'You belong here': Minnesota House passes trans health refuge bill

People speak at a podium and look at a crowd
Rep. Leigh Finke ahead of the Trans Refuge Act vote on Thursday.
Dana Ferguson | MPR News

The Minnesota House of Representatives passed a bill early Friday by a vote of 68-62 that would prevent state courts or officials from complying with child removal requests, extraditions, arrests or subpoenas related to gender-affirming health care that a person receives in Minnesota. 

Physicians who practice gender-affirming care in Minnesota and families who’ve sought it out for their transgender children or teenagers said it would go a long way to ensure that they can continue to access treatment without fear of other states’ laws getting in the way. 

They also said it would send a message to transgender people that they are welcome in Minnesota.

Eight states – Alabama, Arkansas, Florida, Iowa, Mississippi, South Dakota, Tennessee and Utah – have issued all out bans on gender-affirming care for transgender youth, including medication and surgical services. Meanwhile, Arizona has outlawed surgical treatments and dozens of other states have bans under consideration.

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That has meant that transgender youth and their families have had to look to other states for care options.

People hold signs in the house chamber
Supporters and opponents of the Trans Refuge Act stand outside the Minnesota House chamber on Thursday.
Dana Ferguson | MPR News

“Forced detransition is a violence against my community that I can barely begin to imagine. That is what is happening in states across America,” bill author Rep. Leigh Finke, DFL-St. Paul, said. “To all those families across the United States that are afraid and wondering where they can go for help, Minnesota is saying we see you, we love you, and you belong here.”

Gov. Tim Walz earlier this month issued an executive order directing state agencies and officials not to comply with other state’s efforts to penalize out-of-state patients who travel to Minnesota to pursue gender-affirming care. 

But the bill’s supporters said it’s important to guarantee that protection in state law.

Minnesota physicians who provide gender-affirming care said they’ve already seen an uptick in prospective patients from states where their options have been outlawed.

People look on as the governor signs a bill
Supporters of the trans refuge bill watch as Gov. Tim Walz signs the bill into law during a ceremony at the Minnesota State Capitol in St. Paul on March 8.
Ben Hovland | MPR News

Dr. Angela Kade Goepferd, chief education officer and medical director of the Gender Health program at Children's Minnesota, said young people can experience significant mental health impacts when they undergo impacts of puberty that don't align with their gender identity.

“Frequently we will talk about gender-affirming care as life saving health care. And we're not saying that to be dramatic,” Goepferd said. “We're saying that because for kids and adolescents and adults who can't access gender-affirming health care, they are at significantly higher risk of worse mental health outcomes, including suicidality.”

“So these decisions that are being taken up in state legislatures are literally putting lives at stake,” Goepferd continued.

Republican lawmakers in states that have imposed bans, as well as in Minnesota, have raised concerns about long-term impacts of gender-affirming treatments for transgender children or youth.

someone holds a sign that says trans rights are human rights
Activist Derek Torstenson holds a sign in support of the Trans Refuge Act in the Minnesota House chamber on Thursday, March 23, 2023.
Dana Ferguson | MPR News

“The bill makes Minnesota a sanctuary state for so-called gender-affirming care, while simultaneously infringing on the fundamental right of parenting,” Minnesota Rep. Peggy Scott, R-Andover, said ahead of the floor debate Thursday. “It allows children, regardless of age, to seek and receive radical medical treatments.” 

While those comments or concerns permeate the national dialogue around gender-affirming care for transgender and gender diverse people, they don’t square with reality, physicians said.

Major medical associations support gender-affirming care and note it improves mental health outcomes in the short and long term. And while lawmakers carrying proposals to ban gender-affirming care tend to focus on surgical options, providers note that only in rare instances do transgender people under age 18 qualify for surgical treatments.

Goepferd said Children’s Minnesota doesn’t perform gender-affirming surgeries on patients under 18 years old. Patients that come in before puberty undergo counseling to check in about how they’re feeling and developing. After kids reach puberty, typically between ages 12 and 16, they can become eligible for reversible puberty-blocking hormones.

After that, transgender and gender diverse youth can seek out gender-affirming surgeries. But that’s a process that takes time, Goepferd said.

“This care is not new, this care is not fast. This care is evidence-based. It is age and developmentally appropriate,” Goepferd said. “The controversy around this care is new, and has been constructed over the last one to two years. But this care itself is not new. And the care itself is not controversial.”

“So the bottom line is that all kids deserve to access the health care they need and that should not depend on the state that you live in,” Goepferd continued.

Ahead of Thursday’s floor debate, LGBTQ+ families and allies, along with medical providers held up signs outside the House chamber that said “trans rights are human rights” and “you belong.”

And they led a call and response cheer. “When trans kids are under attack, what do we do? Stand up, fight back,” they cheered.

GOP lawmakers and conservative groups offered a prayer outside the House chambers and greeted lawmakers with signs that said “parents know best” as they entered the chamber.

The Minnesota bill is set to be heard in the Senate Judiciary and Public Safety Committee on Friday, and DFL leaders have said it is a priority. Gov. Tim Walz has said he will sign the bill into law if it reaches his desk.