04/15/2024 01:00 PM House JUDICIARY

        HB 338-PHYS LBLTY: GENDER TRANS PROCEDURE;MINORS                                                                    
                                                                                                                                
2:19:19 PM                                                                                                                    
                                                                                                                                
CHAIR VANCE announced  that the final order of  business would be                                                               
HOUSE BILL NO.  338, "An Act relating to  physician liability for                                                               
gender transition  procedures performed on minors;  and providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
2:19:45 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ALLARD, prime  sponsor,  presented HB  338.   She                                                               
shared the sponsor statement [included  in the committee packet],                                                               
which read as follows [original punctuation provided]:                                                                          
                                                                                                                                
     An  alarming  number  of  adults  who  received  gender                                                                    
     transition  treatments or  surgeries  as children  have                                                                    
     regretted  those decisions.  Over the  last few  years,                                                                    
     many European countries  have adopted more restrictions                                                                    
     and started  to reconsider the use  of these treatments                                                                    
     provided to minors.                                                                                                        
                                                                                                                                
     House Bill  338 (HB338)  amends Alaska's Code  of Civil                                                                    
     Procedure  by  allowing  recovery  of  damages  against                                                                    
     physicians  who  perform  a procedure  on  minors  that                                                                    
     result  in injury.  Some of  these surgical  procedures                                                                    
     are irreversible.  HB338 focuses  on the  importance of                                                                    
     rigorous  medical oversight  and  informed consent.  An                                                                    
     action brought  under this section must  begin or start                                                                    
     within  20 years  after  the accrual  of  the cause  of                                                                    
     action.                                                                                                                    
                                                                                                                                
     HB338  is a  necessary  step  towards safeguarding  the                                                                    
     well-being  of children.  It ensures  that the  medical                                                                    
     community in  Alaska adheres  to the  highest standards                                                                    
     of  care  and  that  families  can  make  well-informed                                                                    
     decisions.                                                                                                                 
                                                                                                                                
2:21:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE ALLARD presented the sectional analysis for HB
 [included in the committee packet], which read as follows                                                                   
[original punctuation provided]:                                                                                                
                                                                                                                                
     Section  1:  This section  amends  the  Alaska Code  of                                                                    
     Civil  Procedure,  AS  09.10.055(b), by  adding  a  new                                                                    
     exception to  allow recovery  of damages  under Section                                                                    
     3,  which  relates   to  gender  transition  procedures                                                                    
     performed on minors.                                                                                                       
                                                                                                                                
     Section 2:  This section amends AS  09.55.549(f), which                                                                    
     deals  with the  limitation on  noneconomic damages  in                                                                    
     certain  cases.   The  amendment  specifies   that  the                                                                    
     limitation does not apply if  the damages resulted from                                                                    
     reckless or  intentional misconduct  or from  an action                                                                    
     brought under the newly proposed                                                                                           
                                                                                                                                
     Section 3.  Section 3: This  section adds  AS 09.65.175                                                                    
     to establish  claims for recovery of  damages against a                                                                    
     physician for  any injury or condition  suffered by the                                                                    
     procedure.  The  action  must be  commenced  within  20                                                                    
     years  after  the  accrual  of  the  cause  of  action.                                                                    
     Section 4:  This section specifies  that the  Act takes                                                                    
     effect immediately.                                                                                                        
                                                                                                                                
REPRESENTATIVE ALLARD noted that she  had reached out to numerous                                                               
statewide experts who  are in support of the  bill; however, they                                                               
said  that  the Alaska  State  Medical  Board had  threatened  to                                                               
revoke their licenses during the  COVID-19 Pandemic and felt that                                                               
they could be targeted for coming forward.                                                                                      
                                                                                                                                
CHAIR VANCE opened invited testimony.                                                                                           
                                                                                                                                
2:23:34 PM                                                                                                                    
                                                                                                                                
STEPHANIE WINN, representing self,  gave invited testimony during                                                               
the hearing on HB 338.  She  informed the committee that she is a                                                               
licensed marriage  and family  therapist in  the state  of Oregon                                                               
but is testifying on  her own behalf in favor of the  bill.  As a                                                               
left leaning  therapist who  was once  trained to  provide gender                                                               
affirming  care, she  said  she  began to  pivot  the moment  she                                                               
realized that  people were  being harmed by  this approach.   She                                                               
said she  recognized that it  was her  ethical duty to  listen to                                                               
"detransitioners"   and   those    with   painful   regrets   and                                                               
complications from drugs and surgeries  that do not deserve to be                                                               
called experimental.   She added that  countless colleagues share                                                               
her concerns,  whether publicly  vocal or not.   Since  she first                                                               
began to change her stance in  2020, an abundance of evidence has                                                               
emerged supporting  this position,  including the  publication of                                                               
numerous books,  peer reviewed articles, and  systematic evidence                                                               
reviews.   She added  that more  whistleblowers have  sounded the                                                               
alarm,   and  European   countries  have   changed  trajectories,                                                               
recommending  a cautious  attitude that  provides therapy  before                                                               
life altering  medical procedures,  and prioritizes  the lifelong                                                               
health span of the patient.   She opined that in 2024, physicians                                                               
have  no  excuse  for eschewing  reasonable  caution,  dismissing                                                               
testimonies  of  harmed  and aggrieved  parents,  abandoning  the                                                               
Hippocratic   principle  of   nonmaleficence  in   medicine,  and                                                               
disregarding  the growing  body  of evidence  that pediatric  sex                                                               
trait modification is the most  unconscionable medical scandal of                                                               
this time.   She stated that HB 338 ensures  justice for patients                                                               
and families  who have  been harmed  by unscrupulous  doctors who                                                               
have  the  hubris to  ignore  their  conscience  as well  as  the                                                               
evidence.   She  opined  that medical  professionals should  take                                                               
well  established facts  about  well-established psychology  into                                                               
account and decline  to provide treatments that are  likely to do                                                               
more harm than good  in the long run.  She  proceeded to list the                                                               
potential  physical   consequences  of  sex   trait  modification                                                               
procedures.                                                                                                                     
                                                                                                                                
2:27:52 PM                                                                                                                    
                                                                                                                                
IVAN   ABDOUCH,  PhD,   representing   self,  retired   associate                                                               
professor emeritus at the University  of Nebraska Medical Center,                                                               
gave  invited  testimony  during  the  hearing on  HB  338.    He                                                               
acknowledged that people  on all sides of this  issue want what's                                                               
best  for these  kids;  however, they  disagree  on what's  best:                                                               
medicate and  operate, or wait  until adulthood.  He  agreed with                                                               
the latter.   He shared that he had come  before the committee to                                                               
offer his perspective after 30  years in the business, which says                                                               
that  medical  and surgical  gender  transition  in children  and                                                               
adolescents should  never be done.   He made clear  the following                                                               
misconception:  medical  and  surgical treatment  is  for  gender                                                               
dysphoria,  not to  address the  transgender  state per  se.   He                                                               
requested  that the  committee members  keep the  following three                                                               
facts  in the  forefront  of their  deliberation:  there are  not                                                               
current,  generally  accepted  standards  of  care;  no  one  can                                                               
determine  with certainty  the gender  trajectory of  a child  or                                                               
adolescent  for  their lifetime;  the  danger  of that  incorrect                                                               
selection is  amplified by  the fact  that treatment  effects are                                                               
irreversible, and  the unwanted effects  are lifelong.   He urged                                                               
policy makers to  ask and answer the following  question: What is                                                               
an  acceptable number  or  children  who experience  irreversible                                                               
harm of  lifelong effects  due to  erroneous medical  or surgical                                                               
management?   He submitted  that the  least unsafe  management is                                                               
counseling by  a competent therapist.   He said please  don't let                                                               
misdirected beliefs supersede safety.                                                                                           
                                                                                                                                
2:32:00 PM                                                                                                                    
                                                                                                                                
ARII DEWOLF, representing self,  public policy professional, gave                                                               
invited testimony  during the hearing on  HB 338.  He  shared his                                                               
background  as a  gay, half  black,  Jewish conservative,  adding                                                               
that  "[his] story  is America's  story."   He  commented on  the                                                               
removal  of  the human  individual  in  medicine.   He  expressed                                                               
concern that  big politics  and big money  have joined  forces to                                                               
undermine the  rights of individual  Americans who  are ascending                                                               
in the  next generation.   He opined that people  cannot discover                                                               
who  they  are when  there  is  a pipeline  into  medicalization,                                                               
pharmaceuticals, and  surgical interventions.  He  emphasized the                                                               
importance  of  remembering why  this  country  was founded,  the                                                               
principles of the individual, and common sense.                                                                                 
                                                                                                                                
2:36:24 PM                                                                                                                    
                                                                                                                                
MATT  SHARP, Senior  Counsel,  Alliance  Defending Freedom,  gave                                                               
invited testimony  during the hearing on  HB 338.  He  noted that                                                               
the  Alliance Defending  Freedom  serves as  co-counsel with  the                                                               
State of Alabama,  defending its law that  protects children from                                                               
dangerous gender  transition drugs  and surgeries.   Children who                                                               
experience discomfort  with their biologicals sex  need access to                                                               
compassionate, effective  mental healthcare,  he said.   However,                                                               
activists  and   profit  driven  gender  clinics   have  deceived                                                               
children and  parents alike into  believing that  unnatural, life                                                               
altering,  and  even  permanently sterilizing  puberty  blockers,                                                               
hormones and  surgeries are the  solution to their struggle.   He                                                               
pointed out  that laws have  long protected children  from things                                                               
that  society has  deemed  harmful,  or that  a  child lacks  the                                                               
maturity and  experience to  handle.  He  questioned how  a child                                                               
that  lacks  the maturity  to  sign  a contract,  vote,  purchase                                                               
alcohol, or  get a tattoo  could be  mature enough to  consent to                                                               
experimental,  potentially irreversible  medical procedures  that                                                               
can  lead  to  permanent  sterilization.   He  added  that  court                                                               
rulings  have held  that  states have  a  compelling interest  in                                                               
protecting the  physical and  psychological wellbeing  of minors.                                                               
As a result,  Alaska can limit the freedom of  children to choose                                                               
for  themselves in  making  important,  affirmative choices  with                                                               
potentially serious consequences.   He cited research that swayed                                                               
England's national health service,  along with health authorities                                                               
in  Sweden  and  Finland,  to stop  using  puberty  blockers  and                                                               
hormones to  treat gender dysphoric  youth in  clinical settings.                                                               
Based on this  evidence, he reported that 24  states have enacted                                                               
laws  like  HB 338  to  protect  children from  these  practices.                                                               
Instead,  they  are  prioritizing   counseling  and  therapy  for                                                               
children  who express  distress over  their biological  sex.   He                                                               
referenced recent decisions  by appellate courts, as  well as the                                                               
U.S.  Supreme  Court, that  allow  these  laws  to be  upheld  to                                                               
protect children's health and safety.                                                                                           
                                                                                                                                
2:42:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE ALLARD  noted that none of  the invited testifiers                                                               
had been paid to share these opinions.                                                                                          
                                                                                                                                
CHAIR VANCE sought questions from committee members.                                                                            
                                                                                                                                
2:42:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GRAY asked  whether  the testifiers  had met  any                                                               
happy  transgender ("trans")  children  who do  not regret  their                                                               
decisions.                                                                                                                      
                                                                                                                                
2:43:59 PM                                                                                                                    
                                                                                                                                
DR.  ABDOUCH  cautioned  against  using  the  term  "transgender"                                                               
because  it's hard  to know  with  certainty whether  a child  is                                                               
transgender and/or gender  dysphoric.  He added that  he had seen                                                               
many  children that  were dissatisfied  or  regretful over  their                                                               
decisions.                                                                                                                      
                                                                                                                                
MS.  WINN noted  that  she lives  in Portland  where  there is  a                                                               
"showiness" about trans  pride.  she questioned  whether there is                                                               
evidence  that  any  transient feelings  of  joy,  happiness,  or                                                               
euphoria   some of which could  be placebo or the effect of mood-                                                               
altering  substances    outweigh  the impact  of lost  fertility,                                                               
increased  risk of  cardiovascular disease,  cancer, Alzheimer's,                                                               
dementia, the inability  to have children, and  a greatly reduced                                                               
dating  pool.   She added  that as  a therapist,  she must  think                                                               
beyond face  value to the  long-term developmental  trajectory of                                                               
the individual.                                                                                                                 
                                                                                                                                
MR. DEWOLF  said he  had transsexual  family members  and friends                                                               
who are no longer [alive],  whether by lifestyle or what happened                                                               
to their bodies.   He shared that a gender  clinic is being built                                                               
to  help  people who  have  experienced  harm because  there  are                                                               
enough that have been harmed by it.                                                                                             
                                                                                                                                
MR. SHARP responded that ultimately,  subjective feelings are not                                                               
what  the   legislature  looks  at.     Instead,  he   urged  the                                                               
legislature to consider evidence  and other systematic reviews in                                                               
deciding the best policies for Alaska.                                                                                          
                                                                                                                                
2:49:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   CARPENTER   asked   whether  it's   the   gender                                                               
reassignment   procedure   or   the  opinion   of   the   medical                                                               
professional that puts the child at risk.                                                                                       
                                                                                                                                
DR.  ABDOUCH  answered, "both."    He  reflected on  his  30-year                                                               
practice  in  the  transgender world  with  a  multi-disciplinary                                                               
group  of psychologists,  psychiatrists,  counselors, and  allied                                                               
health people  who would not  treat anyone  under the age  of 25.                                                               
He explained  that the procedures  carry significant  risk beyond                                                               
the  usual  surgical   risk  because  it  attempts   to  treat  a                                                               
psychological problem with medical or surgical treatment.                                                                       
                                                                                                                                
MS. WINN commented on the power  of the authority held by medical                                                               
professionals.    She  agreed  that the  answer  is  "both,"  and                                                               
acknowledged the  emotional weight of a  professional endorsing a                                                               
specific treatment.                                                                                                             
                                                                                                                                
DR.  ABDOUCH advised  using the  terms "trans"  and "experimental                                                               
treatment" with caution, opting instead for "untested."                                                                         
                                                                                                                                
2:55:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SUMNER  shared  his understanding  that  a  small                                                               
percentage  of   babies  are  born   hermaphroditic  or   with  a                                                               
significant  genital malformation.    He  asked whether  treating                                                               
those [anatomic  distortions] would fall under  gender transition                                                               
procedure  or  whether  it  would be  classified  as  some  other                                                               
medical procedure.                                                                                                              
                                                                                                                                
REPRESENTATIVE ALLARD said  that is not included in  the bill and                                                               
shared her understanding that those [distortions] are very rare.                                                                
                                                                                                                                
MR. ABDOUCH  clarified that anatomic distortions  are an entirely                                                               
different conversation.                                                                                                         
                                                                                                                                
2:56:46 PM                                                                                                                    
                                                                                                                                
MS.  WINN informed  the  committee  that she  had  met with  many                                                               
people with  sexual development disorders.   She  emphasized that                                                               
the  disordered   sexual  development  (DSD)  community   is  not                                                               
thrilled about being brought into this discussion.                                                                              
                                                                                                                                
CHAIR VANCE sought closing comments from the bill sponsor.                                                                      
                                                                                                                                
2:58:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ALLARD stated  that  children are  not meant  for                                                               
unintended body  mutilation.  She  opined that anyone  who pushes                                                               
for  their children  to have  breasts  or genitalia  cut off,  or                                                               
given  hormone  blockers,  should   be  held  accountable.    She                                                               
characterized the  procedures as  child abuse worthy  of criminal                                                               
charges.                                                                                                                        
                                                                                                                                
CHAIR VANCE announced that HB 183 would be held over.