to tell me right now, is that you’re speaking for those people. I’ve met a number of them who de-transitioned or want to de-transition, that it wasn’t because they’re unhappy. That it’s just because of lack of family support?
Herzig: Family support and resources. Transitioning is hard. It takes a lot of resources to be able to do it and achieve certain goals.
Sen Clark: That’s interesting because that’s not at all what their story is.
Herzig: Oh, well, I’m in the community with lived experience. So I have a better firm understanding.
Sen Clark: No, no, no, no, no, no, you’re in the community but you said you didn’t know anyone.
Herzig: Not in the state of Arkansas.
Sen Clark: And I do.
Sen Clark: And so what you said about their mindset does not represent the people that I know who have de-transitioned or want to de-transition.
Herzig: To each their own.
Sen Clark: I appreciate that what you know and the people you know but the testimony about why people are doing this I think is completely off-base.
Herzig: I take care of hundreds of patients throughout the State of Arkansas. I’m the main resource center in my pharmacy services. So my view and my patient base I’m sure is far greater than yours.
Sen Rice: Senator McKee, you’re recognized.
Sen McKee: Are you telling us that you’re unfamiliar with the large body of medical evidence of the harm that has come upon people that have gone through these processes?
Herzig: I’m familiar with a large body of evidence that shows that providing good affirming care saves lives.
Sen McKee: Are you saying that you’re unaware of the large body of medical evidence of the harm that has come upon these people in these processes that have been gone through? Are you unaware of that body of evidence?
Herzig: I will repeat what I just said.
Sen McKee: Are you unaware of that body of evidence?
Herzig: I will repeat what I just said.
Sen McKee: You said that you’re a trans woman.
Herzig: A trans female, yes. sir.
Sen McKee: Do you have a penis?
Herzig: That’s horrible.
Sen McKee: You’re the one that brought that into the discussion. You’re the one that brought that.
Herzig: I never said anything about genitalia.
Sen McKee: It’s got everything to do with genitalia.
Herzig: I don’t know what my rights are right now.
Sen Rice: Audience, if you want to stay in here.
Herzig: I don’t know what my rights are but that question was highly inappropriate.
Sen Rice: You do not have to answer any question. If you’re through we’ll dismiss you.
Herzig: Well, I’m not through with questions but I’m not going to answer that question. That’s highly inappropriate.
Sen Rice: Again you can say that and that’s your right.
Herzig: Okay. I’m a healthcare professional, a doctor, please treat me as such. Next question, please.
Sen Rice: Are there any other questions? Not seeing any, and audience let me say this, I did let this witness go over the two-minute mark. She mentioned two different times basically drawing inference to her profession that that’s open and that’s fine but that’s going to be part of the rest of the two minutes. So if you want to promote your business or your profession, do that but that will be part of your two minutes. Thank you.
Herzig: Thank you for your time.
Sen Rice: The next one up that I have as far is Tony Rose. You’ll come up and identify yourself. All of those microphones work, wherever you want to sit. If you’ll identify yourself, and you’re recognized for two minutes.
Rose: My name is Toni Rose. I represent An American Speaks. And I did want to give you real quick to some of the Senators that brought this up, this is from a Swedish study that covered from 1973 to 2003. I don’t think Swedish doctors are any better or worse than ours but they have been performing these surgeries for a long time. And I’ll just wrap up the conclusions, “persons with transsexualism after sex reassignment have considerably higher risk for mortality, suicidal behavior, and psychiatric morbidity than the general population. 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.”
So there’s evidence in the world from people that have been doing this for a very long time that there is definite harm. And where there is potential harm it is our duty as the grown-ups to take care of our children and to intervene, yes to intervene, where there is potential harm to these children. We intervene in abuse cases, we intervene and we don’t allow children to drink alcohol. It doesn’t matter in many of these cases what the parent allows, we as a state, we as a country still intervene on the behalf of an innocent child who is unable to make those decisions.
Sen Rice: Okay. Your time is up. If you’ve got a final statement.
Rose: I wanted to be a lot of things growing up. Sometimes it was based on a TV show, and sometimes it was based on what a friend did or what my favorite uncle started doing. I didn’t end up doing any of those things. So I would ask you to intervene on the behalf of children unable to make decisions when we know that there are studies that this is a harmful practice.
Sen Rice: Thank you. Are there questions from the Committee? Not seeing any, thank you for your testimony today.
Rose: Thank you.
Sen Rice: Next up against, I have Janet Cathy. If you’ll come up. Please make sure that your microphone is on. If you’ll state who you are, who you’re with. You’re recognized for two minutes.
Cathy: Yes. Thank you, Mr. Chairman. I’m Janet Cathey, a lifelong Arkansan. I’m a practicing medical doctor. I’m board certified in obstetrics and gynecology. And I’ve been licensed to practice medicine in Arkansas since 1982. I don’t represent any organization but I speak as a physician who’s been in private practice, the academic setting, as well as the non-profit setting.
I have cared for the transgender population since I went into practice. I founded the Gender Clinic at UAMS. I’ve been Director of Education for Planned Parenthood Great Plains, and have done consulting work nationally on transgender care. So I feel like I am qualified to speak as to the standard of care.
I cannot begin to address the misinformation and inflammatory statements I think that were given by Mr. Stubblefield. Senator Tucker, you’re my new superhero. You may not be a doctor but I think you did your homework. I can only reiterate the questions that Senator Tucker brought up. I think that this bill addresses a very specific medical condition as it applies to minors. And I think it does set a standard of care for the treatment of that condition.
I think the bill puts into law the definition of one medical diagnosis and it determines the way that I would have to treat that condition. It says that medical care is determined not by medical science but by law. I don’t practice medicine the same way I did in 1982. Medicine is not static, it constantly changes and it changes based on the currently best available science and research.
Sen Rice: Thank you for the time, that’s it. The closing remark that I allowed are only for– to make was to balance out the first one again. So thank you for your testimony today. Are there any questions from the Committee? Senator Hester, you’re recognized.
Sen Hester: Thank you for your commitment to caring for people of the State of Arkansas. Do you believe it is necessary that a minor has a say in this process?
Cathey: I think that a minor– I don’t know what you mean by has a say. Yes, of course, yes.
Sen Hester: They do? And so then it would be your belief that a minor can make life-altering decisions for themselves that are a choice and that they shouldn’t be able to make as an adult?
Cathey: I don’t think a minor alone makes that decision.
Sen Hester: But if they have a say?
Cathey: We require parental consent for any type of procedure on a minor.
Sen Hester: Okay, but if a child is opposed and the parents are for it.
Cathey: I don’t see that circumstance.
Sen Hester: Okay but the problem is–
Cathey: You’re saying that a parent is forcing their child to be transgender?
Sen Hester: I’m saying that a parent has undue influence on a child absolutely that’s what I’m saying. Well, so you work in this field. What age can a child actually have influence on this decision? Can a six-year-old or an eight-year-old, 10-year-old?
Cathey: I think that our children always influence what we do.
Sen Hester: Well, but like we both agree that a child should have say. What age can a child have say, like with some actual ability to have say? So like a one-year-old can’t have say. So what age can a child have say?
Cathey: I think it’s variable on the child. I think that children as early as three or four have an awareness of what their gender is.
Sen Hester: So a three-year-old child should be able to have say?
Cathey: And you know you’re taking what I’m saying and changing it.
Sen Hester: No, just would you tell me at what age is appropriate. Because I say it’s 18 years old. At 18 years old someone can have a say on what happens with how they choose to live the rest of their life, not at 17, not at 15, not at 10. Can you tell me what age you think is appropriate that a child should have say?
Cathey: I think that having raised two children, I think that I was aware of what my children needed from the earliest time that they could communicate with me.
Sen Hester: So you are aware of what your child needed. I’m asking when your child is aware. Do you have an idea of what we as a society should believe is appropriate for a child to be able to have say? I say it’s not a child, it’s an adult at 18. Do you have any idea, are you saying one? I mean, can we both agree it’s not one? Can we both agree to that?
Sen Hester: We can’t? Okay.
Cathey: No. Because I mean, how early does a child communicate? You’re just arbitrarily setting this 18.
Sen Hester: Well, society sets that as an adult, 18 years old. I agree it’s somewhat arbitrary but we agree 18, you have to agree somewhere. And we agree in society 18 years old.
Cathey: Okay, if that’s what you think.
Sen Hester: Okay, thank you.
Sen Rice: Senator Clark, you’re recognized.
Sen Clark: Yes, doctor you may need to help me with this because it’s been a while since I looked at this name and I’ll probably get it wrong. Is it the American Child Psychiatric Association, seems like I’m probably leaving a word out.
Cathey: I’m not in the field of psychiatry.
Sen Clark: Okay. Well, it’s something close to that, American Child Psychiatric Association. In reading their – I don’t know if you call it their Bible – but what I found and explained to me by people who did practice, which they explained just what was written, is that gender dysphoria was very rare and happened mostly among toddler males. Is that incorrect? Well, I mean, you’re here as a doctor who treats this subject I thought.
Cathey: To me that’s just kind of a statement. I don’t know the context of it. And it makes no sense to me.
Sen Clark: Okay. Well, I did not look it back up and bring– I had all of this a couple years ago. But it is from the Association, it’s their literature about their position was that it is. Do you think gender dysphoria is not rare?
Cathey: I think gender dysphoria is very uncommon.
Sen Clark: Okay. And you don’t think that it occurs mainly among toddler males?
Cathey: No, I have no idea. I do not know that statement.
Sen Clark: You think they’d be wrong about that?
Cathey: That toddler males?
Sen Clark: And they also according to my reading and that despite treatment, et cetera, that these young males continued to believe that they were girls throughout adolescence but that 90% upon reaching young adulthood, 18 to 25, decided that they were not in fact, girls. Are you aware of that? I mean, this is the American Child Psychiatric Association or whatever the exact name is?
Cathey: I agree that most small children, that little voice that say I want to be a girl, or little girls that say they want to be a boy, most of them do not carry that on into adulthood.
Sen Clark: But that’s not the American Childhood Psychiatric Association not dealing with any little boy and any little girl who says they want to be a boy or a girl. They’re dealing with gender dysphoria, where a young male really believes that he is a girl. That’s the subject, right? And that those affected with gender dysphoria upon reaching young adulthood, 90% according to them, decided that they were in fact not girls. And you’re unaware of that?
Cathey: That may be true. I don’t see how that affects this bill. What my concerns are about this bill, my concerns are standard of care. My concern is that someone can sue me until the day I die.
Sen Clark: Well, people have different concerns. So another study from Sweden, the only exhaustive study that I know of on adolescents who were started out on gender blockers, okay, that 100% when offered surgery did it. Now keep in mind, 90% according to this medical association decided at adults they weren’t actually transgender. But that 100% who started out on the– and these people were not– it was not a study– it’s just a study, they weren’t against it. That this is what happened, that 100% decided to go on with the surgery. Are you aware of that?
Cathey: There are a lot of different studies and again to pull a fact out of context.
Sen Clark: It’s not out of context.
Cathey: Is totally unfair.
Sen Clark: I could not be possibly any more out of context than you might have been. But I am pulling from studies, the most exhaustive study. And the fact that you don’t know about it and–
Cathey: No absolutely, I know about these Swedish studies.
Sen Rice: Let’s ask questions and answer.
Cathey: Excuse me, just you.
Sen Rice: Excuse me.
Cathey: I’d like to answer the question
Sen Rice: You excuse me just a minute, the Chair covered the rules.
Cathey: I defer to you, sir.
Sen Rice: Okay, thank you. What I want is a dialogue back and forth, a question answer. You’re fine to ask a question but don’t talk over each other, please. Thank you.
Cathey: Okay. I’m very familiar with these Swedish studies. My concerns about the bill are that it addresses medical malpractice. And when I am sued for malpractice they do not look at Swedish studies and standard of care in Sweden or in France or in UK. We look at standards of care in the United States of America.
Sen Clark: So if they discovered that something worked in Belgium and it was published and everybody knew it for 10 years and yet it had not become the standard here. You would have no responsibility for it?
Cathey: Well, I know that there are a lot of drugs used in Europe that are not FDA-approved in the United States and we don’t use them.
Sen Clark: That wasn’t my question.
Cathey: Then I guess I don’t understand your question.
Sen Clark: My question was if we discover something that works, you’re aware of it, in another country, you’re not responsible because again the Hippocratic oath about helping folks, you’re not responsible for, if you’re aware of it and that it’s working, you’re not aware of it if it’s not in the American.
Cathey: If it’s not the standard of care within my community.
Sen Clark: How do things become the standard of care if no one–
Cathey: They look at the body of the evidence and the way medicine is practiced within your area. Within your specialty, even within geographic areas.
Sen Clark: So that would explain why gender dysphoria is– we have a much higher percentage among adolescents in California than we do in Ohio, which makes absolutely no scientific sense.
Cathey: I don’t think that’s what necessarily is in the bill.
Sen Clark: Thank you.
Sen Rice: Senator Gilmore, you’re recognized for a question.
Sen Gilmore: Thank you, Mr. Chair. Doctor, I imagine you carry malpractice insurance.
Sen Gilmore: Okay. So and the reason for that insurance is what?
Cathey: Because sometimes unforeseeable events occur.
Sen Gilmore: Great. Thank you. So on page three of the bill, the right of action that’s created in the new section that’s added in 16-114-402 states under the subsection there, “a healthcare professional performs a gender transition procedure on a minor is liable to the minor if the minor is injured, including without limitation any physical, physiological, emotional, psychological injury.” Basically stating what you just stated, if there’s an injury or something created that is life-altering, then this creates a cause of action for which you as a physician have insurance. Would you not agree with that?
Cathey: Insurance is not supposed to make a difference on cause of action, whether you have insurance or not.
Sen Gilmore: Agreed. But you carry insurance in the sense of things do happen. So you are prepared is my point that if things happen or you wouldn’t carry said insurance. Because procedures have a tendency at times to go wrong. May not be anyone’s control, may be out of your control but things do happen. We agree with things do happen that create long-term effects?
Sen Gilmore: Thank you. So we typically trust the court to sort through that, correct? Cases are made, attorneys are hired, cases are presented. They look at all the evidence. Experts come in. Physicians may come in to testify on behalf of the case one way or the other. Is that not correct?
Cathey: I would say that’s correct. But I don’t know of anything else where part of that decision making process is what’s in the law of the state. I mean, there’s not any procedures where state law tells me how I have to practice.
Sen Gilmore: And this bill doesn’t necessarily state that either, it just creates a civil cause of action, correct?
Cathey: To me, it does. It gives the standards of care. It tells exactly the way I’m supposed to treat a patient and what situations, what criteria are set for me to care for someone.
Sen Gilmore: Well, I don’t think that’s what the bill is stating. But to continue on my line of questioning, so we generally trust the courts to be able to sort these things out, correct?
Cathey: I’m not a lawyer. I mean, I don’t– no, many of these things are sorted out well before they get to court. There are experts that address the standard of care. And if you don’t have experts to say that you deviated from that standard of care, it’s not going to go to the court or jury.
Sen Gilmore: But if a lawsuit is brought and it goes to court, as happens quite regularly, the courts do work through that process of bringing in experts to testify and things of that nature?
Cathey: Most malpractice cases do not go to court.
Sen Gilmore: Many of them do.
Cathey: Most do not.
Sen Gilmore: Okay. And we trust–
Cathey: Because you have to have an expert witness to state that you deviated the standard of care.
Sen Gilmore: But we trust in many of those cases the courts to work through that process, do we not?
Cathey: The court, yes.
Sen Gilmore: Thank you. That’s the end of my questioning.
Sen Rice: Okay. And just for information, I’ll remind the Committee there’s 10 more signed up. The time is strictly to be used as Committee sees fit. Next up is Senator Alan Clark, and then after that, Senator Clarke Tucker. Senator Clark?
Ma’am, you were still– there were questions, are you through? There’s still questions for you. The Committee uses the time as they see fit. So I’ve got at least two more that have questions for you.
Cathey: I apologize. I thought you were saying I hope you’re done.
Sen Rice: Senator Clark?
Sen Clark: Thank you, Mr. Chair. Doctor, I’ve always had the greatest respect for the medical community. Have members of my family that are doctors, nurses, and other things. But according to family, I wasn’t there, my great uncle had the flu 100 years ago, my grandpa’s brother, who’s the one who really related it and he was begging for food. And they didn’t give him any because the rule was to starve a fever and he died. Would we have been wrong to as a state to outlaw that practice?
Cathey: I don’t think the state should dictate specific medical care.
Sen Clark: Thank you.
Sen Rice: Senator Tucker, you’re recognized.
Sen Tucker: Thank you, Mr. Chair. Thank you, Dr. Cathey. I don’t want to spend a lot of time on this but I don’t think there’s the greatest clarity on the Committee of how medical malpractice lawsuits function. And I understand you’re a physician, not a lawyer but I would just like to talk a little bit about that. First of all, in a case that actually goes to trial, there’s expert testimony in 100% of those cases, correct?
Sen Tucker: And those expert witnesses, they’re not brought in by the courts, they’re brought in by the plaintiffs who are bringing the lawsuit, correct?
Sen Tucker: And those experts are–they’re of the same type of the medical negligence that’s being pursued. For example, let me clarify what I mean. If you’re suing a doctor, then you have to bring in another physician to establish what the standard of care is for the defendant doctor.
Cathey: And actually it has to be within that specialty. As an OB-GYN, their expert witness has to be an OB-GYN.
Sen Tucker: Thank you. You made my next point for me. It can’t be any doctor, it has to be within the same specialty, correct?
Sen Tucker: And not only that, and this goes to a question Senator Clark was asking before, the locale also matters. If I’m suing an OB-GYN in Arkansas, I can’t bring in an OB-GYN from California to establish the standard of care for the defendant doctor.
Sen Tucker: And so it’s that geography, he made a point about conditions that present in California versus Ohio but that’s not what matters. What matters is the standard of care and the location where you’re practicing medicine.
Sen Tucker: And so in every case in Arkansas that standard of care is not established by a judge or a lawyer or a statute. It’s established by a physician in that specialty from that location, correct?
Sen Tucker: And this bill changes that for these healthcare procedures.
Sen Tucker: Now, that term injury that Senator Gilmore was asking you about, that’s not defined in the bill.
Sen Tucker: In your experience as a physician and health care provider could you see that term meaning a wide variety of different things?
Sen Tucker: As a physician would it be important to you for that term to be defined so you know what kind of liability you may be subject to?
Cathey: I don’t think that we can take one diagnosis and one treatment and subject it to law and ignore everything else. I think that we already have current malpractice laws that determine those standards. You know, that malpractice law is adequate. Current law is adequate to protect children.
Sen Tucker: Thank you, Doctor. One more question. There were some questions for you about toddlers and that sort of thing. And my question is, if you can speak to the distinction between people who may at some point in their lives think that they are the other gender or whatever the case might be. The distinction between that and people who actually attempt to transition genders or seek gender-affirming care, can you speak to that, please?
Cathey: People who seek care, it is a process, it’s not an immediate decision. It’s not a reflex action. It is a process. It’s not as soon as someone decides when they’re three or they’re seven or they’re ten. It’s a process that involves a child, their parents, their healthcare professionals. And not all people do transition. There is not a definite endpoint to transition. Everybody has a different endpoint. It is a very complicated and very thought out process.
Sen Tucker: Thank you. Thank you, Mr. Chair. Thank you.
Sen Rice: Seeing no more questions, thank you for your testimony. You’re excused. Next up, I have Sarah Everett, if you’ll go up to the end of the table. Please state your name, who you’re with. You’re recognized for two minutes.
Everett: Hi, my name is Sarah Everett. I’m the policy director for the ACLU of Arkansas. And I wanted to respond to a few things to make sure we are clear. Care is still available in Sweden, Finland, and the UK. Tavistock did not close because they thought it was a bad idea to provide care, they closed because they wanted to open regional clinics that were closer to their patients.
We have a medical malpractice statute providing claims for people injured by medical treatments. It already provides for claims that arise from treatment that came about without informed consent. And even if we were to accept that no minor in the State of Arkansas is capable of understanding enough to make an informed decision about gender-affirming care, which I do not. It cannot possibly be true that it’s the only treatment that kids might not regret later.
If you want to protect children by expanding medical malpractice claims, you can do so by amending existing code. You can expand the statute of limitations for all malpractice claims for minors. Make it easier to recover damages for emotional and psychological injury for all minor patients. Instead, this bill singles out trans minors to limit their treatment options, even while continuing to allow all other types of treatment, including genital surgeries on young people of all ages, infants who have no choice whatsoever, let alone informed consent. This bill would not provide them a cause of action.
In fact, the bill further singles out transgender minors with disabilities, and those with mental health conditions, preventing them from receiving any medical treatment for gender dysphoria. This puts doctors in the impossible situation of having to choose either to discriminate against their patients with disabilities or lose the potential safe harbor defense.
Sen Rice: Thank you. And time’s up. Questions from the Committee? Senator Clark, you’re recognized.
Sen Clark: Yes, thank you for your testimony. Thank you, Mr. Chair. According to my reading – and perhaps this is incorrect but I don’t think so – but when I was a child in the 1960s, frontal lobotomies on people with certain psychiatric illnesses was widespread. Something that later people seem to think of as being widespread for those particular things as barbaric. If there had been a law passed at that time barring that, would we have been discriminating against those with mental illnesses because they couldn’t choose that care?
Everett: I don’t think I can answer that seeming medical question. I will say I think it’s been pretty evident in–
Sen Clark: Actually, it was a legal question but.
Everett: Well, I don’t know enough about the medicine to say whether that would have been proper at the time because care of today is based on the medical standards we have today. Which as has been said, in the United States, overwhelmingly supports this medical treatment for gender dysphoria.
Sen Clark: You understand why I brought up frontal lobotomies and the fact that now we think that a lot of that was barbaric, is that medicine doesn’t always get it right, am I wrong?
Everett: No you’re right.
Sen Clark: Okay, thank you.
Sen Rice: Any other questions? Thank you for being here today. Next up, we have Kirsten Sowell. Please state your name and who you’re with. And you’re recognized.
Sowell: Sure. My name is Kirsten Laura Sowell. I am a social worker in our state. And I help our pediatric transgender clients in our state too. I want to start off by saying that I was quite upset, Senator McKee, that you asked my friend if she had a penis. And I would just like to tell you that even if you have a penis it doesn’t mean that you have honor or that you’re a man.
I want to say that when I worked in the gender spectrum clinic there were none of the kids that we saw that died by suicide or any medical wrongdoing. There were three kids that I know of during that time that did die by suicide who were transgender. I know about one who shot themselves in the head. I know about another who had a referral to the clinic and was not able to come because they died by suicide before. Their friend luckily was able to come. And I know about another person who was in the ICU twice, who did eventually die by suicide.
Gender-affirming care is a life-saving act. And it is done with medical professionals, mental health professionals, parents. And kids are a part of the process but just like everything else, they have to be 18 to make legal decisions for their medical care. That’s why it takes all of the professionals working together. It doesn’t take actually any Senators or any legislators.
Sen Rice: Are you finished?
Sowell: I am.
Sen Rice: Thank you. Are there questions for this witness? Senator Clark?
Sen Clark: Mr. Chair, it’s late now but mine was simply a point of order about the comments that were made at the beginning that were obviously intended as an insult toward one of our members.
Sowell: I had that same problem with one of your Senators.
Sen Clark: A point of order that I’m being interrupted now.
Sen Rice: Do not speak over.
Sowell: Sure, sure. Thanks.
Sen Rice: Okay. I take your point of order. I have given more leeway here because of the divisiveness in this but we will not have more of that. Seeing no question for you, thank you for your testimony.
Sowell: Thank you so much.
Sen Rice: Next up we have Alex Marshall. Please state your name and who you’re with. You’re recognized for two minutes.
Marshall: My name is Dr. Alex Marshall. I’ve been in academia for over 10 years now. I’m not here on behalf of UAMS. That is where I conduct most of my research, much of which involves being focused on healthcare and treatment of LGBTQ-plus individuals. And it’s this experience that gives me confidence in speaking to you today. I’m also a fifth-generation Arkansan, a wife, and mother. And I’m not here on behalf of myself but on behalf of friends and colleagues who would be negatively impacted by this bill.
If I understand it correctly, part of the bill creates an opportunity for a malpractice suit to be brought up to 30 years after a person’s received gender-affirming care. I cannot after over my decade of experience speak to a single time I’ve encountered a trans person who has regretted their decision. But I’m not so bold to believe that it has never happened or could never happen. I do think however, we should create legislation based on the benefits of knowledge that we have from the many, the many Arkansans and US citizens that we have, and not based on just a few studies pulled from other places.
I’m not familiar with the research from the countries mentioned. However, what my research has shown is that gender-affirming care here in Arkansas has positive outcomes and saves lives, period. I could go on to provide other studies, rebutting many of the points made but I will save time. First, since we do already have the quote-unquote “Safe Act” in place from 2021, I do think this bill is not needed.
Second, I have collected survey and interview data from at least 218 LGBTQ-identifying youth in Arkansas. Among those at least 129 identified as trans or non-binary but many and about half had not visited a gender-affirming healthcare provider but that was because they did not feel like they needed one. This means for this generation of trans youth many are identifying as on the spectrum, which does exist. There is a place for everyone on the gender spectrum. And it does not mean that many of these youth want hormones or want to pursue transition because they are fine just the way they are as long as they have parental and family and friends support.
Sen Rice: Okay. Thank you, time. Questions from Committee? Senator Hester, you’re recognized.
Sen Hester: Yeah, you said you spend a significant amount of time on this. Do you work off of individual grants or do you work off of taxpayer funded?
Marshall: Many of my grants are federally funded.
Sen Hester: Thank you. With you being somewhat of an expert on this, do you believe that a child one-year-old can consent to this type of treatment?
Marshall: I don’t think that my child at one year old would have considered this type of treatment. But also I would not pursue this type of treatment without my child wanting it.
Sen Hester: A medical professional, do you think a one-year-old, any one-year-old can consent to this type of treatment?
Marshall: I’d like to speak to the bill at hand and I don’t think this a point that we’re going to resolve any conclusion on today.
Sen Hester: I assumed as much. Thank you.
Sen Rice: Seeing no other questions, thank you for your testimony.
Marshall: Thank you.
Sen Rice: Next up, Marie O’Connell. You’re recognized to come to the end of the table. Please state your name and who you’re with. You’re recognized for two minutes.
O’Connell: I’m Reverend Marie Mainard O’Connell, and I’m here today both as a pastor and a parent of a trans child. As a minister, this bill emerges from a desire to protect our youth from harm but I perceive it as introducing harm to my child, my family, and the community that I minister with.
As a parent, I have two specific concerns with this bill that I am going to ask to be struck from the bill. The unnecessary delay of care can exacerbate the depression and anxiety that is caused by dysphoria. I’d ask you to turn to page 4, line 3 of the bill. This requires a mental health professional to prove that there is in writing no common comorbidities, no other mental health concerns. And this list includes conditions that can result from gender dysphoria, namely depression, eating disorders, and possibly anxiety, which is the most common result of living with gender dysphoria.
But also this list of conditions here includes genetic and hereditary lifelong conditions, autism, and ADHD. I’m unclear why they are included in this list. It is seemingly to me that they are here because they would preclude an individual from being able to make decisions for themselves. I request that this entire section be struck from this bill or that you otherwise vote no because it makes it impossible for my child to be able to receive continuing care if they already have conditions on this list.
This bill does not provide as well an opportunity for minors to continue their current care, including plans for as yet unstarted hormone treatment or surgery. And my question regarding when one can make these decisions. As a minister, I wonder when one can choose a life-altering decision. At what age can a child choose Christ? My point here is this, that this bill makes the assumption, there are some underlying Christian assumptions here and I speak to it. I hope you have questions about it.
Sen Rice: Thank you. And are there questions from the Committee? Not seeing any, thank you for your testimony. Next up, I have Courtney Frierson. If you’ll come to the end of the table. Please state your name and who you’re with. You’re recognized for two minutes.
Frierson: Good morning. I’m Courtney Frierson a social worker, an AASECT-certified sex therapist and I speak on behalf of my trans siblings, my clients, and all Arkansans who believe in body autonomy. Imagine everyone you encounter all day long telling you that you’re not real, there’s something fundamentally wrong with you. Being constantly invalidated takes a toll, 40% of trans and gender non-conforming people have attempted suicide. When you constantly hear that you don’t matter and you don’t exist, you sooner or later come to believe that, Alok Vaid-Menon, a non-binary artist and activist.
I have so many concerns about this bill, from the statute of limitations being extended from two years to 30. To targeting a specific population. To the government intrusion on bodily autonomy, to the proposed mandatory statement of facts which is not based on robust medical research and does not cite the Worldwide Professional Association of Trans Health that has shaped the standards of care since 1979.
I’m a mental health provider though, so I’ll stay in my lane and focus on the implications on the mental health of trans and non-binary youth. One part of this bill stipulates that a trans minor must have no other mental health concerns. This alone would make nearly all trans youth ineligible for any gender-related care. Citing the Trevor Project’s 2022 national survey, which captured 34,000 LGBTQ youth response, three-fourths of transgender and non-binary youth reported experiencing anxiety. Two-thirds experience depression.
Banning a person with a co-occurring diagnosis from accessing healthcare is outright disability discrimination. 60% of all LGBTQ youth who wanted mental health care were not able to get it, including nearly three in five trans youth. Trans youth are not inherently prone to suicide, depression, or anxiety because of their gender identity. They are at a higher risk because of how they are stigmatized in society, which includes legislation like this.
Sen Rice: Thank you. Are there questions from the Committee? I did allow a little extra time because you got your composure and I didn’t want to penalize you for that.
Frierson: Thank you.
Sen Rice: Senator Tucker, you’re recognized.
Sen Tucker: Thank you, Mr. Chair. Just one question, we heard a statement earlier that suicide rates are the same regardless of whether you successfully transition or get treatment or not. Is it your understanding that for transgender teenagers, the suicide rate is much lower for those who undergo gender-affirming care?
Frierson: To my knowledge, and in my 15 years of experience serving trans people, yes. Being able to access very cautious especially with trans youth – being able to access the standards of care as they currently are outlined for the past 44 years. They are considered to be irreversible– I’m sorry, reversible like hormone blockers. And then they slowly proceed to reversible– I’m sorry, irreversible, which is cross-sex, cross-gender hormones, HRT. And then finally surgeries which to my knowledge are not being done in the State of Arkansas to minors under 18. So yes, being able to access at least puberty blockers as a placeholder to buy some time to sort out all of these things is essential in reducing suicide risk.
Sen Tucker: Thank you.
Sen Rice: Senator McKee, you’re recognized.
Sen McKee: Thank you for testifying. So it appears to me that the only reason we’re discussing standard of care is because the Senator who is against the bill brought it up. It appears to me that this bill is designed to help the very people who you say you represent. Because I myself I will never have the need to sue a doctor who, through fault of their own or not, did gender-affirming care as you call it on myself. I will never have that need. But it seems to me that it would only be those people who are going through that care that this would seek to protect. What am I missing? Who else would it protect?
Frierson: I believe that medical doctors, therapists that have been working with transgender people should establish the standards, not a legislative body of the State of Arkansas. I do not trust you for my medical decisions.
Sen McKee: We’re not establishing standards. All we’re seeking to do is provide those individuals that have, unfortunately, negative impacts because of these acts taken by medical professionals, an opportunity to hold them accountable. Thank you.
Frierson: I would like to answer your question. There’s the statement of facts that must be read 30 days prior to the first appointment, and for the first six months at every appointment both in written form and verbally. And that is essentially an informed consent form. I researched informed consent forms throughout the country that are given to families, and they do not cite the same things that this bill cites. They are actually citing medical evidence.
So if you insist on being a state that governs the body and must have an informed consent standardized in the State of Arkansas to protect children from injury, by all means, use medical research and also use informed consent that already exists by people that serve this community. I highly disagree with that because I believe in body autonomy and the government not regulating that but if you insist as this bill does, you could use actual medical research.
Sen Rice: Were you through, Senator McKee? Senator Hester, you’re recognized.
Sen Hester: I think you’ve nailed the very part of the bill. This is like a child can’t consent. We’re saying a child cannot consent. And the argument in the room is the child should have a decision. They cannot consent. A parent can consent for them. And we’re saying that when a child becomes an adult and feels like they were wronged, that they never had the ability to consent because they were a child.
Frierson: I think that you and I agree on the fact that families, in concert with an interdisciplinary team should be the ones making decisions in addition to a child’s wishes to protect them from injury. Just like every other medical procedure that’s done on a minor. It’s the children, the doctors, the professionals, and an interdisciplinary team. Can we agree on that?
Sen Hester: I do not believe a child can consent to being abused.
Frierson: I also believe a child should never be abused.
Sen Hester: Thank you.
Sen Rice: Senator Clark, you’re recognized.
Sen Clark: Thank you, Mr. Chair. You made a very ardent statement on the subject of suicide, that it was not because of other things but because of the stigmatization of society. Can you provide a citation for that?
Frierson: I sure will. Earlier when you were citing the American Psychiatric Association, I think you were talking about the DSM-5. And the DSM-4 actually had a diagnosis called gender identity disorder but the newer one, the DSM-5 it changed it to gender dysphoria to recognize that the pain in gender dysphoria is about being couched in a society that does not accept any gender variance, not necessarily something fundamentally wrong with the person. So that body which creates the standard of care for mental health diagnoses has already established that. You can open the DSM and read under gender dysphoria to read more about that. I didn’t bring mine with me today.
Sen Clark: I think my question was– you said that suicide was because of that?
Frierson: No, I said the suicide risk is not because of their gender identity, it’s because they’re at higher risk of how they’re stigmatized in society. For example, laws like this that create a public discourse and people who are uninformed, uneducated making decisions about their bodies is very threatening. That even the conversation in today’s room has been violence against my transgender siblings.
Sen Clark: So not only would it be out of order to pass this bill, it’s out of order to have the discussion?
Frierson: I personally don’t believe that our government should be creating laws to govern our body.
Sen Clark: That wasn’t my question. My question was so not only would it be out of bounds to pass this law, it would be out of bounds to have this discussion.
Frierson: If we can have a discussion and not be limited to two minutes our side and infinite minutes your side that might be a fairer discussion.
Sen Clark: There was nothing about fairness. It was that this was harmful.
Frierson: It is doing harm to my clients that come in.
Sen Clark: So the discussion is doing harm? The open free exchange of dialogue is doing harm?
Frierson: The content of this bill and the Safe Act, and the bathroom bill, is doing harm to my trans clients and my trans siblings, yes, I agree with you.
Sen Clark: No, we don’t agree. The question was that can we, or can we not discuss these subjects without causing harm.
Frierson: I don’t think I can answer that without sarcasm. So I’m going to defer.
Sen Clark: I didn’t think you could either.
Sen Rice: I don’t see any other questions. Thank you for your testimony. Next up, we have Diane Skaggs. Come to the end of the table. Please state your name and who you’re with. You’re recognized for two minutes.
Skaggs: Yes. Thank you for allowing me to speak today. I’m Diane Skaggs. I’m a mental health professional social worker for over 30 years. Currently, not with an agency, I retired last year. I felt very strongly about this bill and felt that I should come today. But the social worker part of me just wants to say that we use a multidisciplinary team to have discussions and to discuss things that are not necessarily pleasant but that we have to deal with so that we can alleviate the pain of people that we serve.
As a mother and as a grandmother, I want to make sure that my children and grandchildren are seen under the best medical practices. And that the best medical practices are allowed and not hamstrung by the fear of a 30-year malpractice hanging over their head. That, no other discipline has that, no other population has that except in this bill. I think that malpractice alternatives are important to have. I think that not everybody’s a good actor. But I also believe that undue restrictions limited to a certain population is very harmful. I have people that are dear to me that are transgender and I have seen them suffer. I’ve seen their parents suffer during interviews on a professional level. And think that it’s a very complicated issue and I don’t think it can be decided in these bills. I think that there’s other ways to go about it.
Sen Rice: Thank you. Any questions? Not seeing any, thank you for your testimony. Next up, I had these four more. Jess Disney, you’ll come to the end of the table. Please state your name and who you’re with. You’re recognized for two minutes.
Disney: My name is Jessica Disney. I’m 30 years old, a trans woman. And I’ve had access to medical care for my gender transition for over two years, and socially transitioned prior to that. I want to take issue momentarily with the use of the word mutilation and the multiple mention of youth age consent by some of the people here on this Committee right now. When we are referring to the gender care and whenever you do research into gender care for people under the age of 18, most of that, besides puberty blockers, has to do with social transition. And it is mostly a fear-mongering talking point to refer to it as mutilation and surgical interference. When we have no broad cases, nor any of these surgeries–evidence of these being performed here in Arkansas.
Many people spoke to things that I already wanted to talk about so I’m going to take a second and say that over the last month my time– so I’ve spent years working with marginalized youth in our community here in Arkansas and the central Arkansas area. Over the last month, I’ve had three transgender youth reach out to me and discuss with me their increase in suicidal thoughts. One of these individuals, only one of these individuals is supported by their close family and– sorry, by their close family in addition to their friends.
Two of these individuals have made unsuccessful attempts at their own suicide over the course of this past month. Each one of these expressed to me that this conversation being had by our legislature and these laws that are trying to be passed by you guys is directly affecting their mental health. And their concerns that the state that they were born and raised in, that they must consider having to run away with their family and seek to find other places that could help them live their lives as themselves.
Sen Rice: Thank you.
Disney: Thank you. I’ll take questions.
Sen Rice: Any questions from Committee? Thank you for your testimony.
Disney: Appreciate it.
Sen Rice: Next up I have Ally Thomlinson. Please take a seat at the end of the table. State your name, and who you’re with. You’re recognized for two minutes.
Thomlinson: Hello, everyone. Ally Thomlinson here from Disability Rights Arkansas. You’ve heard a lot of individuals that you all represent here today that are against this bill. And I just want to point out that there is a mental health crisis among trans youth. And pieces of legislations like this do make it worse for children, especially here in Arkansas because that is your audience. I really want to point that out.
This bill introduces nothing but the things that we’ve read on Facebook that’s fear-based. And it’s just full of misinformation. Of course, I did have a long speech prepared to you today but I do want to hit on Senator Clark. I know how we always love all the information that you cite for us. So I have all of this for you and ready just to drop into your inbox and but this is from the standard medicine says that trans and non-binary children are four to seven times more likely than their cisgender peers to experience depressive episodes.
And this study is also from 2022, and it shows us that trans and non-binary youth who receive gender-affirming care are 60% less likely to develop moderate or severe depression and 73% less likely to experience suicidal thoughts. And like I said, I’ll have all of that ready for you.
Everyone on this Committee has talked about saving children and protecting children. That’s the reason why we’re here. This bill is not needed in Arkansas. There are actually, there’s quantitative data out here and ready for you to act on to help the children of Arkansas. For instance, the PTRS Center here in Arkansas, and the boards that are not doing anything about the abuse and neglect that’s there. Now this data like I said, is ready and I’ll be happy to send that along to you but it is accessible for you already. There are children in Arkansas that need your help right now and this bill is not going to do anything because it’s not needed. So I will ask you to not lose sight of your principles, and while you’re on this Committee and vote no so we can get you the real work. Thank you.
Sen Rice: Thank you. Questions from the Committee? I don’t see any. Thank you for being here. Next up, I have Haley Prentice. Please state your name and who you’re with. You’re recognized for two minutes.
Prentice: Yes. My name is Haley Prentice, and I’m a lifelong resident of the State of Arkansas. I was educated here in the State of Arkansas in a rural school district. I attended college here in Arkansas, and I was raised by parents who were both born here in Arkansas.
I am also transgender. And I knew that at an early age but because at the time I grew up in, transitioning for somebody at my age was not possible as a teenager. So I repressed this. I repressed it by different ways, by trying to act masculine, by overeating, by using smokeless tobacco to be more masculine for five years. I still have part of my teeth where I used that. And I quit, fortunately quit, so I still have most of my teeth left.
Senator Stubblefield mentioned something about trans youth being in bondage. Let me say this, I was in bondage for 40 years. 40 years of denying who I was. I knew who I was but I was trying to fit in society, trying to fit into somebody’s idea of society. And it took me a long time to realize that I was not going to be cured of being– I could not be straight or be cisgender because I was assigned male at birth. It doesn’t matter how long you go to church. It doesn’t how long you– how many people you marry. If you’re transgender, and you’re truly transgender, you’ll be transgender. It’s how you deal with this. And I don’t want the youth of Arkansas to be in bondage, and not be able to do something about their condition. Therefore this law is unnecessary and unneeded and I ask the Committee to vote no.
Sen Rice: Thank you for your testimony. Any questions from the Committee? Thank you for testifying today. Last one I have signed up is Lance and LeVar I think. LeVar, Okay. If you’ll give us your correct name at the end of the table, and who you’re with. You’re recognized for two minutes. Thank you.
LeVar: Excellent. My name is Lance Levar, private citizen upper middle class, Christian, cisgender, heterosexual male. I am here to speak against this bill. There have been great points that have been made. I just would like to point out some of the things that were said. Senator Hester spoke a lot about age of consent and how we’ve determined that’s an 18-year-old adult. However, we are able to try children as adults.
In addition, we talk about refusing the suit that happens out there. Are they also allowed to sue doctors who refuse to give this care when they become adults because of malpractice? We’ve talked earlier about the addition of the malpractice to 55 years but also that says or three years from the discovery of whichever is the soonest. So we need to be careful if we’re going to compare different things that we actually give the proper comparison of stuff.
In addition, we talk about the difference between this law and the other law. One is bypassing constitutional rights for civil rights, whereas other child protection laws are not. And finally, I think the most important thing stated was stated from Senator Stubblefield when he said I am not a doctor. And I say that because this is a law that defines medical practice.
I’m against it as a Christian, as a father, as an uncle of a transgender woman. Thank you and I’m open to any questions having been an educator for many years and watched the kids struggle over these types of discussions that are not based in fact but conjecture.
Sen Rice: Any questions for the witness? Not seeing any. Thank you for being here today. Senator Stubblefield, we are back to you, if you want to go to the end of the table. Senator Stubblefield, you’re recognized to close for your bill.
Sen Stubblefield: Thank you, Mr. Chairman. Thank you, Committee for listening and your patience. And thank you for everyone that came today. One of the people who testified said she doesn’t trust us as politicians. I hear that a lot. But the fact of the matter is, 12 million people died last year because they were misdiagnosed in hospitals in the United States, 12 million. Another 250,000 died last year because of medical errors. And another 7,000 to 9,000 die each year from the misdiagnosis of drugs that were given at a pharmacy. So we’ve rehashed the gender when really this bill is about– it’s not about gender. This bill is about a cause of action for medical malpractice. So I would hope for a good vote and I’m closed.
Sen Rice: Are you making your motion?
Sen Stubblefield: I’m making a motion do pass.
Sen Rice: I have a motion do pass. Do I have a second? Any discussion on the motion? Senator Tucker.
Sen Tucker: Thank you, Mr. Chair. I won’t be too long. There’s just a few points I want to make based on the discussion we’ve had. We talked about a constitutional right to child abuse. I think there’s a gross mischaracterization of what’s happening in the field with gender-affirming care.
We’re painting with a very broad brush when we use terms like child abuse and mutilation. There’s not one case in Arkansas history that I’m aware of nor could anybody point to today of gender reassignment surgery for a minor. Two years ago when we passed the SAFE Act and our former governor went on the Tucker Carlson show, Tucker Carlson was talking about chemical castration of minors. There’s nothing like that that is taking place in Arkansas and I don’t believe anybody would think that would be permissible.
The type of care that’s taking place is what one of our witnesses talked about. It’s a placeholder to delay a decision for teenagers who are experiencing gender dysphoria. There’s nothing permanent taking place. And beyond just the placeholder treatment through gender affirming-care that these teenagers receive or that they have been able to receive in the past. Beyond that it just lets them know that they are loved and affirmed for who they are. With this bill– it won’t affect 99% of Arkansans or more, 99.9%. But the people who it does affect, the message they receive from this is that the state they live in hate them. That’s the message they receive from this.
Now, if we were really concerned about kids and not concerned about transgender teenagers, then this bill would read a lot different. There’s no legitimate explanation for prohibiting puberty blockers for teenagers experiencing gender dysphoria but not prohibiting it for kids who experience precocious puberty. It’s either dangerous to kids or it’s not. So if it’s a real problem for kids and the government needs to step in to protect them, then by all means let’s do it for everybody, not just the ones who are experiencing gender dysphoria.
Or as another witness talked about today, there are kids who are born – I think we all understand and realize babies who are born with genitalia for both genders. And there are surgeries that are performed when they’re infants. They’re not consenting to that. That’s life-altering. Should we wait until they’re 18?
And beyond just gender specific issues, there have been a bunch of points today made about kids who experience medical treatment. Well, let’s extend the statute of limitations for all forms of medical treatment for kids. But we’re not talking about any of that. We’re only talking about one very specific thing which is how you know this population is being targeted.
Now, there’s no constitutional right to child abuse obviously, but there is a constitutional right to equal protection under the law. And the Supreme Court of the United States recently, including with all three of President Trump’s nominees confirmed that equal protection when the word sex is involved includes transgender. And I’ve just taken us through how this bill targets folks based on their gender, transgender. So it does violate the equal protection clause of the United States. We already have a case that’s preliminarily decided that in Arkansas, not permanently but we’ll see where that goes. And I agree with Brett Kavanaugh, that private rights of action for constitutional rights is a bad idea. We’re opening Pandora’s Box when we do that not, only in Arkansas but in other states.
But I’ll wrap up, Mr. Chairman. I’m voting against this because I believe it grossly mischaracterizes what’s happening out there. It ignores the experts in the field. Once again we’ve spent two hours on this when there’s about 20 kids in Arkansas who had been receiving this treatment prior to the SAFE Act and 25% of kids in Arkansas don’t know where their dinner is coming from tonight. But these are the issues that we’re focusing on and the bill is problematic for all of these reasons and I’ll be voting no
Sen Rice: Senator McKee?
Sen McKee: I just want to go on record, with all due respect to Senator Tucker, just about everything he said was either incorrect or misapplied with respect to this bill and I’ll be voting for it.
Sen Rice: Okay. And members I’ve offered as much latitude as I can. We’ve got a motion on the table, a second. All in favor aye? Opposed? Bill passes, SB199. And we are out of time. This will conclude Judiciary today. We are through. We’re adjourned.