Iowans react to recent changes in trans laws

In recent months, the United States has seen a shift in laws restricting those as a part of the transgender community. A major component of this is the banning of gender-affirming care for trans youth. Originating this past March, Iowa has joined the list of 16 states that have banned gender-affirming care amongst trans minors. As of now, gender-affirming care is still available for those over 18 in these states, as is transitional surgery. 

Kim Reynolds would sign two bills into Iowa law on March 22, Senate Files 482 and 538. Under Senate File 482, students are not allowed to attend or utilize restrooms or facilities in correspondence with their gender identity, and under Senate File 538, doctors are not allowed to assist or administer gender-affirming care to minors. 

“I am very pro-government spending when it comes to healthcare and education, so providing cheap or subsidized gender-affirming care for youth that need it is a necessity. We also need more programs for queer youth who do not have amicable home lives. The main thing that’s kept me, well, alive as a mentally struggling trans person is my parental support—and sadly far from all parents are accepting of their trans children,” senior August Phillis said. 

An article by the Iowa Civil Rights Commission on Sexual Orientation & Gender Identity published in 2016 comments on restrooms, locker rooms, and living facilities, “The new law does require, however, that individuals are permitted to access those facilities in accordance with their gender identity, rather than their assigned sex at birth, without being harassed or questioned.”

“The most I remember about figuring out who I am is that I remember when quarantine hit I had a lot of time to think about myself and how I view myself as a person. I realized there were times I didn’t always feel female. I had always assumed I wasn’t trans up until that point simply because I didn’t feel male,” University of Wisconsin-Stout freshman Charlie Van said. “Even knowing people there were people who feel like neither, I didn’t honestly realize I felt that way too for a few years. It took time and talking to people who already identified similarly to me to help me understand.”

Supporters of the LGBTQ+ movement state that these new laws will have “devastating consequences” to transgender youth and their families, pushing back against what is believed to be an effort from conservative lawmakers to apply restrictions to those who are a part of the LGBTQ+ community. Supporters of the law, however, state that these laws will be necessary in ensuring the safety of the youth in making life-changing medical decisions that could run the risk of ruining their lives. 

“I think it’s really horrible how this country’s mindset is toward people in my community. It’s been heartbreaking to come home from college multiple times and have less rights than when I left. I feel horrible watching my friends here in Iowa have to fight for their rights, and while I will always fight with them, distance makes it hard,” Van said, “I cannot say that Wisconsin is perfect, but currently, it’s a safer space. People deserve the right to be who they are. We deserve to feel safe going to the bathroom and have gender-affirming care. We deserve to learn about our history, and children deserve to be allowed to learn about it too.”

Additionally, new bathroom and locker room laws within schools state that transgender students are legally required to produce a written consent form, signed by a legal guardian, in order to use single-person facilities. In other cases, students would use multi-person facilities that correspond with their assigned gender at birth. 

“I never really ‘decided’ this is who I was ‘meant’ to be per se, more-so I just sort of discovered and this is who I am—or more accurately, I decided I hated being seen as my birth sex,” Phillis said. “Sometimes I feel really good. It’s easy to see where I’ve come from and how far I’ve gone to be seen as the person I am. Other days, around two-thirds of the days, it’s hard. I see myself in the mirror and think of how ugly I am, or how ‘manish’ I am, or how I’ll never be truly seen as a woman.”

With the implementation of these new laws, life for trans youth can and most certainly will grow increasingly difficult. Many teens currently suffer from mental health issues in high school, and combining that with students hoping to find solace in their preferred gender and fighting for rights only adds fuel to the fire of struggling mental health.

“For those who are confused, my main advice is to be true to yourself, however cliché that saying is,” Phillis said. “Just be kind to people around you. Be open to anything, no matter how anxiety-inducing it may be. The main thing I see preventing trans youth from finding who they are is being scared of being trans. Being trans isn’t easy, but being closeted trans and refusing to acknowledge that part is even harder.”

“It’s OK to be confused. Sometimes labels change, just like people do,” Van said. 

When these laws passed, Iowa was the ninth state to enact laws limiting the transitional abilities of minors. In the law, those who are already partaking in gender-affirming care will be given a 180-day grace period before they are no longer able to continue treatment. 

Access to gender affirmation is extremely important to minors’ mental health. Physician Kyle Christiason said, “Minors who are in the LGBTQ+ community have about two to three times increased risk for depression, for anxiety, for self-harm, for suicide ideation or death by suicide. When those minors are availed to gender-affirming care in any form, those disparities tend to almost equalize.” 

With access to proper care and support, these numbers are shown to almost match those of cisgender minors. ”When we talk about gender-affirming healthcare we think about there is a number of ways that that can be done,” Christiason said. “First and foremost we want to make sure that we are honoring and creating a safe space for folks to declare who they are so in the healthcare area we want to make sure for example that we honor one’s pronouns and honor one’s chosen name and that is an escape of gender-affirming care that has evidence behind it as being incredibly beneficial and of course is something that doesn’t require any medications or referrals or anything of that nature. It’s easy to do and it’s incredibly powerful in terms of its benefit and truly has been shown to reduce the risk of suicide ideation. Gender-affirming care creates a space to treat people the way they want to be treated.“

Christiason and other physicians feel that the given 180 days to stop all current prescriptions of medication is not enough time to make the transition off of medication. “We have national evidence-based prescribing guidelines on doing gender-affirming hormone therapy. We don’t have guidelines on how to proceed in this scenario when access to that care is stripped away. We are now left to a non-evidence-based medical practice. We are doing the best we can to help patients stop their medicine in a way that is safe as possible, but no matter what, this is going to feel like the rug is being pulled out,” Christiason said. He said the time frame given is not enough to ease the change as there is not enough current research to aid doctors in making the best decisions with their patients. Unitypoint clinic in the Cedar Valley will continue to provide gender-affirming care, but now without the option of prescription. 

For transgender individuals who are seeking to continue medical care, the place to look for medical support is out of state. Christiason said the physicians at UnityPoint Clinic “are working on nurturing those partnerships and trying to find an easy way to hand off that care to a physician in a surrounding state.” While this creates a space for people to get the care they need, it comes with a lot of obstacles. 

Christiason said that “Insurance is not likely to cover some of this care when it’s done outside of the state. People have a hard time with transportation and so getting to Minnesota, Illinois or Wisconsin is logistically challenging. It could be they can’t afford the gas money or they can’t afford to take time off work to spend a day of travel, so these are the pragmatic problems that many are going to experience.” 

Currently, there are no systems in place to help with these logistical aspects, and an ask for aid is sent out to the community. 

Christiason suggested some other resources to consult under this topic too:

Honoring chosen names

Having accepting adults

Access to care during adolescence

Mental health effects of gender-affirming hormone therapy

Story by Nate Rosckes and Ian Rhys Hitchman

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