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Need gender-affirming care? It's hard to find in Billings

Inside a Billings hospital
Posted at 8:56 AM, Sep 20, 2023
and last updated 2023-09-20 10:56:20-04

BILLINGS — An ongoing debate surrounding Senate Bill 99 (SB 99), a new Montana law banning gender-affirming care for transgender youth, continued this week in Missoula.

MTN News took a look at where these services are offered in Montana. It turns out providers offering gender-affirming care in Montana aren't easy to find, largely because they don't want to advertise their services for care that has become politically charged in Montana.

Much of the debate started during the 68th Legislative Session held in the spring.

"SB 99 intends to prevent anyone from receiving gender-affirming care. In doing so, it takes away the choices that families would typically make with their physician," said Dr. Lauren Wilson, the president of the Montana chapter of the American Academy of Pediatrics, on Tuesday. "This law says that they can’t do that, and it also has a spot that makes it even not okay for physicians to refer patients for gender-affirming care, even if that were out-of-state.”

Dr. Lauren Wilson
Dr. Lauren Wilson

The American Academy of Pediatrics (AAP) is the largest professional organization for pediatricians in the United States. Wilson said its goal is to protect the health of children.

Now, with a new ban on gender-affirming procedures set to take effect in two weeks—including surgery and hormone treatments for minors—the issue has moved to the courts.

On Monday in Missoula, state District Judge Jason Marks heard testimonies as he considered whether to put a hold on SB 99. He has not yet made a decision in the case.

Attorneys for the state in the lawsuit argued children need to be protected from these procedures.

"Give them the chance to grow up, give them the chance, the right that they have, to future autonomy to make this decision for themselves,” argued Michael Russell, the assistant attorney general for Montana, on Monday. “In this area of unfolding medical and policy debate, the state has more rather than fewer options."

On the other end, Malita Picasso, the attorney representing plaintiffs seeking to overturn the ban, said it would cause real harm.

“We’re not just talking about statistics or numbers. We’re talking about real people who are suffering real harm, and those people include people who are sitting in this room today,” Picasso said on Monday. “I could think of no better example of an irreparable injury than having to be forced out of your own home state by your elected officials because they’re attacking your children."

Regardless of opinion, MTN News wanted to know where gender-affirming care is offered in Montana.

That's when we discovered providers were hesitant to advertise their services. Wilson says most Montana hospitals that offer gender-affirming care are worried about safety.

"We’ve seen threats of violence against children’s hospitals for offering this care at all. There have been bomb threats phoned in. There’s all sorts of stuff that people are trying to deal with when they’re really just trying to take care of patients," Wilson said. "And so our goal is just to take care of patients. The rest is unfortunate, but it’s a bit of a distraction from what’s actually going on. And I think we need to put the well-being of kids and families first."

Inside a Billings hospital
Inside a Billings hospital

St. Vincent Healthcare, a Catholic hospital, told MTN Tuesday it doesn’t offer gender-affirming surgeries but didn’t respond to questions about other care.

Billings Clinic provided MTN with the following written statement: "Billings Clinic does not provide gender-affirming surgical procedures for minors. The medications referenced in the legislation are used at Billings Clinic for a wide variety of treatments including lifesaving, fertility, and cancer care. Billings Clinic remains committed to following all applicable laws."

Helena capitol building
Helena capitol building

SB 99 references puberty blockers and other synthetic drugs that suppress the production of testosterone and estrogen.

"Laws like this absolutely do harm. They take away options for families to consider for care that really is evidence-based," Wilson said. “I think this kind of care is really widely misunderstood. People really haven’t lived or walked in the shoes of a family who might be struggling to access care for their child. And because a lot of this is misunderstood, it’s really rife with misinformation that’s being spread nationwide."

Care Wilson said is misunderstood, which could explain why finding those providers isn’t necessarily easy.

“There are gender-diverse people and gender-diverse youth in every city and town in Montana. And there are resources. We always recommend that people reach out to their primary care provider, so a family doctor or pediatrician if they have any concerns or health questions," Wilson said. "There’s also advocacy organizations within the LGBTQ community. 406 Pride in Billings is an organization that’s really aiming to just support the needs of the community there."

To read SB99 in full, click here.

To learn more about the lawsuit in Missoula, click here.