2023 has been a landmark year with the most anti-trans bills introduced ever. The current legislative session has seen more than 350 anti-trans bills across 36 states. Ranging from prohibiting gender affirming care for youth to bathroom bills making a resurgence, many states are currently having hearings related to many aspects of life impacting trans people's lives. This week, we'll take a look at the Oklahoma Millstone Act and some other trans related legislation within Oklahoma and around the country.
What is the Oklahoma Millstone Act?
Oklahoma SB 129 was introduced in February this year by David Bullard (R) and Kevin West (R). This bill would would prohibit medical professionals in the state from providing gender-affirming care to anyone under 26 years old.
The bill defines "Gender transition procedures" as any medical or surgical treatment including but not limited to physician’s services, inpatient and outpatient hospital services, or prescribed drugs related to gender transition that seek to:
- alter or remove physical or anatomical characteristics or features that are typical for the individual’s biological sex
- instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s biological sex, including but not limited to medical services that provide puberty-blocking drugs, cross-sex hormones, or other mechanisms to promote the development of feminizing or masculinizing features in the opposite biological sex, or genital or nongenital gender reassignment surgery performed for the purpose of assisting an individual with a gender transition
The bill does call out a few different circumstances that are not included in "gender transition procedures" under the act. First, the bill allows for behavioral health care services or mental health counseling and medications for treating depression and anxiety to be allowed. Then, the bill allows for medications prescribed, dispensed, or administered specifically for the purpose of treating precocious puberty or delayed puberty in that patient. Services provided to individuals born with "ambiguous genitalia, incomplete genitalia, or both male and female anatomy, or biochemically verifiable disorder of sex development (DSD)" are also allowed. If someone receives a gender transition procedure and requires treatment for an infection, injury, disease, or disorder caused by or exacerbated the procedure are also allowed, "whether or not the gender transition procedure was performed in accordance with state and federal law".
If a provider/hospital chooses to provide care deemed as a "gender transition procedure" the bill prohibits them from receiving government funding and opens them up to a felony ($1,000 fine or two years in prison). Providers would also risk loss of their medical license. The bill allows individuals to pursue legal action up to 40 years following a violation (receiving a gender transition procedure within Oklahoma) or 40 years from when the patient turns 18.
The "Millstone Act" title reportedly refers to Matthew 18:6 "If anyone causes one of these little ones—those who believe in me—to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea." This verse has been interpreted to mean that it would be better to have “a heavy millstone" hung around someone's neck causing them to drown in the ocean than for someone to cause a child to sin. The age of majority in Oklahoma is 18.
A Similar Oklahoma Bill with a Younger Age Limit
Another Oklahoma bill, introduced on the same day as the Millstone Act, would place an age restriction of 21 on gender-affirming care within the state. It would also subject providers who violate the act to much more severe penalties, a sentence of up to ten years in prison and fines up to $100,000. Under this bill, providers and health care providers may not refer individuals under the age of 21 “to any healthcare professional for gender transition procedures.” A referral would be classified as “unprofessional conduct” and "shall, upon an adverse ruling by the appropriate licensing board, result in immediate revocation of the license or certificate of the physician or other health care professional."
Similar Moves around the Country
Oklahoma is not the only state working with this type of legislation. Arkansas passed the Save Adolescents from Experimentation (SAFE) Act in 2021 making it the first state to forbid doctors from providing gender affirming care (hormone treatment, puberty blockers, sex reassignment surgery) to anyone under 18 years old. This law also banned doctors from referring the minors to other providers. The bill was vetoed by the Governor, to have legislature overrule the veto, to then be blocked by a Federal Judge. This year, lawmakers introduced a bill to effectively reinstate the SAFE Act, still temporarily blocked, as it aims to force medical providers to stop offering gender-affirming care because of malpractice insurance. The bill, which was signed on March 16th by Governor Sanders, would allow someone who received gender-affirming care as a minor to file a malpractice lawsuit against their doctor for up to 30 years after they turn 18. This would make it nearly impossible for doctors who choose to provide this care to get malpractice insurance due to the heavily increased liability risk. Medical malpractice claims must be filed within two years of what the law refers to as an “injury” under current Arkansas law.
Florida's ban was a result of the Florida Board of Medicine creating rule that prohibits health providers from offering gender-affirming care (puberty blockers, cross-sex hormones, surgical procedures) for those under the age of 18.
As of the writing of this blog, 19 "SAFE" Acts have been introduced across the country in: Arizona, Lousiana, Missouri, Mississippi, Ohio, Oklahoma, and Virgina. New York proposed a bill that "suspends all unnecessary travel to Arkansas by government agencies, departments, boards, authorities, and commissions as long as HB 1570 (their SAFE Act) is in effect." There are currently 49 bills proposed relating to prohibiting "gender transition" for minors that do not necessarily use the "SAFE" Act verbiage across the nation.
You can also access these bills within our mobile app with Mobile Access Code:IWDMCCB.
Other Legislation Impacting Trans People in Oklahoma
Oklahoma has passed a decent amount of legislation targeted at trans people. Last year, Oklahoma Governor signed the Save Women's Sports Act (similar to US legislation, the Protection of Women and Girls in Sports Act of 2021) into law, prohibiting state schools athletes from participating in sports that correspond with their gender identity. Also last year, they also passed a bill requiring schoolchildren to use only gendered facilities that correlate their sex assigned at birth.
SB408, which also crossed over the beginning of March, known as the "Women’s Bill of Rights" aims to "bring clarity, certainty, and uniformity under the laws of this state with respect to natural persons of both biological sexes and the manner in which they are treated as such under the laws of this state." The legislation defines "female" to mean "a natural person whose biological reproductive system is developed to produce ova," and defines "male" as "a natural person whose biological reproductive system is developed to fertilize the ova of a female." The bill also defines "sex" to refer to "a natural person’s biological sex at birth." This bill excludes transgender women from the legal definition of women.
My Conclusion.
I believe all people should have agency over their own bodies. I also know there are extensive vetting procedures done by healthcare professionals to ensure people who receive "gender transition procedures" are fully informed. In 2022, the World Professional Association for Transgender Health released new guidelines about minimum age for gender affirming care. They stated hormones could be started at age 14 and some surgeries done at age 15 or 17. In the report, the group acknowledges potential risks around giving gender affirming care, but also highlight the harmful risks associated to withholding early treatment. The age was lowered based on studies from the last decade which suggest treatments can improve psychological well-being and reduce suicidal behavior for trans youth.
Some type of argument can be made related to making children wait until "adulthood" for these types of medical procedures, although I agree it can be incredibly harmful to make kids wait, but there is no doubt that adults should absolutely be able to make these choices for themselves without lawmakers weighing in. This type of legislation is a new kind of concerning to me. Not only because it is inhumane, but it poses another threat in the fight to protect all of our bodily autonomy.
Cover Photo by Thiago Rocha on Unsplash
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