Rep. Andy Harris, the Maryland Republican who strives to be on the wrong side of everything, has developed the same bizarre obsession with gender identity and trans rights as the higher-profile demagogues within his party.
Harris, an anesthesiologist, presented himself at recent congressional hearings as an outraged doctor come to save civilization from the Biden administration, the American Medical Association and other organizations that support health care for those whose gender identity differs from the sex they were assigned at birth.
Harris’ worst play to prejudices against transgender people was when, in regard to minors, he described the rare instances of gender-affirming surgery as “gender-denying mutilation.” Referring to Rachel Levine, the pediatrician who serves as one of the nation’s top health officials, Harris said it is “reprehensible for a government official, let alone the Assistant U.S. Secretary of [Health and Human Services], to promote the genital mutilation of minors as becoming a standard practice in the U.S.”
Because of his track record — voting against certification of President Biden’s 2020 election victory, refusing to honor police officers who defended the Capitol against the Jan. 6 insurrection, touting 1st District infrastructure projects he voted against, stoking fears about the coronavirus vaccines — I was skeptical of Harris’ statements on trans health. I spoke to a pediatrician who, unlike Harris, has successfully treated adolescents within the tiny portion of the American population we call trans.
First, a word about the Republican fixation on trans issues.
This vulnerable minority represents the new “other” for the country’s harshest conservatives. Dismissing medical science, eschewing live-and-let-live, or even common decency, Republican politicians go out of their way to associate trans people with the political left, raising fears and riling the evangelical base. It’s truly disgusting.
According to a CQ Roll Call summary in March, Republican legislators have introduced hundreds of bills targeting transgender individuals across the country. “At least 10 states have banned gender-affirming care for minors,” the congressional news service reported, “and another 21 have introduced bills, even as multiple studies have found access to gender-affirming care reduces the risk of depression and suicide for trans children, who are more likely than not to have considered suicide.”
Andy Harris apparently detests the idea that the federal government, through public health subsidies, might fund gender-affirming care for kids.
The AMA, on the other hand, opposes policies that discriminate against trans people. “Gender-affirming care is medically-necessary, evidence-based care that improves the physical and mental health of transgender and gender-diverse people,” the AMA said in response to legislative efforts to ban physicians from serving trans patients.
I asked Dr. Sari Bentsianov, a pediatrician who treats transgender kids as director of adolescent medicine at the Robert Wood Johnson Medical School at Rutgers, to comment on some of Harris’ reported remarks at congressional hearings. Both his and her comments have been edited for brevity.
Harris: As a physician, I was proud to co-sponsor the Protect Children’s Innocence Act, which would prohibit harmful medical procedures used to treat gender dysphoria in transgender minors, including puberty blockers and surgeries in which minors alter their body to correspond to a sex that differs from their biological sex.
Bentsianov: Puberty blockers have been in use for decades for conditions such as precocious puberty. Overall, there is a favorable safety profile with no serious long term adverse effects. This intervention is completely reversible; once it is withdrawn, puberty proceeds. … Surgeries in minors are incredibly rare. The majority of gender affirming surgeries in minors are for chest masculinization in transmasculine youth with chest dysphoria. Studies published have shown satisfaction with results with minimal regret. The evaluation for surgery in minors is complex and requires a clinically and developmentally appropriate approach with the input of a multidisciplinary team including the patient and their parents.
Harris: Many pediatricians have expressed serious concerns about the use of puberty blockers and sex transition surgeries in minors.
Bentsianov: The majority of medical societies, including many representing pediatricians, support gender affirmation treatment for transgender adolescents. … There are many physicians creating “societies” that seek to speak out against this with no evidence. I would be cautious of who these physicians are and where they are gathering the evidence to support their claims.
Harris: Medications and procedures can impact children’s bone growth, fertility and risk of breast and prostate cancer. … We must protect our children.
Bentsianov: It is well known that all of the medical interventions can impact reproductive potential, including potential loss of fertility. This is not the only field of medicine prescribing medications with long term fertility implications; pediatric oncology comes to mind. … Bone mass accrual is highest during adolescence, and puberty blockers can lead to lower bone mass later in life. Bone mass accrual is multifactorial and pubertal hormones are not the only determinant of bone health. Bone health is monitored throughout treatment. … No research has shown that estrogen therapy itself increases one’s breast cancer risk. Current breast cancer screening guidelines for transgender individuals on estrogen (or transgender males on testosterone) are the same for cisgender [not transgender] women. … [There is] no data that feminizing regimens increase the risk for prostate cancer.
Bentsianov, who received her undergraduate degree from the University of Maryland, is most concerned, as many in her field are, with depression and the risk of suicide among trans children. Her mission is what a doctor’s should be — on healing and helping, not on scoring cheap political points.
