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SALT LAKE CITY — The author of Utah's child transgender treatment ban and his Democratic opponent in the 3rd Congressional District race said they would both support a federally commissioned study of transgender treatments for minors like the one that recently led to major policy changes in the United Kingdom.
State Sen. Mike Kennedy, R-Alpine, is the Republican nominee running against former Summit County Councilman Glenn Wright, the Democrat nominee, in the general election to replace Rep. John Curtis. While the two candidates agree on the need for more research on transgender treatments for minors, they disagree strongly on the state law Kennedy helped pass that made those treatments illegal in the state of Utah.
In 2023, Kennedy introduced legislation that banned sex reassignment surgeries for minors, put an indefinite pause on hormonal treatments for new child patients and ordered a review of the medical evidence surrounding these treatments to inform future policies. The law, SB16, also established credentialing requirements for transgender treatment providers and expanded the ability for patients to sue medical practitioners for malpractice.
The main reasoning behind the legislation was the lack of quality scientific research on transgender treatments and their long-term effects, Kennedy told the Deseret News.
"Where is the 30-year data? And the answer is, we don't have that data," Kennedy said.
What is the Cass Review?
An exhaustive report commissioned by England's National Health Service, released in April, came to similar conclusions as Kennedy, leading to a prohibition on puberty blockers and cross-sex hormones as a treatment for minors in the world's second-largest public health system. NHS Scotland followed suit one week later, becoming the sixth European country to limit transgender medications.
The so-called "Cass Review," named after Dr. Hilary Cass, the former president of the Royal College of Paediatrics and Child Health, examined dozens of studies in addition to interviewing individuals diagnosed with gender dysphoria who received transgender treatments as minors and their parents. As the Deseret News previously published, the findings of the report were stark.
"Systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices," the Cass Review summary said.
Not only was the rationale for prescribing early puberty suppression "unclear" and the effects of cross-sex hormones on minors defined by "unknowns," the Cass Review also found that these treatments were likely not completely reversible — potentially impacting bone density, brain maturation and fertility — and did not appear to improve suicidality.
What's more, amid a surge of female minors seeking clinical transgender treatment in England, the report found that, "Clinicians are unable to determine with any certainty which children and young people will go on to have an enduring trans identity." Therefore, the report concluded, "For the majority of young people, a medical pathway may not be the best way to manage their gender-related distress."
Should there be an American "Cass Review"?
Kennedy said he was encouraged by the impact of the Cass Review in the United Kingdom.
"People are starting to recognize that there's not a great deal of robust data to support these significant measures that have been put into place to help children transition," Kennedy said.
But there have not been similar steps taken in the United States, where the institutional approach of health care institutions has mostly been to embrace an ideological approach to transgender treatments "hook, line and sinker," Kennedy said. "In spite of many professional organizations like the American Academy of Pediatrics — they've entirely endorsed this — the science is weak."
If elected to represent the 3rd District, where he now works as a family physician, Kennedy said he would support federal steps to task "our best and brightest minds, that are not ideologically motivated," to conduct high-quality, longitudinal studies on the long-term implications of transgender treatments on minors.
Wright, a retired loss control insurance consultant and Vietnam War veteran, told the Deseret News that "more data is always useful" and that he would "absolutely" support a federally commissioned study of how transgender hormone treatments affect young people. But he pointed out that the Cass Review was limited to a shift in public health policy, not legal penalties for private practitioners.
The law passed by Kennedy allows for an investigation to result in the revocation of medical licensure if a doctor is found to have performed transgender surgeries or treatments in violation of the new age limits and credentialing requirements. The law also extends the statute of limitations to allow children that have undergone transgender treatments to sue their health care provider for malpractice up until the age of 25 "to encourage these doctors to live up to the high standards that we all would expect for the children in our state," Kennedy said.
Wright described the legislation Kennedy helped craft as "abominable" and "unacceptable." Gender dysphoria is a serious condition that affects only a "small group of people" with treatments that have been around for decades, Wright said. The 2023 law was passed not because hormonal transgender treatments are "new or radical," Wright argued, but because they represent a type of treatment Kennedy "doesn't particularly like."
In contradiction to the Cass Review, Wright claimed that hormonal treatments before puberty are "reversible" if the patient "changes his or her mind," and that such treatments typically occur only after "very extensive counseling" with patients, parents and doctors.
While researching his bill, Kennedy said he was "shocked" to find a lack of caution, credentialing or consistency with how transgender care was provided in the state.
Should there be a federal ban on transgender treatments for minors?
Wright does not have an "adamant position" on sex characteristic reassignment surgeries for minors — which can potentially remove body parts and potentially make them sterile. This decision should be left up to "parents and their children ... as much as possible," according to Wright, who considers Kennedy's legislation a violation of "personal freedom."
"I think what this does is it is usurping the rights of parents to help their children," Wright said. "What right does he have to tell a parent what treatment they should be receiving?"
The question of transgender treatments is not for Congress, or state legislatures, to decide, Wright said, explaining that he believes the federal government should not get involved in private health concerns and should stick to protecting people's rights.
Kennedy also has concerns about a federal ban on transgender treatments but for very different reasons. A national prohibition would likely lead to a national lawsuit before the U.S. Supreme Court, Kennedy said, which could potentially lead to a win for "the other side."
Federal policy is also a worse venue for navigating nuanced subjects like this, Kennedy said.
He said he sees room for federal action on encouraging the Food and Drug Administration to provide guidance on transgender hormonal treatments. But what Kennedy really hopes to see is for other states to follow Utah's example.
"The state of Utah and other states are working on this in a productive fashion," Kennedy said. "And that's really best in these cases, left to the states, unless there's some compelling national interest that we may need to step in on the federal level and do something about it."
