Senators square off over who decides on matters of gender dysphoria, transition medical procedures

The ongoing debate about gender dysphoria and transition medical treatments devolved Wednesday on Capitol Hill under expected partisan division, with Republican senators calling for an to such procedures and liberal ones arguing that the federal government shouldn’t get involved.

Those in the packed Senate Health, Education, Labor and Pensions Committee hearing room heard from 21-year-old detransitioner and advocate Chloe Cole, legal director of the National Center for Lesbian Rights Shannon Minter and Do No Harm chief medical officer Kurt Miceli, as well as the committee’s senators.

In his opening remarks, Vermont Independent Sen. Bernie Sanders slammed the hearing title: "Protecting Our Children: Exposing the Dangers of Irreversible Gender Transition Procedures on Minors." 

Sander, one of the most liberal members of Congress, argued that “gender-affirming care should be between a doctor, a patient and their parents, not politicians or the federal government.”

Miceli said that medicine can be inaccurate, emphasizing that doctors earn the public’s trust by facing and correcting their errors. 

He argued that his group, Do No Harm, works to protect children from the dangers of gender-transition procedures, saying  it has identified almost 14,000 minors who received gender-transition procedures from 2019 to 2023, totaling over 5,700 surgeries. He said around 24 systematic reviews found no credible evidence supporting that such procedures – including  vaginoplasty and breast augmentation, in fact improve mental health among young people.

Miceli also argues that such procedures’ irreversibility leads to long-lasting consequences for those affected, including infertility, sexual dysfunction, bone density issues, cardiovascular disease, elevated mortality and lifelong regret.

Cole, who began transitioning from female to male at age 12, agreed with the argument. Cole testified that puberty began at about age 8 but that she felt like a tomboy due to the influence of her older brothers and a lack of female role models in her life. While dealing with mental health issues, Cole learned of the option to transition genders on social media. She and her parents were told by their healthcare providers that the only possible solutions to her feelings were suicide or changing genders.

“The entire premise of transgenderism is that I will take my own life if I don't transition,” Cole said. “The lie was once doctors denied that boundary between male and female, they also denied the boundary between child and adult.”

Cole was given puberty blockers and testosterone starting at 13, then underwent a double mastectomy at 15. She said she was not fully informed of the consequences she would undergo as a result of these procedures, including vaginal atrophy, severe uterine cramps, increased susceptibility to dehydration and infection and potential infertility.

Minter – born female but transitioned at 35 – said the government is attempting to rob the American people of decisions they should have the right to make themselves, attacking “safe and effective medical care” and attempting to seize medical records from families for an “unlimited and unknown purpose.”

Several Democratic senators supported Minter’s argument that the federal government should not intervene in an issue they believe should remain within the home between parents and their children.

Among the was Virginia Sen. Tim Kaine, who used his speaking time to criticize “hostility against transgender people,” bringing up the Texas election controversy with Democratic Texas state Rep. James Talarico and the Air Force’s recent decision to disallow transgender people from retirement so they can’t claim benefits. Kaine thinks the broader solution is for affected individuals to file malpractice lawsuits against their doctors.

“Your story is a tragic case of medical malpractice,” he said to Cole.

Sens. Ed Markey, Massachusetts, and Tammy Baldwin, Wisconsin, voiced discontent with Republicans, Markey arguing that if the Trump administration truly cared about children, it would put its efforts into making healthcare affordable.

“This morning, instead of addressing issues that people actually care about, Republicans are here to say that politicians should be involved in parental decisions,” Baldwin said.

Republican senators did not mince their words when it came to disagreeing with the Democrats. 

Missouri Sen. Josh Hawley questioned Minter’s credibility multiple times and said it’s “absolutely outrageous” that young people who disagree with transgenderism are being compared to the Jim Crow laws. 

He also accused Planned Parenthood of spending federal money to push transgender surgeries and hormone therapies on children, arguing the funds were diverted from Medicaid, Medicare, which help poor and senior citizens.

“It’s not hateful to say that little girls shouldn’t be told that they really ought to be boys,” he said. “Let’s do our jobs and protect the children in this country.”

Florida GOP Sen. Ashley Moody also demanded answers from Minter, questioning the reversibility of gender transition surgeries and the youngest age at which Minter recommended that the youth get these surgeries. Minter simply answered, “surgeries not recommended for minors.”

In his opening statement, Miceli pointed out that other countries appear to be pulling back on gender-transition, or gender affirmation, procedures on young people, amid concerns about the negative consequences: the UK recently banned puberty blockers and stopped hormone provision. And medical professionals in Sweden and Finland began self-correcting under their left-leaning governments in February. Miceli also criticized the World Association for Transgender Health for what he said was their failure to impartially examine evidence and correct course.

“WPATH has positioned itself as the pre-eminent authority on gender medicine and has influenced other groups to adopt its recommendations, favoring gender transition procedures on minors,” Miceli said. WPATH recommendations for children have been invoked by legal groups and adopted by insurers, hospitals and regulators.

“If we want to restore the American public's trust in the medical profession, we must start by admitting that we have made a great mistake, and the time to fix it is now."

He also said that support for gender transition procedures for minors is rapidly declining among voters, citing a New York Times poll last year that found only 10% of Americans supported allowing puberty blockers for minors as young as 10.