Delaware lawmakers seek to enshrine protections for gender-affirming care

First published June 23, 2023 in the Washington Blade.

Delaware residents who receive gender-affirming care and the doctors that provide it can breathe a sigh of relief if a bill aimed at protecting those who seek gender-affirming care and the doctors that provide it passes. 

The bill, introduced by Rep. DeShanna Neal (D-District 13) last week, tacks on gender-affirming care protections to existing protections for those who receive or provide abortions.

“I filed House Bill 230 because we are seeing other states weaponizing their laws against the transgender community, and we should be clear that we will not let those other states’ laws prevent people from seeking gender-affirming care in Delaware,” Neal said in a statement.

The bill would prevent out-of-state people from suing a patient who received gender-affirming care in Delaware and the doctors that provided that care. It would also prevent insurance companies from penalizing doctors providing gender-affirming health care so long as they are not breaking Delaware’s laws. 

Kelly Nichols, a nurse practitioner who provides gender-affirming care like hormone therapy to patients at Planned Parenthood clinics in Delaware, said the bill is extremely important given the wave of anti-transgender legislation around the country. 

“It’s really important in the face of that that we have protections as providers here for patients who may be traveling here to seek care,” Nichols, the associate medical director at Planned Parenthood of Delaware, said in an interview. 

The country’s major medical groups, including the American Medical Association and the World Health Organization, all support gender-affirming health care. 

Despite that support, Neal wrote in a statement that they won’t be pushing the bill forward in the House Health & Human Development committee this year, adding that the bill would start a useful discussion about transgender health care protections. They did not reply to an email asking for an interview and a House Democratic Caucus communications staffer said it was hard to nail legislators down because the legislature is in session. 

Neal’s move came after opposition from Senate Republican leaders, including Senate Minority Leader Gerald Hocker and Senate Minority Whip Brian Pettyjohn. The two senators claimed that the bill would erode parental rights in a statement, which has become a standard talking point for Republicans across the country. Two representatives for the Senate’s Republicans did not respond to an email and multiple phone calls requesting an interview with the legislators. 

The senators added that children are “rarely” held liable for crimes because their brain is still developing – and so is their body – so, they claim, it makes little sense to allow them to undergo “irreversible changes” to their body. 

In fact, teens rarely undergo surgery before 18. Doctors must agree that a patient, child or not, needs the physical transition care. Each surgery has different guidelines associated with it, and the major medical associations all fully support gender-affirming care and oppose bans. 

Teens who receive gender-affirming care are much less likely to die by suicide, according to an observational peer-reviewed 2022 study in the Journal of the American Medical Association. In the cohort the study examined, youth were 73% less likely to attempt suicide.

The senators also say the legislation erodes parental rights, a claim that has become the standard talking point for Republicans across the country who see gender-transition care and children’s ability to explore their gender – especially at school – critically. 

Neal said they will spend their legislative break, from July 1 into 2024, building support for the bill and educating residents about transgender healthcare. 

The bill also gives the state more tools to combat legislation in other states preventing healthcare for transgender people: It allows Delaware to hear child custody cases for kids in Delaware for gender-affirming care from states that ban the care; it prevents Delaware from turning over people that broke another state’s ban; it allows anyone sued in another state for getting or helping someone receive gender-affirming care to countersue them in Delaware; and prevents trans patients’ records from being shared without their consent. 

“Unfortunately, as we’ve seen with the reaction of some in Delaware already,” Neal said in the statement, “more dialogue is needed. I look forward to future discussions regarding the importance of protecting the rights of those seeking gender-affirming care in Delaware.”