Law barring transgender medical care for minors leaves Arkansas families with agonizing choice

Republican lawmakers recently passed a bill that bans gender-affirming medical care for minors. That means the care some transgender kids see as essential to helping them become their true selves will soon be prohibited for anyone under the age of 18, leaving families with a difficult choice: stop treatment or leave the state.
Dylan Brandt, 15, is a transgender teen from Arkansas who has been taking testosterone but will no longer be able to receive the hormone once a new state law takes effect this summer that bars gender-affirming medical care for minors. (CBC)

Time is running out for the families of transgender kids in the state of Arkansas who are staring down a brutal choice.

Republican lawmakers recently passed a bill that bans gender-affirming medical care for minors. That means the care some transgender kids have come to rely on and that they see as essential to helping them be their true selves will soon be prohibited for anyone under the age of 18. 

"It's sad and it's frustrating knowing that a place I've lived all my life ... is making it seem like they don't want me here," said Dylan Brandt, a 15-year-old trans boy who lives in the small town of Greenwood, near the Oklahoma border. 

His and other families are now contemplating whether they should move out of state so their children can continue with their medical care elsewhere. Unless the bill is challenged in court, it will take effect this summer. 

What's happening in Arkansas is part of a broader national trend. Lawmakers in more than 30 states have proposed more than 100 bills that have the potential to impact the transgender community over the past few months. 

Dylan's mother owns her own home and small business and doesn't want to leave the state but also doesn't want to ask Dylan to have to stop his gender transition. (CBC)

The majority of the bills relate to barring trans women and girls from participating in sports teams consistent with their gender identities. Idaho was the first state to pass such a law in 2020, though it has not come into effect because of a court injunction. 

In his ruling, Judge David Nye wrote that the state had not identified a "legitimate interest" that would be served that the preexisting rules in Idaho did not already address, "other than an invalid interest of excluding transgender women and girls from women's sports entirely, regardless of their physiological characteristics."

There are also a series of bills to ban gender-affirming care for minors, such as the Save Adolescents From Experimentation Act passed in Arkansas. The so-called SAFE Act would bar doctors from providing hormone treatment, puberty blockers or gender-affirming surgery to minors or referring them for such treatment (although opponents of the law have pointed out that surgical procedures were not being performed in the state anyway).

Process involves medical team, therapy, family

According to the American Academy of Pediatrics, gender-affirming medical care for minors involves the "process of using cross-sex hormones to allow adolescents who have initiated puberty to develop secondary sex characteristics of the opposite biological sex."

It and the American Medical Association have both come out against state interference in the provision of such care to minors.

Delee Fortson, a psychological examiner in Arkansas, says seeking out and receiving this kind of care is a long process involving the child, parents and a team of medical professionals. She says it is not accurate to suggest anyone is experimenting with gender-affirming medical treatments as the law's title implies. 

"Whenever you are starting this process, you have to go to therapy, you have an evaluation by a psychologist and endocrinologist ... there's a whole team," she said. 

"There's a widely held belief that some mom is choosing for their four year old to all of a sudden be a different gender. That's not happening at all."

WATCH | Teen says he's more confident since starting gender-affirming hormone therapy:

'I'm so much happier, so much more confident'

1 year ago
Duration 0:22
Dylan Brandt, 15, explains why he feels better physically and mentally since he started taking testosterone nine months ago.

A prominent Republican defender of the Arkansas law admitted there is no evidence that parents are forcing kids into gender-affirming care, one of the justifications for the ban. 

Arkansas Attorney General Leslie Rutledge told CBC News during a brief interview last week that the law was needed to protect children from "bad parents."

"There are so many things we don't allow adolescents to do because of the maturity level of those adolescents, whether it's vote, get married, buy cigarettes, get a tattoo," Rutledge said outside the Arkansas state house in Little Rock.

"No one's saying when they turn 18 that they can't do this."

Arkansas Attorney General Leslie Rutledge, pictured in July 2020, says minors don't have the maturity level to make the decision to use hormone treatment, puberty blockers or gender-affirming surgery. (Jacquelyn Martin/The Associated Press)

She suggested she feared kids may be forced into gender-affirming care by parents or foster parents and that children need to be protected from that possibility. 

"I'm not saying there are bad parents doing this but … having worked with foster kids, we dealt with bad parents," Rutledge said.

But in response to follow up questions from CBC News, Rutledge's office acknowledged in a statement that the attorney general "is not aware of any cases involving children being forced to change their gender."

Nevertheless, she is standing by her defence of the new law.

"She has over the course of her 20 years in public service seen too many children suffering from physical, emotional and sexual abuse by parents who do not love those children as they should, and this is one of the reasons why the attorney general supports the law," the statement said. 

WATCH | Arkansas attorney general defends transgender law:

Aim of transgender law is to protect young people, AG says

1 year ago
Duration 0:46
Arkansas Attorney General Leslie Rutledge tells CBC News that the intent of the new law on gender-affirming medical care for minors is to protect young people from making a decision 'that they may not have the maturity level to make.'

Wedge issue

Arkansas state Senator Joyce Elliott, a Democrat, says Republicans are targeting the transgender community as a way to rally the socially conservative part of their voter base. 

Democratic state Senator Joyce Elliott says transgender medical care for minors hasn't been an issue in the state and that the new law is simply a way for Republicans to appeal to the socially conservative part of their voter base. (CBC)

"The way to remain in power now is to create these wedge issues that are absolute hot button issues," said Elliott during an interview outside the state house.

"It's not an issue that is a problem in Arkansas." 

The Williams Institute at the UCLA School of Law estimates there are 1,450 transgender youth in Arkansas. Across the U.S, there are approximately 150,000 transgender kids representing 0.7 per cent of the population between the ages of 13 and 17. 

Arkansas Gov. Asa Hutchinson vetoed the transgender bill but was overruled by the Republican majority in the state house. (CBC)

There are currently no official complaints filed in Arkansas challenging the participation of transgender girls or women in women's sports, Governor Asa Hutchinson told the New York Times last month. And CBC News could not find evidence of any complaints about the provision of gender-affirming medical care. 

The Republican governor vetoed the SAFE Act but was over-ruled by the Republican majority in the state house. He did however, sign two other bills into law that impact the transgender community, including a ban on transgender women and girls competing in school sports teams consistent with their gender identity and a bill that allows medical workers to opt out of non-emergency services based on religious or moral objections.

When asked by CBC what he would say to families considering leaving the state because of the SAFE Act Hutchinson said:

"We value you; we want you to stay here. It's important to our workforce and the diversity we have. It saddens me, but I also understand the decisions that have to be made for health care purposes."

'Unacceptable and unnecessary'

The Brandt family isn't sure what to do next, especially considering so many other states are debating similar pieces of legislation.

Dylan's mom, Joanna Brandt, does not want to uproot her family. The single mom owns her own home and her own small business. She is also unwilling to ask Dylan to pause his transition. 

Dylan walks with his brother, Luke, 13, his mom and their two dogs. The Brandt family is now waiting to see whether the American Civil Liberties Union is able to successfully challenge the law in court. (CBC)

"Watching him really become the person that he was always supposed to be has been amazing and wonderful," she said. "And the idea that that could be taken away, and all the progress that he has made come to a screeching halt, is incredibly upsetting to all of us and really unacceptable and unnecessary.

"He has grown into such a competent, caring, loving, and happy young man."

WATCH | Dylan and his mom explain what access to gender-affirming means to their family:

Mom calls new law 'unacceptable and unnecessary'

1 year ago
Duration 0:37
Joanna and Dylan Brandt talk about why the Save Adolescents From Experimentation Act will roll back some of the progress transgender teens like Dylan have made in recent years.

Dylan doesn't want to leave his friends either. When he came out as transgender two years ago, he says, the voices of his supporters drowned out criticism from bullies. 

"Going back now would be really hard, really devastating. It would take a big toll on me," Dylan said. 

Losing care would be a setback. teen says

Dylan came out as transgender to his mother when he was 13, writing her a note about his feelings. 

"I said something along the lines of this: 'I'm not changing who I am; I'm just changing how I present … you're not losing a kid. I'm just becoming who I want to be,'" Dylan said.

"I don't want to be your daughter anymore. I want to be your son. I am your son." 

Dylan says that before he started using testosterone about nine months ago, he was often upset. He fears losing access to the care and losing the happiness he's gained. 

"It would probably set me back further than … before I was even on hormones," he said. 

The American Civil Liberties Union has vowed to fight this legislation in court. If that happens, it will give Dylan some breathing room, as he will likely still be able to get care if the law is stuck in a legal battle.

Until there is some clarity, his mother says she'll keep Googling trans-friendly places where she might be able to move her family. Though she hopes it doesn't have to come to that. 

WATCH | Arkansas law part of wider legislative changes around transgender:

Arkansas ban on gender-affirming care for minors leaves families with difficult choice

1 year ago
Duration 5:17
Some families of transgender kids in Arkansas fear they will be forced to leave the state if they want their children to keep receiving hormone treatments or puberty blockers after a ban on those treatments for minors.


Katie Simpson is a foreign correspondent with CBC News based in Washington. Prior to joining the team in D.C. she spent six years covering Parliament Hill in Ottawa and nearly a decade covering local and provincial issues in Toronto.