KNOXVILLE, Tenn. — East Tennessee Republican lawmakers introduced a bill that sparked some concerns among the transgender community. HB 2816 was introduced by Rep. Jeremy Faison (R - Cosby) the House Republican Caucus Chairman.
"Once you start reading the definitions of what it actually means, it boils down to further stigma and stigmatization of the LGBTQ+ community, of transgender people. It's targeting, specifically, transgender people as some kind of 'health welfare' for the community," said Gibran Cuevas, the Vice President of Appalachian OUTReach.
The bill is framed as a kind of "bill of rights" for transgender people who seek to better conform to their gender assigned at birth.
A survey by the National Center for Transgender Equality, as well as other advocacy organizations, found in 2022 nearly all of its respondents were at least "a little more satisfied" with their lives after getting transition-related care. Only around 4% said they were either not satisfied or less satisfied with their lives.
Around 98% also said they were at least a little more satisfied with their lives after getting hormone treatment, and 97% said the same about gender-affirming surgery.
The bill says that to guarantee public transparency, the bill would require medical providers to report statistics on transition-related care which includes patient information like their age, any drugs prescribed, the state they live in, diagnoses they may have received and contact information of healthcare professionals.
Providers would need to fill out the report within 15 days after the end of the month transition care was provided, or else face disciplinary action. It could also face a fine of up to $150,000.
The bill also prevents cities and counties from prohibiting "the provision of mental health therapy to help a minor" facing issues relating to gender dysphoria. It also prevents local governments from prohibiting parents from "consenting to, or withholding consent from, the provision of mental health therapy to help a minor."
Medical providers that offer gender-affirming care and get funds from the state, either "directly or indirectly," would also need to agree to provide care to help people who want to better conform to their gender assigned at birth.
"Transitioning means that a person is in a state of kind of change and growth and in exploration, and so, to transition, it means that a person is kind of taking their awareness of themselves and starting to take any number of steps," said Shannon Brown, president of Appalachian OUTReach. "Transitioning can look like a person who says, 'Yeah, I'm somewhere on the gender spectrum. And that's an acknowledgment that I have for now.' And then they spend time exploring that."
For many members of the transgender community, transitioning can take several forms. Some people only ask for preferred pronouns to be used, and others may seek hormone treatments. Young transgender people may be prescribed puberty blockers to prevent existing anxieties from worsening as they progress through puberty. Some transgender people may put on a blouse as part of exploring their gender identity.
"Everybody's transition is completely different. And so, a lot of times when we get into these conversations, we're always talking about medical transitions. But there's also a big social component to transitioning," said Ray Holloman, from the Tennessee Transgender Task Force. "A lot of times, the first step for a lot of people is just that social transition, telling people like, 'Hey, this is what I want to go by. This is the pronouns that I want to use.' And for some people, that may be all that they do, because that alleviates their dysphoria enough."
Brown also said gender dysphoria is usually a reaction to hostilities from other people, and the best treatment for it is acceptance and support.
"Gender dysphoria is a reaction that people have to a society that engages in oppressive acts. So, it is a response that people have to a lack of acceptance. So, dysphoria is more like an awareness that someone has that they are not accepted," she said.
Faison's bill also requires that if an insurance policy covers transition-related procedures in Tennessee, it must also cover procedures for people returning to their gender assigned at birth. Insurers would also need to report statistics on insurance claims for those procedures in Tennessee. The bill specifically allows the state Attorney General to investigate insurers according to the bill.
"All that this bill will do is negatively affect transgender people's care — affect their medical and mental health, affect insurance companies. Who wants to jump through hoops with a client for no reason?" said Cuevas.
Several members of the transgender community said instead, they would want lawmakers to focus on protecting transition-related and gender-affirming care, helping make sure people could get care if they're faced with gender dysphoria.
"I would love to see protections for anybody to be able to transition in the way that they want to, whether that be medically or socially. Being able to update birth certificates, that's a huge thing. Being able to change your birth certificate, so you don't have to go get a passport to show citizenship and show that you have the right gender markers in every location. You know, having you know hate crime protections for gender identity. Just, being able to feel like you're a full-fledged citizen of this state, and not like a second or third-class citizen," said Holloman.
Brown also called for mental health workers to support clients exploring their gender, and to advocate for them with lawmakers.
"These types of laws do harm, we have taken an oath to do no harm. We know that these kinds of laws do harm. And so, I'm saying to the rest of the mental health providers that are out there, we need to do something. Because our hands are being forced to do harm," she said.
Faison declined an interview for the bill until it's heard in a committee. However, he did release a statement about it.
“A person in distress who is suffering from gender dysphoria should be treated with respect, love and understanding as well as with the appropriate mental health care,” he said in the release. “This legislation recognizes the trauma endured by these individuals and helps to provide a way back from the harm inflicted.”