Republican Dan Crenshaw Says Gender-Affirming Care Ban Is ‘The Hill We Will Die On’

U.S. Rep. Dan Crenshaw, a Republican from Texas, on Wednesday hotly debated a witness about what he called the “elephant in the room” during a hearing about federal funds for pediatricians’ education. Whereas the House Committee on Energy and Commerce typically stays within the lanes of science, in this hearing it devolved into the right-wing culture war on transgender people, Democrats noted.

Crenshaw questioned Yale School of Medicine assistant professor Meredithe McNamara, a pediatrician with expertise in gender-affirming medicine, about his new proposal to remove federal funding from training hospitals that provide gender-affirming care to minors, such as puberty blockers, cross-sex hormones, or surgery.

The Children’s Hospitals Graduate Medical Education program funding is reauthorized every five years, and 58 hospitals receive it, training most pediatricians. Since 1999, it has been reauthorized five times.

“This is the issue of our time,” Crenshaw said, parroting anti-trans right-wing talking points.

“This is my bill, and what it does it withholds funding from these hospitals if they engage in what they call gender-affirmation therapy,” he said. “These physical changes to a child’s physiology, permanently disfiguring them through either puberty blockers or even surgical modifications.”

Gender-affirming surgeries are not performed on children.

He added, “It is indeed compassionate to stop kids from being permanently physically altered based on little to no evidence that it will improve their underlying mental condition.”

All major credible medical associations have endorsed gender-affirming care as science and evidence-based, proven essential medical treatment for people suffering from gender dysphoria.

“This is the hill we’re going to die on,” Crenshaw said.

“This is taxpayer money, and when 70 percent of taxpayers opposed these barbaric treatments on minors, then taxpayers should not fund it,” he asserted.

“Examining Proposals that Provide Access to Care for Patients & Support Research for Rare Diseases”www.youtube.com

However, McNamara laid out the flaws with the GOP talking points and explained why gender-affirming care is not only proven but essential for the well-being of patients.

“As a physician with a commitment to patient care, I’m honored to be able to do more for them here than I can do in the office,” she said. “The past few years mark a rapidly shifting hostile political climate towards medical care for transgender people with, a harsh focus on youth care. That should be a private matter for families, patients, and providers is now being directed by legislators based on unsupported fears and misinformation. I understand that this care may be confusing to those who are not medical providers with expertise in treating this population or those who do not have a personal connection to a transgender person.”

She said that as a medical practitioner and a member of a vast community of experts in this type of care, she sees five categories of misinformation as responsible for the attacks on medical care for patients in distress: denial of the medical condition of gender dysphoria, false claims about standard practice, false claims about the evidence that backs care, false claims about the safety of treatments, and an attack on medical authority.

“I’m here to ensure that you have the facts to address this misinformation,” she said. “Gender dysphoria, the long-standing and significant distress that many transgender people have from the incongruence between their gender identity and the sex they have at birth, is real. It’s a recognized and serious medical condition. Transgender people of all ages exist. Their health care is based on established standards of care and clinical practice guidelines, which are themselves based on substantial medical research and evidence as well as decades of clinical practice. Based on these standards, youth and parents receive informed counseling about the risks and the benefits of specific treatments, and every major medical organization has endorsed this care.”

Miriam Grossman, a psychiatrist who advocated in the hearing for a conversion therapy approach, stated that most kids with gender dysphoria need counseling and nothing else. She admitted under friendly questioning by Crenshaw that his proposal appears to be a government overreach.

Grossman is part of the fringe group Do No Harm, made up of medical professionals and activists who stand in opposition to widely accepted care for kids with gender dysphoria.

“Medicine is unfortunately permeated with politics at this point,” Grossman said. “Now, ideally, we wouldn’t be stepping in. Who wants the government stepping in between doctors and parents and children? But when there’s something that is so wrong that is going on, then I think we have to.”

The American Medical Association this week came out strengthening its support for gender-affirming care for transgender youth.

McNamara tells The Advocate that giving voice to a witness who peddles in actual dangerous practices is detrimental to the conversation.

“One thing that I was deeply disheartened by was how [the hearing] heavily platforms somebody was who espouses conversion practices, which are dangerous and discredited,” she says. “And also quite simply ineffective.”

Conversion therapy is the discredited practice of attempting to change somebody’s sexual orientation, gender identity, or gender expression. It is a dangerous and harmful technique that has been outlawed for use on minors in states across the country and places around the world.

“Science shows over and over again, study by study, that youth who qualify for and desire gender-affirming care and have the support of their loved ones and their parents, they thrive,” McNamara says. “I am hopeful, seriously hopeful, that will no longer be a contentious issue soon. “

But Republicans appear to have picked their culture war issue, and they’re sticking to it.

“This is the hill we are going to die on. It is too important,” Crenshaw quipped.