When South Dakota legislators discuss transgender issues, they tend to ignore facts and experts. For instance, chiropractic Rep. Fred Deutsch (R-4/Florence) is so bent out of shape over transgender kids that he is thinking about proposing a bill to ban doctors from doing sex-change operations on kids. But if Deutsch spent our tax dollars attending real informational conferences rather than conservative rage fests, he’d know that real doctors are way ahead of him: medical professionals don’t operate on children’s genitals to deal with gender dysphoria.
The World Professional Association for Transgender Health (WPATH) publishes standards of care covering all aspects of health issues transgender people face. Dr. Anne Dilenschneider, one of only three mental health providers in South Dakota recognized by WPATH as capable of including transgender care in their scope of practice, tells me that Version 7 of the WPATH standards of care include age of majority as one of the criteria for performing surgery:
Genital surgery should not be carried out until (i) patients reach the legal age of majority to give consent for medical procedures in a given country, and (ii) patients have lived continuously for at least 12 months in the gender role that is congruent with their gender identity. The age threshold should be seen as a minimum criterion and not an indication in and of itself for active intervention [World Professional Association for Transgender Health, Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7, 2012, p. 20].
The only surgery allowed on minors by the WPATH standards of care is chest surgery for adolescent females transitioning to males:
Chest surgery in FtM patients could be carried out earlier, preferably after ample time of living in the desired gender role and after one year of testosterone treatment. The intent of this suggested sequence is to give adolescents sufficient opportunity to experience and socially adjust in a more masculine gender role, before undergoing irreversible surgery. However, different approaches may be more suitable, depending on an adolescent’s specific clinical situation and goals for gender identity expression [WPATH, 2012, p. 20].
South Dakota legislators have rejected WPATH standards of care before. The South Dakota High School Activities Association originally wanted to use WPATH standards to inform the enforcement of its rules on transgender youth participation, but dropped WPATH from its policy to placate legislators who think WPATH advocates too much for transgender youth.
The Legislature has very few practicing medical experts (I can think of one doctor and one nurse*). Medical experts have laid out the WPATH standards of care to ensure that transgender patients are treated properly. Those standards restrict almost all surgery on minors, with only one exception for adolescents transitioning from female to male under specific criteria designed to prevent greater harm. Representative Deutsch, how about we just trust the doctors on this matter and focus on real public policy issues?
*Update 12:51 CST: Multiple attentive readers raise our Legislative nurse count to two: Rep. Jean Hunhoff (R-18/Yankton) is also an RN.