Hearings to examine gender transition procedures on minors.

Education, labor and pensions will please come to order. As parents, children are often the greatest source of joy and the greatest source of worry. Their happiness and safety are a top priority. And we, collectively, want to protect and also let them grow and flourish into successful and independent adults. Many parents, have particular concern about transgender ideology taking over children's schools, social media feeds, and monopolizing pediatric medical focus. Gender ideology is being pushed to convince children and parents that cross-sex hormones and irreversible sex change operations are acceptable solutions to gender dysphoria. More children than ever are confused about gender. from twenty seventeen to twenty twenty five the number of children children identifying as transgender increased about three hundred and eighty three percent by the way it seems to be more of an issue for children than adults nearly twenty five percent of all transgender americans are children given the number of individuals identifying as transgender decrease decreases as age increases This suggests that oftentimes, children grow out of gender confusion. With rare medical exception, a child should not have this ideology forced upon them by an over-eager institution, which often makes a significant amount of money from doing these procedures. These drugs and procedures leave children with long-lasting, life-altering, irreversible, psychological, and physiological damage. Medical organizations claiming to care for children, namely the American Association of Pediatrics and the Endocrine Society, alongside fringe, discredited activist organizations like the World Professional Association for Transgender Health, continue to advocate for irreversible gender transition procedures for children, despite mounting evidence these are harmful. They defy science, the medical community, and executive orders directing federal agencies to ensure children are not subjected to chemical and surgical castration. After years of help investigations and public pressure, medical organizations like the American Society of Plastic Surgeons and the American Medical Association have begun to change course. The ASPS, or the American Society of Plastic Surgeons, changed their position statement to recommend that, quote, " surgeons delay gender-related breast, child, genital and facial surgery until a child is at least nineteen. In agreement, the AMA told the in the New York Times, the evidence for gender affirming surgical intervention in minors is insufficient for us to make a definitive statement. In the absence of clear evidence, the AMA agrees with the ASPS that surgical interventions in minors should be generally deferred to adulthood. That should be obvious. Americans and their health care providers deserve to know that medical guidelines, especially for children, reflect the best scientific evidence and are not influenced by extreme ideology. The stories are heartbreaking. In a Supreme Court amicus brief, Laila Jain shared her experience of medical professionals confusing children about gender identity. She suffered from an array of complex mental health symptoms and was exposed to online transgender influencers who falsely led her to believe she was transgender at just eleven years old. Her parents sought guidance from various doctors who immediately promoted gender transition. In L- Laila's own words, "I went straight from training bras to binders to a double mastectomy by thirteen." No doctor ever asked me about my past sexual trauma or why I thought I was transgender. After being prescribed and taking puberty blockers and testosterone, Her breasts were surgically removed after a mere seventy-five minute mental evaluation. Uh, Layla Jane de- de-transitioned when she was seventeen, but her medical procedures have left her with persistent nerve pain, poor self-image, and fertility complications. Unfortunately, there are a lot of stories like this, and our witnesses today will speak more on this. Chloe Cole is a de-transitioned twenty-one year old woman from California. who went through the process of medical transition starting at age twelve. Our other witness is Doctor Curt Miscelli, a psychiatrist and chief medical officer at Do No Harm. And I thank you both for being here. If a doctor, teacher, or therapist tells a concerned mom that if they don't agree to transition their child, they will lose them to suicide, what is a parent going to do? First, there is zero evidence that gender transition procedures improve mental health. The opposite is often true. Second, the reality is that many of the children suffering from gender dysphoria will outgrow their diagnosis within a few years. Allowing minors to permanently change their body causes more significant harm to their overall health and well-being long-term. And we shouldn't confuse advisory boards, uh, but as a physician, I am part of professional organizations, and understand how people who have got a certain viewpoint gravitate towards the advisory board within that organization. So we should not confuse advisory boards being overtaken by activists as if that is necessarily sound scientific evidence. We should be treating each child with the specialized care they need, not encouraging a nine year old boy to become a girl. It is our jobs as parents, as doctors, as teachers, to protect children from harm. As senators, it is our job to stand up for what is right against what is wrong. to support science and to speak out against quackery, and to align public policy with the best interests of children and families. This includes not funding providers or organizations, taking generous federal dollars, and then promoting or performing gender transition services on minors. Let's put politics aside, and first do no harm. Let's fulfill our duty to let kids be kids. With that, I recognize Senator Sanders.

Thank you very much. Mister Chairman, and I have to say, uh, that this hearing is disappointing. It is disappointing in the sense as to why millions of Americans are giving up on the political process. They look to Washington at a time when they are facing unprecedented crises, and they're saying, who is responding to our needs? And today we are spending a hearing, discussing spending hours on a hearing that impacts an infinitesimal number of people. Now, I'm wondering why, if you're concerned about children, why are we not dealing with the fact that the United States has the highest rate of childhood poverty of almost any major country on Earth? Now, here's the good news. We're not in last place. We're only in thirty-fifth place out of the thirty-six countries looked at by the United Nations. We're ahead of Uruguay. What about a hearing on that? What about a hearing on why in the richest country in the history of the world, millions of children today are going hungry, and Republican policies have made that worse? What about a hearing, Mr. Chairman, to ask why it is that the United States remains the only major country or enough not to guarantee health care to all people as a human right? What about a hearing to discuss What does it mean that sixty thousand Americans will die this year because they don't get to a doctor on time? Sixty thousand Americans. What about a hearing talking about how our life expectancy is lower than other countries, despite spending twice as much per capita on health care as the people of any other country? But what this hearing about is not about health care. It's not about children. It is about base politics. It is what my Republican colleagues do to get votes. you pick on a powerless minority, today it's not undocumented immigrants, today it's trans kids, and maybe we can get some votes getting everybody to kinda hate this powerless minority. Here are the facts when we talk about uh transgender kids. According to two peer-reviewed studies published in the Journal of the American Medical Association, the largest medical association in America, Not a single child in our country under the age of twelve has received a transgender surgery. Zero. A grand total of eighty-five transgender teenagers between the ages of thirteen and seventeen received a surgery to deal with their bodies and most of these procedures was chest related in other words boys who had breasts they were concerned about that et cetera et cetera. Less than one hundredth of one percent of teenagers in America receive medications for gender, dysphoria, and none of these medications went to a child twelve years of age or younger. In other words, Mr. Chairman, we are using precious committee time dealing with an issue that impacts at most less than one hundredth of one percent of teenagers throughout America and zero kids under the age of twelve. Let's be clear. The standard of care for transgender youth that my Republican colleagues are attacking today is supported by the American Medical Association, the largest professional association of doctors in our country, and the American Academy of Pediatrics, the largest professional association of pediatricians in our country. What the medical and scientific community tells us is that gender affirming care is associated with a lower risk of depression, severe anxiety, and suicidal thoughts. Bottom line, gender affirming care for youth should be between a doctor, a patient, and their parents, not politicians and the federal government. Not only would banning gender affirming care do nothing to protect kids, it will make it harder for them to get the health care they need. And that would be a tragedy. Thank you, Mr. Chairman. First, uh, uh, witness, we'll go to our witnesses.

We're joined by Doctor Kurt Miscelli, Chief Medical Officer at Do No Harm. Doctor Miscelli has extensive experience working in mental health crisis centers, drug and alcohol rehabilitation programs, and adolescent residential treatment facilities. He received his BA in economics and BS in biology at Villanova University, his MBA from UVA Darden School of Business, and MD from Drexel University College of Medicine. He is board certified in psychiatry and internal medicine. Uh, thank you, Doctor Miscelli, for being with us.

Thank you. Chairman Cassidy, Ranking Member Sanders, and members of the committee, thank you for the invitation to speak. My name is Kurt Miscelli. I am a psychiatrist and Chief Medical Officer of Do No Harm, a diverse group of over fifty thousand health care professionals and concerned citizens committed to keeping the practice of medicine grounded in scientific evidence. in line with today's hearing my organization works to protect children from the dangers of gender transition procedures. i want to start by acknowledging an uncomfortable truth, which is that my profession, medicine, sometimes gets things wrong. from frontal lobe lobotomy to the opiate overprescribing crisis, medicine is riddled with examples of misadventure and even scandal. however what earns doctors the public's trust isn't being mistake free, but rather our willingness to face up to those errors, and correct course. Do no harm has identified nearly fourteen thousand minors who received gender transition procedures from twenty nineteen to twenty twenty three, including over fifty seven hundred surgeries. Yet nearly two dozen systematic reviews find no credible evidence supporting these interventions, not for overall mental health improvement and not for preventing suicide, which is thankfully very rare. Meanwhile, the known or expected harms include infertility, sexual dysfunction, bone density problems, cardiovascular disease, and markedly elevated mortality. Tragically, many of these youth will experience lifelong regret, given irreversible effects of these interventions. Other countries have rightly reacted to this evidence. The United Kingdom has banned puberty blockers, and the National Health Services has stopped providing cross-sex hormones for youth. In Sweden and Finland, medical professionals began a self-correction under left-leaning governments. In February, the American Society of Plastic Surgeons, representing over eleven thousand surgeons, appropriately responded to the scientific evidence by recommending against gender surgeries in minors. ASPS also warned about the risks of puberty blockers and cross-sex hormones. One organization bears primary responsibility for my profession's failure to examine the evidence impartially and correct course, and that is the World Professional Association for Transgendered Health, or WPATH. WPATH has positioned itself as the preeminent authority on gender medicine, and has influenced other groups to adopt its recommendations favoring gender transition procedures on minors. In twenty seventeen, the Endocrine Society released its gender transition guidelines, authored almost entirely by individuals with clear ties to WPATH. The American Academy of Pediatrics endorsement of pediatric gender transition explicitly cites WPATH's authority. To date, WPATH's recommendations for children have been by insurers hospitals and regulators they have been invoked in legal briefs in short in the united states pediatric gender medicine is w path and w path is pediatric gender medicine but the foundation upholding w path's recommendations has effectively collapsed in twenty twenty four court proceedings revealed egregious misconduct in how w path developed its highly influential standards of care first w path commissioned systematic evidence reviews on treating minors but suppress them when finding, when the findings didn't support its approach. It then deceptively claimed that such reviews in adolescents were quote " not possible", unquote. News of Wpath's misconduct was widely reported. One headline in The Economist read, " Research into transmedicine has been manipulated." The Washington Post editorial board wrote, " The World Professional Association for Transgender Health interfered with systematic reviews it commissioned." And The Atlantic concluded, this is not how evidence-based medicine is supposed to work. No less egregious, within hours of publishing its standards, WPath deleted all age minimums for hormonal interventions and most surgeries under pressure from the Biden administration and the American Academy of Pediatrics. These revelations illustrate a troubling pattern. WPath's recommendations are not driven by science but by ideology. And one of the most tragic aspects of this medical scandal is the over-representation of same-sex attracted youth among those who are harmed by medically unnecessary drugs and surgeries. In the landmark Dutch study that launched this field of medicine, sixty-eight out of seventy were same-sex attracted. Today, many young people who express regret and detransition say all they needed was help in accepting their homosexuality. Instead, they were affirmed as the opposite sex. This is not medicine. The public knows this as well. Support for gender transition procedures for minors is rapidly declining among all A New York Times poll last year found that only ten percent of Americans supported allowing puberty blockers for minors as young as ten years old. If we want to restore the American public's trust in the medical profession, we must start by admitting that we have made a grave mistake and the time to fix it is now. Thank you.

Thank you, sir. Next, our next witness is, um chloe cole an advocate and de-transitioner she began the process of medically transitioning at age twelve and later underwent a double mastectomy at age fifteen before de-transitioning at age sixteen now at twenty one years old chloe is an advocate working to end gender transition procedures for minors and exposed the institutions that have failed them Of everyone here, you have the most courage. I look forward to hearing from you today. Thank you.

Chairman Cassidy, Ranking Member Sanders, and committee members, thank you for your time. My name is Chloe Cole and I am known I am what is known as a de-transitioner. I was diagnosed with gender dysphoria and given life-altering drugs and irreversible surgery when I was only a child. As an adult, I have dedicated my life to making sure that my future children will not grow up in a world where they can be subjected to the same sex experimentation procedures that I, and hundreds of thousands of children have suffered from. Despite what the doctors told me, I was not a sick boy trapped in a girl's body. I was a distressed girl. But the medical system treated my body as the problem. To any normal adult, my middle school insecurities would seem par for the course. But to my physicians, clearly they meant that I needed a scalpel to my breasts. My mom and dad, who never once believed that I was a boy, were told by psychologists and physicians that insignificant things like me wanting to become an athlete or having short hair meant that I actually was their son. The central thesis that attempts to justify child transitioning is "transition your daughter or bury her." That's the lie my parents were told, and every parent of a trans-identified child I know. was told the same thing. Let me say that one more time. The entire premise of transgenderism is that I will take my own life if I don't transition. Yet here I am today. What they were told was that trying to change my sex would destroy my mental health or, more importantly, that we had another much healthier option, saying no to all of this and encouraging me to truly accept myself. Instead of honoring my parents' instincts to keep me safe, the doctors put me on a chemical castration drug to stop my puberty, followed by massive doses of testosterone to induce a fake male puberty. And at fifteen, my breasts were taken from me. I had a double mastectomy while I was still developing. The surgeon confirmed with me that my breasts were perfectly healthy. I hadn't even had my first kiss or practiced driving before. How could they take away part of my womanhood before I was old enough to call myself one? The peace and self-acceptance that I was promised never came. I'm almost twenty-two years old now. I have no breasts because they were replaced with scars. Because of Lupron, this log- this drug that doctors lie is reversible. The first thing I feel when I wake up every day is the pain in my hips and knees. I have days, weeks, months, even when the post-traumatic stress gets to me. Some days I'm not able to feel anything but numbness. Other days, I'm having flashbacks where I see my scars bleeding. And I'm having nightmares whether I'm awake or asleep. For me, the worst part is that nobody knows whether I'm able to have children now. I have no idea what my future is going to look like. No studies, surveys, or numbers are ever going to be able to quantify just how heartbroken I am. This is not medicine. Medicine heal heals what is sick. But me being female was not a disease. The lie was the disease. Once doctors denied that boundary between male and female, they also denied the boundary betwe- between child and adult. That's how my confusion became evidence, my parents' instincts became bigotry, and a surgeon's knife became care. When I detransitioned, the transgender cult responded by harassing me and my family, even stalking my grandmother, And it escalated into violence. Just a few weeks ago, I had hundreds of activists calling for me to be murdered. Why? Because I was going to speak on campus. This is how it is for those of us who de-transition. The trans community tries to intimidate us into silence. But even worse is that we've all been left for dead by the same doctors who promised to save our lives. I'm not alone. I have hundreds of friends who have been through the same thing. An entire generation of children were lied to. There is no such thing as a child being born in the wrong body, but there are physicians and medical bodies who prey on the confusion of perfectly healthy young boys and girls. Congress needs to ban these procedures on minors, protect parents who refuse them, investigate the medical institutions that promoted them, and make sure that children who have already been harmed are cared for. The American people have shown that they do not want this lie imposed on their children. Any member of Congress who defends this should have to look parents in the eye, and explain why their child's body is now a commodity that they can sell to the gender industry. Do not wait until there are more children sitting in this chair, crying to you about what was taken from them.

Thank you, Miss Cole. I now defer to Senator Sanders to introduce his witness.

Thank you, Mr. Chairman. I'd like to introduce Shannen Minter, who is the Legal Director at the National Center for LGBTQ Rights. Mr. Minter is one of the nation's foremost experts on policies to protect lgbtq youth mr. mr. mentor thanks for being with us

thank you so much chair and members of the committee thank you for having me i'm shannon mentor uh legal director of the national center for lgbtq rights for nearly thirty years i have worked with transgender young people their families and their doctors i would like to touch briefly on three points first that the government is attempting to rob families of the right and freedom to make medical decisions about their own children. Second, the government is baselessly attacking safe and effective medical care. And lastly, in a way we have never seen before in this country, the government is attempting to seize secretly the medical records of families, to use private medical information about their children for an unlimited and unknown purpose. Few principles in American law are more settled than the right of parents to make medical decisions for their own children in consultation with their doctors. Parents exercise that right every day for every other medical condition their children may face. Parents, not politicians, know their children best. They see them every day, they sit beside them in exam rooms with their child's doctor, making these decisions. parents should not be robbed of the right to make decisions about their child's health just because that child is diagnosed with gender dysphoria. This care is not new. It has been available for more than two decades. It is supported, as Senator Sanders noted, by our nation's leading medical associations, the AMA, the American Academy of Pediatrics, the American Psychological Association, many others the clinical standards require careful assessment reserve medical treatment only for adolescents with persistent well-documented gender dysphoria fewer than one percent of adolescents receive any medications in fact fewer than one tenth of one percent receive any medications a substantial body of research has found those treatments to be safe for those carefully screened young people the utah legislature actually commissioned the most recent and largest review was published last may it's more than a thousand pages hundreds of studies tens of thousands of transgender youth it found the use of hormone therapy to treat gender dysphoria in adolescents to be safe and effective and that quote there is virtually no regret associated with receiving the treatments even in the very small percentage of patients who ultimately discontinued them Scrametti the Supreme Court upheld one state ban but did not consider the question of parental rights that was not before the court if it had been that case might have come out very differently what we are talking about today is a proposal to rob parents across the country of the right to make healthcare decisions for their own children something that could affect any family in any state right now the federal government is taking unprecedented action something that has never been done before in the history of our country using subpoenas issued in secret to demand families private medical information without telling parents so that it can use their children's medical information in any way that it wishes with no limits these actions are happening on the heels of multiple federal courts rejecting similar attempts by this administration the judges rejecting those attempts were nominated by both democrat and republican presidents one judge found that the demands contained quote " more than a whiff of ill intent" another concluded that they were motivated by quote " extensive evidence of animus against transgender people" as a transgender person myself has benefited from a supportive family and church and from access to medical care as a parent recently a grandparent I can tell you what is at stake for these families, their right and their freedom to make medical decisions about their own children. Thank you.

Thank you, Mr. Mentor. Uh, I will defer and let Coach Tuberville go first.

Thank you, Mr. Chairman, thanks for having this in this hearing, this very confusing hearing to most of us, while we're even even have to talk about something like this. Chloe, thanks for you being here today. Thank you. for your testimony. Uh, after all your surgeries and things that you went through over the years, do you think now that with all the information out there that a minor can make an informed decision, uh, about transition?

Thank you for your question, Senator. I do not think that children have the developmental capacity or worldly experience to make decisions like this that are very adult in nature. Because this is not just a cosmetic change that these interventions cause to the body. Puberty is the only process through which a child can fully develop into adulthood, physically, psychologically, socially, and of course, reproductively. I didn't know what was at stake. I didn't know how much it would mean for me to lose my ability to breastfeed, and my, potentially my ability to have children at the time that I was allowed to go through this, because I still very much was a child myself. I was still growing up. No child can consent to being sterilized. Thank you.

Uh, you mentioned also that your parents were not fully informed about the alternatives, like watchful waiting, counseling, and long-term risk. including infertility and sexual dysfunction, you know, what improvements could be made in the informed consent process so that minors and their parents are fully aware of what their options are?

Thank you, Senator. I think that, first of all, we need to stop allowing these treatments to happen in the first place, because frankly, they're dangerous for children. They're dangerous for the human body, regardless of how old you are, but the younger you go, the more damage results from this. But I think that parents need to be told that they have an option that isn't just medically experimenting on their own child. Their children don't need puberty blockers. They don't need cross-sex hormones. They don't need surgery. Because the issue is not their body. This is completely psychological in nature. There is no gene. There is no structure in the body or brain that makes somebody transgender. These are feelings that these kids are experiencing that are real, but it doesn't mean that they are true. Because sex is not something that can be changed in human beings. Parents need to be informed of the risks of doing these procedures, especially the younger the younger their child is. And also the fact that they can watchfully wait how they can they can wait and watch and to see how the child's feelings about their body progresses. And for the most part, most children with gender confusion will desist by the time they enter adulthood and reintegrate with their their identity with their sex. That's the information that parents need.

Thank you, Doctor Carl. Uh, nearly two dozen uh, reviews have found weak or no credible evidence supporting gender transition procedures for minors based on this evidence. Why do you believe that major US medical organizations continue to endorse this process.

Thank you for the question, Senator. Thank you for the question, Senator. I believe unfortunately many of our medical societies within the United States have been captured in some respect. I mean, we look at the American Medical Association and it speaks to the, quote-unquote, medical necessity of these gender procedures in minors, yet they don't look at the evidence that is there. And that's very much in contrast to what the American Society of Plastic Surgeons has done in terms of looking at the systematic reviews recognizing that very low evidence of benefit, understanding that the risks are significant, taking into account the ethical considerations as well as the issue of consent. And when medical societies start doing that, we'll find that more and more of them support the American Society of Plastic Surgeons statement, as opposed to supporting the WPATH standards of care, which has clearly been quite scandalous, I would argue. And certainly in terms of taking off safeguards, taking off any sort of need for psychiatric assessment, just totally eliminating any sort of barriers and allowing a free fall access, it has been dangerous, and again, especially not in light with evidence. Again, we need to look at the evidence reviews. We need to look at what our European counterparts have done in the United Kingdom, in Sweden, in Finland, and elsewhere. And I think when we do that, we understand that these procedures are are harmful and they come with very low evidence of any benefit.

Thank you. Thank you, Mr. Chairman.

Senator Sanders.

thank you uh mr. chairman thank you panelists uh as i think miss cole has demonstrated this is a sensitive issue it's a difficult issue and there are families all over this country uh who are dealing with it uh mister minta who should be making those decisions do you think the members of the us senate committee on health education labor and pension should be intervening in the decision process for families who are struggling with these issues what do you think that should be done by the parents to young people and their physicians

i think that mmm

could you talk into the mike a little bit

yeah sorry the entire premise of our legal system when it comes to parental control over decision making medical decision making is that it is parents who are the ones who best know their own children that is also the entire premise of this care parents are involved at every stage of this care from the initial evaluation and assessment to meeting with doctors and providers throughout the entire process it is not the young person who consents to this care just as with every other type of medical fair uh care affecting youth it is parents who have the legal responsibility and authority to consent to the care. And the standards of care require, very specifically, that parents are informed fully about all of the treatment options and the risks and benefits. So, Senator, no, I do not think there's any place for, uh, federal

As brilliant as the members of this committee are, you think maybe the decision should be left to parents and doctors and young people themselves.

Yes, sir, I do.

All right. Let me ask you this. Um, the uh utah state legislature uh which by the way has a republican super majority recently commissioned a report uh on the on the evidence for this care could you talk a little bit about what the republican legislature found

yes that is very significant the legislature asked the university of utah which has one of the most well-respected programs in the entire country to evaluate the efficacy and safety of various medical treatments to perform an exhaustive review of the medical literature on treatments for gender dysphoria with transgender adolescents it took the program a long time to complete it they did the most comprehensive and exhaustive review that has been done to date they concluded unequivocally that these treatments are safe effective that there's virtually no regret associated with the with those who receive these treatments that they provide very significant benefits to these young people, mental health benefits, physical health outcomes, and significantly reduce suicidality.

And can you remind us what the major medical associations in our country, what their position is, like the AMA?

Yes, uh, every major medical association in this country has endorsed the careful provision of of these treatments for appropriately screened minors uh several of them have done their own independent analyses and developed their own practice guidelines the endocrine society the american academy of pediatrics the uh american psychiatric association all have looked at the evidence and developed their own practice guidelines all of which agree that this treatment can be beneficial for a small set of kids who have persistent severe gender identity into adolescence

when you say a small set of kids i mean how many young people are we talking about here do you think

extremely small number of young people there was uh uh data analysis for a five year period from twenty seventeen to twenty twenty one that found that about hundred and twenty thousand young people were diagnose with gender dysphoria this is over a five year period of that number only about fourteen thousand seven hundred received any medication that is an incredibly small percentage

five year period

over a five year period we are talking about fewer than one in a thousand young people i mean this is a very small group of of young people receiving any type of medical treatment it's only after the most careful screening

ok mr. metel thanks very much

one out of a thousand, we've got a lot of kids in our country. One out of a thousand in an absolute number could be significant. I wanna point out by the way there's a lot of pions to uh parental rights, but I will say Republicans are the ones who have stood up for parental rights on schools, and asking a parent to be involved in a child's decision to have an abortion, and my colleagues here have always objected to those. Um, I also wanna point out that there's

Your colleagues do not think it's a great idea for the federal government to tell every woman in this country what she could do. With the body, that's correct.

So, going back to and uh reclaiming my time, please. That's not appropriate. Now that said, um, and there's also evidence that the Biden administration, uh, was working with hijacked groups in the medical societies to promote this, this policy, uh, and we have evidence of that. That said, um. Dr. Maselli, speak about this Utah study that Mister Mentor finds so important.

The Utah study was uh as noted um ordered by the uh Utah legislature and done by the Drug Regimen Review Committee of the University of Utah. I I will say to start this study was aimed to be a systematic review, and it is anything but that. In fact there is no evidence of synthesis that is done by the Utah study, so when you do a systematic review, one of the key parts of it is to synthesize the evidence, to - to look at the, not just the risk of bias, but to look at the variation that's within studies, to look at studies based on their study size, to analyze them fully. None of that is done in the - in the Utah report whatsoever. Uh, another factor is that in the studies that the Utah Review looked at in the clinical studies, they only analyzed forty percent of them. Sixty percent of them weren't analyzed. What this becomes is a complete data dump into a report. And in fact, when they look at clinical practice guidelines, they take them at face value. There is no assessment of bias in the clinical practice guidelines that the Utah study takes. It just accepts them, it accepts the WPath standards of care eight, it accepts the Endocrine Society, it accepts them as gospel. It has no critical analysis.

Yeah, has the uh, Utah what has the Utah legislature done with the study?

Well, the Utah legislature recently passed a bill to to effectively end the moratorium and to issue a ban of

So they banned it. They saw the shortcomings of the Utah study that Mr.

They did.

Now, uh, Miss Cole, Mr. Minter makes much of the fact that the parents are going to be presented as an option. I'm a physician. I am very aware that the doctor with the bias can coach language in a way which points a parent and a family in a certain direction. That's been recognized. way back when California legislature, a governmental body, required that all options be given to a woman with breast cancer because they feared there was a financial incentive for the physician to do a mastectomy instead of the lower cost less profitable lumpectomy so that was a governmental body intervening in quote unquote medical practice and by the way that was a good thing so Mister Minter makes much of this but you point out that the way it was explained is, if you don't do this, your child will die of suicide. Now, any comment upon Mister Mentor emphasizing that the parents are informed in the experience that you had?

Thank you for your question. I disagree with I mean, there is, there's been a lot of discussion in this hearing about parental rights and about parents consenting to this treatment for their children. But I think for the most part that parents are actually not being allowed to consent because they're not being given the information that they need in order to make a decision in the best interest for their child if you're giving a parents an ultimatum of transition or your child is going to kill themselves they're going to take what seems like the better of those two options the only options that were given to them Clinicians are using the single greatest fear that any parent could have, and that is outliving their own child, to make the parents consent to something that ultimately goes against their instincts. I agree that parents know their children best. But, a doctor telling them to go against that instinct, to go against the way that they were made, that their child was made in their mother's womb, because they will die otherwise, is not giving them the information they need in order to consent.

In your opinion,

This is coercion.

in your opinion, is there need for federal legislation banning the prescription of hormone therapies, puberty blockers, and surgical interventions in children with gender dysphoria?

we absolutely need federal legislation on this. We need to stop these treatments being used in children entirely because they are abuse. This is medical abuse.

Thank you.

And it's not just between it's this isn't just about disrupting conversations between the parents and their child's clinicians. Because it doesn't matter who consents to this. This is child abuse. And we already have legislation that is making other forms of abuse in children illegal. This is no different, and we need to act now to ensure that the generation that comes after mine will never have to know what it is like to have their momentary confusion, these, ultimately for a lot of children, very normal confusion that comes around the time of puberty, with these rapid changes in your body and your life, to dictate the rest of their life and lead them into adult lives where they are miserable, they are sterile, they have no sexual function, and their health is compromised. children deserve better than that.

Thank you. Senator Baldwin.

Thank you. Uh, Mr. Chairman, I wanna start, as did, uh, the ranking member, uh, by putting this hearing into some larger perspective. This week, Republicans are trying to ram through a partisan funding bill that does nothing to address the issues that I hear about, from Wisconsinites, when I'm home. Meanwhile, we saw the president create a one point eight billion dollar slush fund to pay out to his supporters, some convicted felons with taxpayer money. That money could be used for so many better purposes, like medical research, access to health care, affordable child care. And now this morning, instead of addressing the issues that people really care about, like the high cost of things, the high cost of health care. Republicans are here to say that politicians should be involved in families' health care decisions. Let me be clear. Health care decisions should be left to patients, their parents, and their health care providers and doctors, not politicians. Once again, Republicans are trying to distract from the issues they are not taking any steps to address. Exploding health care costs, coverage loss, high cost of groceries, skyrocketing costs of gas. But we're here. And, Mr. Minter, thank you for being here. Uh, we've heard a lot of falsehoods, uh, uh, today, uh, so far, and it is of great concern. As you said in your testimony, parents' involvement in health care decisions for their children is a long established right. It is settled law and should remain free from political interference. It is not the place of politicians to insert themselves into these conversations, which are so unique to each child and their families. Parents want to get their children the health care that they need and not be denied access just because A politician thinks they know their child better than they do. I think about a a parent who comes to a pediatrician to seek health care for their child, who in the future may the provider may have to say, " I I cannot help." "The government has said I cannot help and do what's best." So can you discuss how the actions by this administration and

thank you senator yes the level of anguish

mmm

that this administration's targeting of these healthcare providers and these families has created is really profound i mean over the past thirty years you know i have met with dozens and dozens of parents across the political spectrum from every part of this country many from uh very conservative uh backgrounds and this i hear the same experiences from these families over and over you hear parents who said my child uh would not get out of bed my child uh stop speaking my child would not make eye contact with people my child completely stopped interacting with with their friends doesn't wanna go to school these parents have worked hard believe me to understand what's going on with their child to get accurate medical information it is a it is a process it is a journey for these families and then what you hear from them is that i got my child back i recognize my child again this is the happy outgoing kid that that we knew and that is what is being taken away or threatened to be taken away uh by this body and that has already been severely undermined uh, by this administration's attacks.

I have limited time left, but I I lament when I hear um, uh, Miss Cole talk about being protested. I also lament when I hear about our doctors, our pediatricians, our clinics being, uh, protested and threatened, uh, their lives in many cases. This is the unfortunate atmosphere that has been created. Uh, are you familiar with the level of of threat that has been uh uh uh that is happening right now with uh folks who are simply doing their jobs as medical professionals?

Yes, this administration has targeted medical providers across the country, demanding the seizure of these private medical records. It is really a blatant attempt to misuse now the criminal law they're using now criminal subpoenas to intimidate these providers and you know treat them uh as as though they're doing something uh that is is going to lead to federal prosecution i mean that it is a it's just a blatant attempt to intimidate and harass them and i will tell you again in my thirty years these are providers who are dedicated to helping kids and families They have done nothing wrong. They're following medical standards. They are helping young people who really need this care. And the actions of this administration in targeting them are so unfair and so cruel, and so counter-productive to protecting these families and these young people.

Thank you.

Senator, by the way, I want to point out that the committee has had several hearings on healthcare affordability. And multiple Republicans have spoken about, spoken out about the slush weaponization fund, just for the record. With that, Senator Husted.

Thank you, Mr. Chairman. Um, appreciate you holding the hearing today on this topic and uh, I do have great empathy for what children and teenagers are going through these days with the inundation that they get over social media and other platforms, uh, that affect their mental health, their well-being, their ability to um, make judgments. And I also, I also know that there are a lot of things that the government does to protect children, in law, from everything from smoking to alcohol to gun purchases, all kinds of things. And so it's very appropriate that we talk about how we would, uh, help protect children, uh, from life-changing surgeries, uh, particularly if they feel like they're

Thank you for your question, Senator. I started puberty a little bit earlier. I was about eight or nine.