Utah Outlaws Providing Sex-Altering Surgery or Hormones to Minors

'Legislation that impacts our most vulnerable youth requires careful consideration and deliberation,' said Governor Spencer Cox


Utah Governor Spencer Cox signed legislation prohibiting gender-transiton related surgery and restricting hormone treatment for minors who identify as transgender.

The act marked the first time Cox has taken a public stance on transgender related issues. 

Legislation that impacts our most vulnerable youth requires careful consideration and deliberation,” Cox said in a Jan. 28 statement. “More and more experts, states and countries around the world are pausing these permanent and life-altering treatments for new patients until more and better research can help determine the long-term consequences.”

Cox described Senate Bill 16 as “not a perfect bill” but said he appreciates the “more nuanced and thoughtful approach to this terribly divisive issue.”

While we understand our words will be of little comfort to those who disagree with us, we sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures,” Cox said. 

While surgical intervention for gender dysphoria is outlawed, SB 16 – otherwise known as the “Transgender Medical Treatment and Procedure” Bill – permits hormone therapy under new, strict conditions. As of July 1, medical providers will be required to determine if minors who are seeking hormone therapy related to their transgender identity have “other physical or mental health conditions, identify and document any condition, and consider whether treating those conditions before treating the gender dysphoria would provide the minor the best long-term outcome.”

If the medical professional wants to move forward with hormone therapy, both the minor and his or her parents will need to sign and submit a written consent form. Doctors must also discuss the risk of hormone therapy and “the likelihood that the hormonal transgender treatment will meet the short-term and long-term expectations” as well as the possibly adverse effect of puberty inhibiting drugs, which are not approved by the Food and Drug Administration for the treatment of gender dysphoria.

According to SB 16:

The use of cross-sex hormones in males is associated with risks that include blood clots, gallstones, coronary artery disease, heart attacks, tumors of the pituitary gland, strokes, elevated levels of triglycerides in the blood, breast cancer, and irreversible infertility; and… the use of cross-sex hormones in females is associated with risks of erythrocytosis, severe liver dysfunction, coronary artery disease, hypertension, and increased risk of breast and uterine cancers.

Minors must also undergo a mental health evaluation before receiving hormone therapy. 

The legislation does not apply to individuals who were born with “external biological sex characteristics that are irresolvably ambiguous,” with “46 XX chromosomes with virilization, with “46 XY chromosomes with undervirilization,” genetic sex development disorders or complications, or cancer. 

As part of the new law, Utah’s Department of Health and Human Services has been ordered to hold a “a systematic review of the medical evidence regarding hormonal transgender treatments” and reports its findings to the legislature. 

The policy was introduced by Utah state Senator Michael Kennedy, a doctor and a Republican. Kennedy said that permitting the gender transition treatments represented “a radical and dangerous push for children to enter this version of health care,” per the National Review.

The Utah branch of the American Civil Liberites Union objected to the legislation. In a letter submitted to Cox the day before he signed the policy into law, the ACLU argued the bill “bans access to life-saving medical care.”

“By cutting off medical treatment supported by every major medical association in the United States, the bill compromises the health and well-being of adolescents with gender dysphoria,” wrote John Mejia, the organization’s legal director. “It ties the hands of doctors and parents by restricting access to the only evidence-based treatment available for this serious medical condition and impedes their ability to fulfill their professional obligations.”

Urging Cox to veto, Mejia added, “This bill clearly discriminates on the basis of sex and transgender status. The bill also infringes upon the substantive due process rights of parents to direct the care, custody, and control of their minor children, which includes the right to follow medical guidelines for treatment.”

At least 18 other states are currently considering bills that would limit or prohibit offering surgery or hormones to minors who identify was transgender.

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