A look inside the playbook on transgender health bills

May 19, 2023, 9:42 PM

FILE - Advocates for transgender youth rally outside the New Hampshire Statehouse, in Concord, N.H....

FILE - Advocates for transgender youth rally outside the New Hampshire Statehouse, in Concord, N.H., Tuesday, March 7, 2023. A nonprofit that launched last year to oppose diversity initiatives in medicine, has evolved into a significant leader in statehouses to ban gender-affirming care for transgender youths, producing model legislation that an Associated Press analysis found has been used in at least three states. (AP Photo/Holly Ramer, File)

(AP Photo/Holly Ramer, File)

Aaron and Lacey Jennen’s roots in Arkansas run deep. They’ve spent their entire lives there, attended the flagship state university, and are raising a family. So they’re heartbroken at the prospect of perhaps having to move to one of an ever-dwindling number of states where gender-affirming health care for their transgender teenage daughter, Sabrina, is not threatened.

“We were like, ‘OK, if we can just get Sabrina to 18 … we can put all this horrible stuff behind us,’” Aaron Jennen said, “and unfortunately that’s not been the case, as you’ve seen a proliferation of anti-trans legislation here in Arkansas and across the country.”

At least 17 states have enacted laws restricting or banning gender-affirming care for transgender minors, though judges have temporarily blocked their enforcement in some, including Arkansas. An Associated Press analysis found that often those bills sprang not from grassroots or constituent demand, but from the pens of a handful of conservative interest groups.

Many of the proposals, as introduced or passed, are identical or very similar to some model legislation, the AP found. Those ready-made bills have been used in statehouses for decades, often with criticisms of carpetbagging by out-of-state interests. In the case of restrictions on gender-affirming care for youths, they allow a handful of far-right groups to spread a false narrative based on distorted science, critics say.

“These are solutions from outside our state looking to solve nonexistent problems inside our state,” said Aaron Jennen. “For whatever reason, they have the ear of legislatures in states like Arkansas, and the legislators will generally defer to and only listen to those individuals.”

The AP obtained the texts of more than 130 bills in 40 state legislatures from Plural, a public policy software company, and analyzed them for similarities to model bills peddled by the conservative groups Do No Harm, which also criticizes efforts to diversify staffing in medicine, and the Family Research Council, which has long been involved in abortion restrictions.

One of the clearest examples is in Montana, where nearly all the language in at least one bill can be found in Do No Harm’s model. Publicly available emails from December show the Republican sponsor, Sen. John Fuller, tweaked the model before introducing it weeks later. Democrats criticized his efforts.

“This is not a Montana issue; it is an issue pushed by well-funded national groups,” Democratic Sen. Janet Ellis said during debate in February.

Republicans pushed back.

“Someone mentioned this is not a Montana solution. And I can tell you that I won my election on this issue,” said Republican Sen. Barry Usher, who ran unopposed in the general election after winning his contested primary.

The Montana bill passed in March with much of Do No Harm’s model language intact and has been signed into law.

Do No Harm’s model and the rebutted by major medical organizations — that the risks of gender-affirming care outweigh its benefits.

Republicans’ recent focus on legislation to restrict aspects of transgender life is largely a strategy of Pew Research Center survey a year ago found broad support among Republicans, but not Democrats, for restrictions on medical care for gender transitions.

“These organizations are not introducing this model legislation to make legislators’ jobs easier, to support kids in their constituencies. They’re introducing this model legislation to gain wealth, to gain eyes, to gain power, and to gain access,” said Heron Greenesmith, a senior research analyst who monitors anti-LGBTQ+ rhetoric for Political Research Associates, a liberal think tank.

Such bills often distort valid science that supports gender-affirming care for youths, said Dr. Jack Drescher, a psychiatry professor at Columbia University who edited the section about gender dysphoria in the American Psychiatric Association’s diagnostic manual. Do No Harm cites the manual in its model bill.

“These bills are not at all interested in patient care,” Drescher said. “These bills are designed to inflame.”

It’s problematic “any time policymakers are cherry-picking isolated studies or scientific research that arrives upon a different conclusion than the rest of the community or that relies upon studies without having that expertise,” said Marty P. Jordan, an assistant professor of political science at Michigan State University. “It’s problematic for the individuals that the legislation could impact. It’s problematic for the larger public, and problematic for democracy writ large.”

Kent Syler, a political science professor at Middle Tennessee State University, said: “If it’s a good bill, no one should be shy about where they got it because that’s the federal system working correctly.”

Do No Harm launched last year with an initial critical focus on the role of race in medical education and hiring, and the Virginia-based nonprofit has registered lobbyists in at least four states. People associated with it have testified in statehouses around the U.S.

When asked about Do No Harm’s legislative activity, founder and chair Dr. Stanley Goldfarb responded in an email: “Do No Harm works to protect children from extreme gender ideology through original research, coalition-building, testimonials from parents and patients who’ve lived through deeply troubling experiences, and advocacy for the rigorous, apolitical study of gender dysphoria.”

The Family Research Council, an advocacy group that opposes abortion and LGBTQ+ rights, has been behind what it calls the Save Adolescents from Experimentation Act, or SAFE Act. Among other things, it falsely asserts that “‘gender transition’ is an experiment.”

A leader of the Family Research Council declined to directly answer several questions about its model bill, including where it had been used and which legislators it had worked with, but said, “What should be an issue debated in the scientific community now has to be dealt with through legislation.”

“The SAFE Act gives minors a chance to experience development before imposing lifelong chemical and surgical procedures that increasingly show evidence of psychological and physiological harm and completed suicide after the transition,” Jennifer Bauwens, the organization’s director of family studies, said in an email.

In Arkansas, Sabrina Jennen — who will turn 18 in July — continues to receive gender-affirming health care while her family’s suit winds through the courts.

“For these outside groups to carry more weight than the people these legislators were elected to represent is very upsetting,” Aaron Jennen said. “They didn’t listen to us before, but now they have to listen to us because we filed a lawsuit and went to court.”


Contributing to this report were Associated Press journalists around the country, including Andrew DeMillo in Little Rock, Arkansas; Amy Beth Hanson in Helena, Montana; and Michael Goldberg and Emily Wagster Pettus in Jackson, Mississippi.


Harjai is a corps member of the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

United States News

(AP Photo/Andrew Harnik)Credit: ASSOCIATED PRESS...

Associated Press

Biden, GOP agree to 2-year debt ceiling deal, avoiding default

President Joe Biden and House Speaker Kevin McCarthy reached an “agreement in principle” late Saturday as they raced to strike a deal to limit federal spending and resolve the looming debt crisis, the House speaker said.

19 hours ago

Associated Press

Timeline of events leading to the impeachment of Republican Texas Attorney General Ken Paxton

AUSTIN, Texas (AP) — A timeline of events that have led to three-term Texas Republican Attorney General Ken Paxton, 60, being impeached Saturday. The vote by the GOP-controlled Texas House of Representatives also means Paxton is immediately suspended from office. 2015 Paxton takes office as attorney general after more than a decade in the Texas […]

19 hours ago

This undated photo provided by the Grand Forks County Correctional Center shows Steve Shand. Shand,...

Associated Press

Florida man at center of fatal human smuggling case pleads not guilty in Minnesota

ST. PAUL, Minn. (AP) — A Florida man charged with human smuggling after four migrants were found dead last year near the Canadian border has pleaded not guilty to the federal charges. Court records show that Steve Shand, of Deltona, Florida, entered the plea Friday in a hearing for his arraignment held via video conference. […]

19 hours ago

FILE - This June 14, 2018 file photo provided by the Indianapolis Police Department shows Indianapo...

Associated Press

Man charged with killing Indianapolis police officer seeking insanity defense

INDIANAPOLIS (AP) — A man charged with fatally shooting an Indianapolis police officer when she responded to a domestic violence call in 2020 is seeking an insanity defense as he seeks to avoid the death penalty. Attorneys for Elliahs Dorsey filed a motion with the court Wednesday saying a report prepared by a doctor states […]

19 hours ago

FILE - Former Secretary of State Henry Kissinger speaks during a meeting with President Donald Trum...

Associated Press

Former US diplomat Henry Kissinger celebrates 100th birthday, still active in global affairs

Former diplomat and presidential advisor Henry Kissinger marks his 100th birthday on Saturday, outlasting many of his political contemporaries who guided the United States through one of its most tumultuous periods including the presidency of Richard Nixon and the Vietnam War. Born in Germany on May 27, 1923, Kissinger remains known for his key role […]

19 hours ago

Associated Press

Baby eels remain one of America’s most valuable fish after strong year in Maine

PORTLAND, Maine (AP) — Fishermen in the U.S.’s only commercial-scale fishing industry for valuable baby eels once again had a productive season searching for the tiny fish. Baby eels, called elvers, are often worth more than $2,000 per pound because of how valuable they are to Asian aquaculture companies. That makes them one of the […]

19 hours ago

Sponsored Articles



Thank you to Al McCoy for 51 years as voice of the Phoenix Suns

Sanderson Ford wants to share its thanks to Al McCoy for the impact he made in the Valley for more than a half-decade.


OCD & Anxiety Treatment Center

How to identify the symptoms of 3 common anxiety disorders

Living with an anxiety disorder can be debilitating and cause significant stress for those who suffer from the condition.

(Desert Institute for Spine Care in Arizona Photo)...

Desert Institute for Spine Care in Arizona

5 common causes for chronic neck pain

Neck pain can debilitate one’s daily routine, yet 80% of people experience it in their lives and 20%-50% deal with it annually.

A look inside the playbook on transgender health bills