Utah lawmakers won't revisit pause on gender care for minors after report finds positive outcomes

SALT LAKE CITY — Republican lawmakers in Utah say they don't plan to revisit a moratorium on gender-related care for minors even after a report commissioned by the Utah Legislature found such care leads to "positive mental health and psychosocial functioning outcomes."

Lawmakers enacted the moratorium on gender-related care in 2023, pressing pause on surgeries and hormone treatments that can be used to help bring a person's gender expression in line with their gender identity. That law, SB16, also directed the Department of Health and Human Services to review the evidence of "hormonal transgender treatments to minors."

At the time, GOP lawmakers who supported the law said its goal was to protect youth. And although the American Academy of Pediatrics recommends certain treatments for children and teens with gender dysphoria, lawmakers argued there was a lack of research on the long-term impacts of those procedures on children.

"I believe this one is the right bill, the one that approaches it in the right way," Gov. Spencer Cox said in January of 2023. "All he's saying is we're going to push pause, we're going to look at the research, we're going to gather all of the data and make sure we're not doing any long-term harm to our young people. And I think that's a very reasonable approach."

The 1,051-page report, published quietly on the Legislature's website last week, concluded that the "conventional wisdom among nonexperts has long been that there are limited data on the use of (gender-related hormone therapy) in pediatric patients with (gender dysphoria). However, results from our exhaustive literature searches have led us to the opposite conclusion."

But Republicans said they're not interested in revisiting SB16, even in light of the report. Rep. Katy Hall, R-Ogden, the floor sponsor of SB16, and Rep. Bridger Bolinder, R-Grantsville, the chairman of the House Health and Human Services Committee, said they "intend to keep the moratorium in place" in a statement to KSL.com.

"Young kids and teenagers should not be making life-altering medical decisions based on weak evidence," they said. "Utah was right to lead on this issue, and the public agrees — polls show clear majority support both statewide and nationally. Simply put, the science isn't there, the risks are real, and the public is with us."

The report itself pushed back on the idea that there is not enough research, and one of its authors said she was surprised at just how much evidence there is.

"I think it would be hard to look through the evidence tables in our report and conclude that there is 'not enough research' on the question of how effective and safe these treatments are for the outcomes we looked at," Joanne LaFleur, director of the University of Utah's Drug Regimen Review Center, told KSL.com. "These drugs have been evaluated in hundreds of studies and many thousands of patients."

Senate President Stuart Adarms, R-Layton, said SB16 was meant to "safeguard" the health of children, saying: "The future and safety of kids are paramount." He thanked the department for its report and said lawmakers would review it "as part of our ongoing commitment to the well-being of Utah's children."

A spokesman for the governor did not respond to a request for comment.

Equality Utah, an LGBTQ+ rights organization, urged lawmakers to "engage seriously with the report's findings as they consider the future of health care for transgender youth," arguing that policy "should be grounded in rigorous, evidence-based research — not driven by politics or transient debates."

"Our shared goal should be to ensure that every child in Utah — and across the nation — has the opportunity to grow, thrive and succeed in a supportive and compassionate environment," the organization said in a post.

Report finds positive outcomes from gender-related care

LaFleur said researchers examined conclusions from dozens of academic studies over the past 15 years to try to draw a consensus about the research. The report was presented to the Department of Health and Human Services and is dated Aug. 6, 2024.

The report found that hormonal treatments can increase "some specific types of benign brain tumors," but had mostly positive conclusions about those treatments.

"Overall, there were positive mental health and psychosocial functioning outcomes," the report states. "Increase risk of mortality was consistently due to increase in suicide, non-natural causes and HIV/AIDS. Patients that were seen at the gender clinic before the age of 18 had a lower risk of suicide compared to those referred as an adult."

LaFleur said she was surprised "by the amount ... and the consistency of the evidence."

"I was also surprised by the safety outcomes and by the dearth of negative outcomes," she said. She noted that the studies demonstrate that "treatments are pretty safe in terms of metabolic changes, bone health and cancer outcomes."

The report also found that few pediatric patients treated with hormones regret the treatment later on. It concluded that policies that restrict hormonal treatments to children and teens with gender dysphoria "cannot be justified based on the quantity or quality of medical science findings or concerns about potential regret in the future."

The Department of Health and Human Services declined to take a position on whether lawmakers should lift the moratorium on gender-related care for minors, but said if the pause was lifted, lawmakers should consider creating a treatment board to oversee standards of care for minors, limit who can practice such care and enhance informed consent for the procedures.

Asked how she hopes to see the report used by policymakers, LaFleur said: "My hope is that we can move beyond saying that there is a lack of evidence for use of these treatments. Based on what we found, the magnitude of it and the consistency in it, we can put that belief to rest. I would like to see that."

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