Judiciary Committee - Senate

I know that I think we have quite a few people signed up to speak for the bill that's on the agenda. And if I could I'd like to make a motion to limit debate to two minutes per person just to try to manage time in this committee today. So with that I'll make that motion. All right that's not a bad one motion with second all those in favor instruction. All those in favor say aye aye opposed. Okay Senator awesome as you come into thank you chair. Yes. Senator Stubblefield you're recognized the president Senate bill one ninety nine. Thank you Mr. You know if I came in today and I advocated for the chemical street castration sterilization mutilation of young adults most of you would consider may be crazy. And yet that's exactly what a lot of our medical professionals these activists they're promoting and defending gender affirmation care. In the end the problem with these agenda I die ideologies is that while it's possible to identifies anything it's not possible for man to become a woman. Our woman to become a man to obscure this fact these activists have manufactured a small dictionary of sweet sounding terms like transgender gender fluidity and non binary. Gender affirming care in the phrase actress of corn to describe sex change treatments such as puberty blockers hormonal injections and double mastectomies. I cannot even imagine. And I know I'm a little older than most deal. A doctor taking a scaffold carving a small child in order to put together sexual organs and putting the children on puberty blockers and cross sex hormones that haven't even been approved by the FDA. And not only that we don't have enough we don't have enough data. now to even know what the outcomes of many of these operations. Bring for. Shocking what children's hospital or big players in these games The Boston children's hospital website has posted videos which doctors describe full menu of medical treatments including hysterectomies and gender confused teens the gender clinic at the Barbara bush children's hospital at Maine offers instructions. Two little boys. On how to tuck their board parts. To make them look more like girl pars. Yes university pediatric gender program director said she medically assisted children as young as three years old on their agenda journey and then you have a Vanderbilt. Vanderbilt Medical Center has assess gender care to be a new profit center. One of the doctors explained that attempting to change someone's sex creates a permanent patient. And that's not hard that is not hard to comprehend when you're talking about and I'm not a doctor their doctors here but when you're talking about. Capillaries and thousands of nerves that had to be tied back together I told the doctor that we hear from you a mass I had knee surgery three years ago my knee is still numb that's a navy. Imagine having sexual organs. Todd back together. But this is a children's hospitals are big players in this. One of the doctors explained attempting to reach a change someone sex creates a permanent patient. And attempted to change someone's secretary to participate knowing patients will have to return for recurring treatments is a guaranteed money maker. You know what that tells me. That tells me that they're putting money ahead of our children. If this is a lucrative lucrative business one of the largest of American care stable Smith the transgender identity claiming. In the U. K. has shut its doors along with Sweden and Finland you don't want to shut the doors college. Because it wasn't working out what they had planned. The children were not responding okay plan imagine that. So they shut their doors. Yes. In America. We considered we continue to go over the cliff. U. K. server first shuttered its state run traffic was up Transcaucasia under identity clinic which was the largest paediatric gender clinic in the world that's report found that the patients were considered more risky unquestioning affirmative approach a more accurate description for this approach would be medical malpractice. And no other part of the medical world is it considered acceptable or even legal. The damage the body of a healthy person. The reversibly. See these kids can. When a little girl has a secretary. She can have a baby. She can have an orgasm. Many can't have sex. When I grow up with this little ten year old girl grows up and she decides she wants to get married how is that gonna work out for her betterment. Because all this is a reversible. They can't put it back. If a mentally ill man who identifies as a double amputee ask a doctor to amputate is perfectly functioning are to match his identity every self respecting surgeon was sent away. R. for girl who is suffering from anorexia walked into a hospital after liposuction. No one in their right mind would grant her request and that's because what suggestion swear an oath. They swear an oath to do no harm to preserve and protect and heal a person's body as best I can in spite of any delusions. The person may be experiencing and yet doctors violate that oath every time they promote gender affirming care. The motive no matter how compassion. They might sound. relevant but the idea that teenagers long little children are capable of making such a life altering decisions if not only brand new. It is absurd. As a society that allows them to do this is a deeply broken society. So how are you gonna stop this. Stop going along with this language games that they've created these ID all ideologues wants to play their men women boys and girls and there are men and women boys and girls confused about their gender. There's no such thing as having a place on the gender spectrum. With the rare exception we're born one of two separate sections of male or female sex is not a sign identical identical part of who we are right from the moment of conception it's true for horses true for cal's is true for dogs to for every other species on the planet. There's no such thing is agenda for affirming care you cannot affirm something that does not exist what does exist is chemical castration sterilization and surgical mutilation. What we need is a legal accountability. Patients who have undergone physical medical agenda treatments as minors should be able to see doctors and hospitals that perform the treatment. The rest a serious financial responsibility or bring this act of barbarism to end faster than any kind of protest you can have. This is vital that we must win. Not least because there's an entire generation of boys and girls being but I do believe that the reversibly changing their bodies will fix the social and emotional anxieties. The experience. Our children are counting on us to fix this and we can do this today. Mr chairman I am closing I would be glad to take questions. The questions from the committee I have met sure I do have some people that I would like to come up sure okay go ahead. You want them to speak before we take questions. No they said they just going to ask questions. Exceed table will ask you go in a dignified your self and then we'll go to committee for questions. You Mr chairman my name is Michael Cantrell with the attorney general's office. Good morning my name is Jordan rules and I'm with the attorney general's office so all okay thank you both for being here and you can just pull at my crown or unity okay questions from committee Senator Clark you're recognized. Clarke Tucker. Thank you Mr chair top of several questions I'd like to I'd like to ask this morning. I just want to kind of start with the framework of what we're talking about essentially this functions as the private civil enforcement of what the state did with the safe act two years ago is that fair. The question is is whether or the bill creates a private right of action that's that's correct right the sensually of of the rights that the state was regulating in the safe act two years ago. So to speak. Of. Well that's a that's a different piece of of of legislation I'm not sure it deals with gender firming care for teenagers. So that was a public enforcement this is a private enforcement same same right correct yes this it creates a private right of action for medical malpractice concerning gender transition procedures right yes Sir from the testimony two years ago. the physicians in Arkansas who were performing this type of care said that there were approximately twenty kids per year to receive this type of care and a hundred percent of the time it was with their parents involved in the process of making the decision with them along obviously with medical advice of the professionals who are administering the treatment. do you have any reason to dispute that. I apologize Senator Tucker I'd I'd don'ts I'm not sure that I have any basis to dispute a I'm not sure what the testimony was that you're referring to and all I would I would prefer to be able to look at that more particularly if if possible Shorrock that is the basis for my understanding of us a lot of the questions I'm gonna ask and so I I think it's important to establish that and one other fact is that during the course of the trial seeking to strike down that law there was testimony from the American medical association the American academy of pediatrics and the intern society that have called these treatments safe if properly administered you have any reason to dispute that. I believe that there. There was testimony from From individuals to that effect yes okay thank you. Last one of these questions is there was also testimony I don't know about the trial but two years ago when the safe act was being proposed in the liberated on. That none of the procedures are being administered there were no surgeries being administered to teenagers and from the physician's perspective at least and you may disagree with this but at least from the physician's perspective there was no treat gender affirming care being administered that would permanently affect the teenager's life that was the that was their testimony at the table so I did I just want to mention that and and you again may not recall that testimony or be as familiar with it as I am but I I just wanted to kind of establish that that baseline for the conversation that we're going to have here today. with that I I would like this I think go through a little bit of the language in the bill. I'm curious why what will first of all we already have laws on medical negligence in the state correct. That is correct so what is this bill do that we don't already have to occur medical negligence laws. Sorry little awkward anger angle here and so this. Cause of action would extend the statute of limitations to be more consistent with this type of care so the current act that we have the statue limitations is two years and so based on treatment plans things of that sort this would extend the statute of limitations to make it more consistent and aligned with this type of medical treatment it extends the statute to thirty years correct. How is that consistent with this type of care to use to use your language. Yes so because the care can last over extended period of time and again it goes to potential for a cause of action later in life even after maybe the care has ended so it would allow for that. I have a few questions about the statue limitations have you ever heard of another statue limitations in a civil context that's thirty years. Child sex abuse is extended to thirty year or excuse me fifty five to age fifty five. For fifty five years at age fifty five and that's a civil statue limitations yes Sir in Arkansas. Okay what I've heard and in other contexts is that. a statue limitations is tolled until the person can know about an injury. Did you consider that and for example in in a medical context sometimes the statute is told until. You can know about an injury and then you have two years to bring the claim which is what the current medical negligence statue limitations as you can did you consider that approach. It's a little bit different and how it plays out in the courts on what's discoverable and when you could or couldn't have known and so yes is taken into consideration here but because the statute of limitations that exist and the main part of the medical malpractice act again doesn't necessarily allow for the circumstances that would apply to the care and treatment it is considered but that wouldn't Always work under the circumstances. Okay for the medical negligence laws that we already have in the state whatever the type of treatment is whether to surgery or anything a cancer diagnosis there are standards of care established by the medical profession correct. Yes Sir. and those standards of care or what are that those are what is used in the course of a medical malpractice case to determine whether another physician or or healthcare professional has violated the standard of care. Correct. Yes Sir are you aware of a of another standard of care that's established by the legislature rather than by the professionals in the industry. I don't know that this act is written establishes a per se standard of care and include state park or language but I I don't necessarily see I don't necessarily read it to say that establishes a quote standard of care as is typically used by in the medical contacts what is the standard of care berries that's how you get different sides of the coin on an action but. What malpractice by definition is violating the standard of care. Are you asking of you do you agree. Yes so this will this law establishes liability for performing certain acts as a healthcare professional. And it has medical malpractice and the title of the bill correct. Yes Sir it does. So we're establishing if this bill passes civil liability on a healthcare professional that's established by something other than the standard of care in the industry. I don't know maybe could you rephrase that I'm not sure I understand your I'll just take it one piece at a time were establishing civil liability for healthcare professionals through this bill if it passes correct. Yeah that that would be correct and you and you just testified a moment ago that you're not necessarily establishing a standard of care and this piece of legislation. That would be true yes so taking those two thoughts together were establishing if this bill passes civil liability for healthcare professionals based on something other than a standard of care established in the industry. I don't think that it can be read to be independent I think it can take into consideration testimony of experts in the course of litigation on a case by case basis so again it has a safe harbor provision but I don't know per se that it is staff which is a standard of care as we're talking about that and that's fine if you don't want to say the spouse is standard of care but it does establish civil liability regardless of. Regardless of what the industry says that's my point no matter what. The other medical professionals have to say about it it establishes civil liability if a healthcare professional violates the terms of this act. Right. Theoretically Canson FOR talk they could still the case could still be defensible. Even if certain aspects of the safe harbor one followed. Well as expert testimony things of that sort as far as what would be consistent again every case is so different it's hard to play facts but again it's not as. Per se establishing a standard of care but I understand your point that it's not establish yes not establishing a standard of care but you're telling me that if the physician performs one of these procedures set out in the act and the safe harbor provision to the safe harbor provision does not apply that they still might be able to avoid liability. Yes Sir that would be up for a jury to decide just like all of our other civil causes of action then what is the purpose of the law. The main purpose would be to create a cause of action that would allow for civil liability to protect children and their parents To create a again it goes back kind of to the statue of limitations issue. That would maybe they wouldn't otherwise have this cause of action under the law as it currently stands. I just don't understand how we have a bill to create civil liability if you do X. but then if you do acts you still may be able to avoid liability but we'll just have to agree to disagree about that. You know we we. You mentioned parents Is a team allowed under the law to make a decision about their health care like this without their parents to your knowledge. I think the age of sixteen as it's written currently. it's did you consider us are I understand that for the agenda from care you have a number of types of care listed here correct are you aware of any. Press secretary taking place on a on a minor in Arkansas for gender affirming care. At the going ahead. Could you repeat the question are you aware of any. Surgical procedure of a minor taking surgical procedure for gender affirming care taking place to a minor and the state of Arkansas. That's a difficult question to answer it it's hard to know that motivations for any particular procedure I could not point you to one I don't mean to suggest that y'all have universal knowledge of every surgical procedure that's taking place I'm just asking if you know if you know of one and it sounds like the answer maybe now. I could not point you to one that I could confidently say a surgery that was performed for the express purpose of a gender transition procedure in Arkansas. In the last several pages of the bill goes into great detail about the type of notice that healthcare professionals have to provide parents and patients before they administer any gender affirming care correct. The bill does provide a safe harbor provision which would include notice written notice to To the To the minor in the minor's parent yes I don't know whose research you relied on and that I'm that's not I don't want to get into that that's not my point but whoever it was. What if their thoughts on this changes in the next two years are going to come back in two years and change the notice and we're going to do that every session of the research changes during the interim period. I cannot answer that question senator. The question is why do we not leave this for to be promulgated a rule rather than putting in the code. Again I think that is a. That is a question for the The Committee that that's not a question that that I can answer. Bills that require this level of specificity it's it's well it's not a question so I move to my next question to ask questions please. What you might not on Senator one of the largest state senators to approve you will pull you back over to you one of the largest state run agenda care unit in the U. K. largest in the world why would they shuttered their doors on their agenda from care facilities. I don't know the answer to that and I just told you the answer they gave the answers service within San Juan and I said because it wasn't working out like they had planned that's on where they want to achieve in the results. That they thought they would she wanted started these mutilations. That's fine center in a I take exception to the ward mutilations but I'm I'm more concerned I'm less concerned with the U. K. hospital and I am the American medical association the American academy of pediatrics and the pediatric endocrine society in the United States are. You are concerned with the word mutilation. Have you ever witnessed one of the servers. To my knowledge there's not been one of these surgeries take place on a teen and and that you would not want any toward states I'm talking about the state of Arkansas senator because that's where we lost a lot of you know we don't know who get services and who don't a lot of times I mean I don't know who's getting a gallbladder removed this morning UAMS. I have a heart transplant over there so there's a lot of this is one of things we don't know. I'm gonna I'm gonna get back to the language in the bill. On page five the in the notice it says. Q. B. blockers may also caused may also cause diminished bone density for your child increasing the risk of fracture and early osteoporosis. Blockers may also prevent your child from ever being able to engage in sexual activity or achieve orgasm for the rest of your child's life. Is that true of peer review occurs that's why you put it in the bill. Our. And that is that is correct based on available information. So is that also true. Of a child to use the language you'll have in this notice provision is that also true of a child who has precocious puberty. Those risks I think the the difference what would be the timing at which the puberty blockers would be administered FOR precocious puberty again on available information treatment for Parker precocious puberty is given to children who have not yet reached the age at which. You're pretty would be. That would be appropriate typical for a child so by definition that's going to be a pretty young child yes. I'm no physician but I would think that the risk of this type of medication would be greater for a younger child and for someone who's fourteen or fifteen do you have any reason to disagree with that. At the. Based on available information Senator there there is reason to believe that That these medications given to A child who is at twelve thirteen fourteen would it creates more. more of a risk of osteoporosis later in life than it would if it were administered earlier okay so to my knowledge children have been taking puberty blockers for precocious puberty for. All four generations now fifty sixty or something in that range because of these risks of puberty blockers for osteoporosis and the others mention the bill do not need to protect those children from their parents and their physicians as well. I think. Certainly it's appropriate to protect children from risks as a. Indicated to me to go there there is reason to believe that the risk of osteoporosis is greater when these drugs are administered later on and why is that do you have a to a physician or a medical expert here to testify that I've no but I can I can point you if if you would like to to literature it's the same medication correct. Yes and so you're telling me the risk of osteoporosis is greater if it's treating one condition rather than another. Mistreating gender dysphoria and set of precocious puberty I think the the difference in risk comes with the timing of the what we established that the risk is greater for a younger child and the child with precocious puberty will be taking at a younger age than a child taking for gender dysphoria do no I believe that's that's incorrect through the risk would be greater for a child who was was older than the typical precocious puberty patient and and what is that based on what literature There is if you will give me a moment I can please I could find this. Senator I'm consulting and a report from doctor Paul Cruz which provides a great deal of information that would what we would not be able to go through at this moment I would but I would to refer you to To an article. but see total bone mass in young adulthood following hi good now to trope in releasing hormone analogue treatment and cross sex hormone treatment in adolescents with gender dysphoria. Published in the journal of clinical endocrinology and metabolism. The author is I clink K. I. L. and K.. Indicates that the emerging data shows that our patients have a lower bone density which may lead to increased fracture risk okay thanks and that's fine I understand that right now I'm trying to establish the comparison. Between those who take puberty blockers for gender dysphoria and for precocious puberty I understand we're expected to vote on this piece of legislation today right. That's what you're asking us to do. So in order to make an informed decision about this I need to know why we're not also protecting. Kids who take puberty blockers for precocious puberty from there to parents and their doctors. And you're telling me that the risk of osteoporosis is less for kids to take puberty blockers for precocious puberty and I I want to know what the research is on that. I I I think the the more fundamental point would be. That there is a complete lack of long term studies concerning the The risk administering the puberty blockers later and later and later okay is there a is there a plethora of studies about. Committee blockers for because the voter yes I'm giving wide latitude I do have other members in your school I'm this I'm I'm giving as much latitude as you can but I simple I'm I don't have a ton more questions Mr but I do have a few more but I'm very happy to let someone else have a turn. Okay if we will do that and I may help you even and in some of your presentation Senator you're more you're recognized thank you Mr and and thank you Senator Tucker for suspending briefly for for questions I don't know exactly who this question might be for perhaps Senator Stubblefield or tourney's at the on the table are are you where in any way former fashion that the the learning and educated healthcare community and I think there's about eleven or so countries in Europe might be sub standard to to ours in their care are you are you aware of any factors that might indicate such as to the reason why they may have taken actions that we haven't taken in this country. Senator Stubblefield are you are you. From what I read these use your micro Senator Stubblefield please use your microphone. From the articles I've read these these travel stock they've been around a long time and they dealt with people blockers across sexual means for a long time so they should have their doors because these things were not working on these kids so it is not as simple as that so it's it's a work in the desired result at the expected okay so it's it's safe to say that in a lot of these procedures Europe. Obviously made decisions of ahead of us is that is that fair to say in the sense of doing in allowing these procedures. Does that make sense and I have a second layer five would you would you agree that in Europe some of these procedures were taking place before perhaps here in the US for extended period of time and now they are ahead of us in seeing some of the effects which I would agree to that totally so is it also safe to say that because they're seen some of these. affects that they're taking now actions to correct some of that that that we and in the US should consider absolutely thank you. Senator Hester you're recognized. Sir Stubblefield we are aware that the we do not allow minors to make decisions specifically life altering decisions I mean simple things would allow minors under sixteen to drive would allow him to vote on about Act alcohol and tobacco do you agree with that I agree with that I also agree with the fact that most doctors tell me that the human brain is not a fully developed over twenty four twenty five so you could even go a little further out if you really wanted to do but yeah I would agree with that absolutely would you also agree that and when we've seen the situation a horrific situations where there are parents that allow their children to be abused so even a parent and a child would agree to some sort of abuse and that happens routinely in the state of Arkansas we call that a crime can you imagine in those scenarios yes. Thank you. not seeing other committee members the Senator Tucker back to you. Thank you Mr others follow up with wire center Esther was I've been hearing a lot of talk in this building the last couple years that the government. Should not stand between parents and their children. Whether it comes to a school board requiring a mass to go to school. Whether it's. Where a parent has a an opportunity to send their child to school. And so but this is an example where you think the government should stand between parents and their children is that true. I would say living I would say living a life in bondage to one of the surgeries would not be freedom Senator Tucker. Right but do you think the government should step up and protect these kids from their parents. I thank you and I should protect kids not for parents but protect kids. From themselves or from who. Well that a child is not capable of making this kind of let's do not talk to a ten year old girl back in the fall anymore she got our ideas to have one of the servers Office tick tock. Because the Chinese were showing this little girl on tictoc he said this is changed my life. So now we're getting our information from the Chinese communist government on how to how to keep the servers going. Fortunately we have laws on the books that prevent that secretary for minors but so this is I'll I'll wrap up here shortly just kind of two more questions I want to ask. Never trust a lawyer on my side I'm away. But one is about the enforcement the private enforcement. The safe act was passed two years ago now. There's been a case to strike the a lawsuit to strike that down the trial on the merits has been held there waiting judgment is final decision however judge moody granted a preliminary injunction. To prevent the law from being enforced because it violates the equal protection clause of the Fourteenth Amendment to the United States constitution the eight circuit. Affirm the preliminary injunction. So we're talking about a constitutional right. The right to equal protection. Now. The state of Texas recently passed a law that said. There was a private right of enforcement against a clinic that wasn't administer an abortion. That case went to the Supreme Court United States and two justices of the Supreme Court justice Bragg Cavenaugh and justice Amy Coney Barrett. Hi questions. For the state of Texas about that and they said they may not personally be big fans. Of they did put it this way I'm putting words in my mouth when I say this part they may not personally be big fans of a hospital or medical clinic administering abortions. But they were big fans of constitutional rights. Being safeguarded. And not being attacked through private enforcement and justice Cavenaugh for example specifically mentioned freedom of speech. Freedom of religion the second amendment. So my question is if states. Start passing laws. Using private enforcement. To prevent constitutional rights from being protected in this case the right to equal protection what's to prevent another state not the state. But what's to prevent another state from passing a law that says. Every gun dealer. Who sells a gun. Is responsible and liable for all damages caused by that go on for a statue imitations period of thirty years now that's not infringing on the second amendment because the state's not saying you can't own a gun it's just a private right of action for liability that's related to a constitutional right so that's my question of state start passing private enforcement that prevent constitutional rights being protected are we not as justice Bragg Cavenaugh pointed out. Are we not opening Pandora's box for what states all over the country might be passing. Everyone of those rights you referred to has a duty connected with the. Just because you have the right to free speech doesn't mean you have the right to run to the theater you know far it doesn't mean just because you have the right to own a firearm to protect your property your family doesn't mean you can go out and kill an innocent person those rights when you took the oath and you put your hand on the Bible out here a few weeks ago. You took an oath to uphold the constitution is that correct yes Sir and I planted you taken no the needle sold seventeen of the constitution or the constitution the constitution including the equal protection Clarice my case. So I'm a vote today will be consistent with the protection clause my last question is about. Suicide rates we know that suicide rates among transient or Americans are higher. and they're even higher for teenagers about four to five times as high. And we also know that there were reports of attempted suicide in the state of Arkansas transmitters one the safe act was passing through legislative process two years ago and I'm just curious if that has any effect on your session before with this bill. I don't think we actually know all the figures that are related to suicide I don't think there are reported anymore than the reporting of we just thank the cold I don't think all those got reported so we we don't have an accurate count we don't have any long lasting day to look at and see if the thing you're really working other than the ones in Europe who are shuttered and closed down because they weren't getting the desired results. So we have some data from Europe that we should listen to but the data from here United States is just not developed enough you may look at data from the guy invented Bill the service is a lucrative business we can't let it go I mean the date about suicide rates for each transient or Merican especially. Okay so it's not developed enough okay thank you Mr. Okay I have three centers in the queue to enter Gilmore first. I think this might already been addressed but I heard my friend and colleague Senator Tucker make a statement about a laws we have on the books and and laws we have particular but to the center Stubblefield I guess I pose the question is chair judiciary you see a lot of bills come through here the become law to protect people. Correct correct do you see this in any way is different than any of those bills that we were trying to protect minors we're trying to protect children and like I said we have a lot of those laws on the books with with this bill being different than than any of those and try to protect children these are the most vulnerable among your microphone Sir. These what we're talking about here this morning. Is a category of the most vulnerable people among us these are kids. Of all people we should protect its kids. Watson I just got a call a couple weeks ago from a mom and dad who both smoke or taking her one. And the mom took the kids to school and almost ran over the the crossing guard. So there comes a time when when you have to step in you asked about government sometimes you have to step in to save the life of a child senator. Good. Yes and and with those laws to the to that point with those walls sometimes we even have to protect. children from their parents and for exactly right I've sat in court rooms and listen to abuse is taking place that have been imposed by by parents regrettably and so this would this would be the in this case this could be something that would help protect even more thank you. Centrum Mickey and then Senator Clark you're recognized. Senator Stubblefield we know that there are our Kansans who believe you should be able to mutilate unborn babies. We know that there are Kansans believe you should be able to mutilate the genitalia of children. Does this law stop what they call gender affirming care from occurring. No. It wouldn't stop it it was simply put a. they would be liable for any any problems which seems like a reasonable standard yet to have because none of the information we know the long term effects of the suicides were brought up the data shows that that those in. The transgender who are experiencing that kind of gender dysphoria have higher rates of suicide but the dead also shows that those who transition are consistent with that that rate stays consistent this bill will affect I would call I would disagree with those statistics I would say that the rate among children who were on drugs is higher than than those who commit suicide from having one of the servers so that but this law would affect their ability to go through this what they call gender affirming their. It just make sure that. If there are if there are negative impacts on that individual's health or mental state in the future because of these treatments that's correct they have recourse in the courts that's correct thank you senator. Senator Clark you're recognized thank you Mr of an I don't know what data you all have been don't have but are you aware that of Sweden who has been. Allowing in doing the surgeries for decades has the most exhaustive study of owned the after effects of prince agenda secretary of anyone. I read I read a lot of the city's Senator Clark. Of an unexpected personal the addressing suicide are you aware that in that study where they followed every person who had the surgery that of all the effects besides. Many times increased mental hospitalization rate above the normal population of the our it was also a much higher suicide rate of those who had the printers are very aware that yes thank you. Senator Hester you're recognized. So a follow from some of the things I've I've heard today we do not have a constitutional right to abuse children. Agree with that and I think that they can what what we're talking about today is do we believe that this is abuse of a child or not some in this room thank you does not abuse of a child by the vast majority of people in this room state of Arkansas in the country believe this is absolute use of a child. I would say what we're talking about is does this child once they're not eight ten twelve fourteen years old and they're an adult one day when they cannot perform as a natural human if if they feel like they were abused as a child at the hands of some doctor do they have a cause of action at that point I think the reason there's concern is because almost everyone in this room believes there's a legitimate chance that when a child was put into this therapy or put under the knife will one day look back and say this was a mistake and I should not been abused as a child in they're gonna have a cause of action that's the question that's all about today the reason people have concerns they believe. But later in life these children are gonna look back and feel like they were abused and have a cause of action thank you. Okay not seen anymore questions from the membership we have thirteen people signed up of thank you didn't die report justifying appeal of Senate side or whatever you could be called back. We're reminded the committee of. Past motion for two minutes per person. First up we have went one Persis may want to correct my pronunciation of your name please come up. In the table. You're right there yes please identify yourself make sure your buttons lit up. To answer your or your with you're recognized speak for two mins. Good morning my name is Dr Gwen one page her sick owner and pharmacist apart was pharmacy in Little Rock Arkansas I've lived my entire life in Arkansas born in Newport race in northeast Arkansas and completed my doctoral degree at UAMS in little rock I'm still happily married to my high school sweetheart have two daughters ages three and six both rotten and also instantly familiar with disadvantaged communities and myself a transgender female before voting on this legislation I highly encourage you to first stop and my pharmacy visit with me so I made a still any unknowns and share my experiences of those in my community my staff and I are always readily available to serve and we are conveniently located in west little rock if anything you can always stop at trader Joe's and say it wasn't a wasted trip. In my practice I have not experienced a single instance of a patient regretting their transition or starting puberty blocking medication I have hundreds of patients currently on hormone replacement therapy that identifies being in it and the transgender community each happy to have the opportunity to be themselves and state about the chronic dysphoria that plagues them the biggest obstacle that the transmitter individual faces is the lack of empathy affirming care and resources to help them succeed in life bills like SB one ninety nine or designed to hinder not help Parkinson's by creating barriers to evidence driven health care they deserve under the guise of protecting young and innocent as a youth experienced tremendous as a youth to experience tremendous is for instance the age of twelve this is horrific I was fortunate to develop a copayment. Positive coping mechanism through my calendar years the age of thirty of insistent goal setting it to distract myself which turned into anxiety ridden OCD but many are not as important as a half committee develops severely destructive ways of coping this substance abuse social isolation poor hygiene in many more. I would also like to point out that this bill represents Sweden Finland France and United Kingdom with medical authorities those medical authorities are not defined in this bill and as much as I value collaboration the United States of America have their own twenty medical authorities that I can list for available for your reference at the transgender legal defense and education website and I would probably go as far to say vote for this bill is unpatriotic and cast doubts on our own health and research institutions who work Health through healthcare fields to improve the lives of Americans. In closing I would like to circle back around inviting you to my party need to wrap up your over your time I'll let you go and wrap up sorry is not closing in closing I would like to circle back around inviting you to my pharmacy a refuge for those who have too few resources again I'd like to provide you a new perspective the existing barriers that our patients are forced to overcome only died lived experience but the knowledge and compassion to know each person has their own life to live and wanna make sure they have the tools to grow and thrive what questions do you have for me are there any questions from the committee. Not sending a thank you for your test instrument Senator Clark you're recognized. Yes I just want to know you said that you were not aware of anyone that. Was unhappy are you aware that there is a large number of people in this country who are unhappy I thought muscle multiple social media sites for those who do transition and those who do it due to transition and I've not had any instance in Arkansas it's generally because they have the lack of family support or resources not necessarily because they've agreed to the decision that they made. You're speaking for those people that that that's what you're gonna tell me right now is that you're speaking for those people of mental. The number of them. That. that want to the transitional to the transition that it wouldn't cause are unhappy that just because a lack of family support family support and resources transitions hard it takes a lot of resources to be able to do it and she certain goals and so that's interesting because that's not at all what their story is now well I'm in the committee with lived experience so I have a better understanding no no no no no a year in the community but you said you didn't know anyone not in state Arkansas and I do okay and so what you said about their mind set does not represent the people that I know who have the transitioned or want to the transition. This. Their own appreciate that what you what you know when the people you know but you. Of the testimony that about what people think is completely off office I take care of hundreds patients throughout the state of Arkansas I'm the main resource center and my pharmacy service so so my view and my patient base I'm sure is far greater than yours. Senator Teague you're recognized. Are you telling us that you're unfamiliar with a large body of medical evidence of the harm that has come upon people have gone through these processes I'm familiar with the large body of evidence that shows that providing good affirming care save lives are you saying that you're unaware of the large body of medical evidence of the harm that is come upon these people in these processes in alter our you unaware of that body of evidence our people and I just said are you aware of that I bought what I just said you said that you're a trans woman I transfer now yes Sir do you have a ****. That's horrible you're the one you're the one that brought that into the discussion either the one never said anything about genitalia everything okay I don't know what my rights are right now audience if you want to stay in their. I don't know what my right but that question was inappropriate you do not have to answer any questions if you if you're through will dismiss you well I'm not through with questions but I'm not going to answer that question that's highly inappropriate again that I've you can say that in in that you're you're right okay I'm sorry your question treat me as such next question please are there any other questions. Not seeing any an audience on me say this I did electors witness go over the two minute mark she mentioned two different times basically of drawing. Inference to her profession that that's open and that's fine but that's gonna be part of the net the rest the two minute so if you want to promote your business or are are you profession do that but that will be part of your committee thank you thank you for your time the next one up but I have it is far is Tony Roach you come up and. Identify yourself. All of those microphones work for everyone says. Field and for yourself you're recognized for two minutes. My name is Tony rose I represent an American speaks. And I did want to give you real quick to some of the senators that brought this up. This is from a Swedish study from the covered from nineteen seventy three to two thousand three. I don't think Swedish doctors are any better or worse than ours but they have been performing these surgeries for a long time. And I'll just wrap up the conclusions persons with transsexual is after sex reassignment have considerably higher risk for mortality. Suicidal behavior and psychiatric morbidity than the general population our findings suggest that sex reassignment although alleviating gender dysphoria may not suffice as treatment for transactional as. And should inspire improved psychiatric and somatic Care after sex reassignment for this patient group. So there's evidence. In the world from people that have been doing this for a very long time that there is definite harm. And where there is potential harm it is our duty as the grown ups to take care of our children. And not and to intervene yes to intervene where there is potential harm to these children. We intervene in abuse cases we intervene and I would allow the children to drink alcohol it doesn't matter in many of these cases what the parent allows. We as a state we as a country still intervene on the behalf of an innocent child who is unable to make those decisions your time to if you have a final statement. I wanted to be a lot of things growing up. Sometimes it was based on a TV show and sometimes it was based on what our friend dead or what my favorite uncle started doing. I wasn't I didn't end up being doing any of those things so I would ask you to intervene on the behalf of children unable to make decisions when we know that there are studies that this is a harmful practice thank you are there questions from committee. I'm not seeing any thank you for your testimony today thank you next up against I have Janet Cathy you come up. Please make sure that your microphone is known if you will. State who you are who you're with. You're recognized for two minutes yes thank you Mr chairman I'm Janet Cathy a lifelong or Kansan I'm a practicing medical doctor I'm board certified in obstetrics and gynecology and I've been practice licensed to practice medicine in Arkansas since nineteen eighty two I don't represent any organization but I speak as a position he's been in private practice academic setting as well as the nonprofit setting. I have cared for the transgender population since I went into practice I found that the gender clinic at UAMS I've been director of education for Planned Parenthood Great Plains and have done consulting work a nationally on transgender care so I feel like I am qualified to speak as to the standard of care. I cannot begin to address the missing information and inflammatory statements I think for that were given by Mr Stubblefield. Senator Tucker you're my new superhero you may not be a doctor but I think you did your homework. I can only reiterate the questions a that Senator Tucker brought up I think that this bill addresses a very specific medical condition as it applies to manta minors and I think it does set a standard of care for the treatment of these conditions I think the bill puts into law the definition of one medical diagnosis and it determines the way that I would have to treat that condition. It says that medical care is determined not by medical science but by law. I don't practice medicine the same way I did in nineteen eighty two. Medicine is not static it is constantly changes and it changes S. changes based on the currently best available science and research. Thank you for your thank you for the time they see it the the close remark but I allowed our only for to make was to balance out the first one again so thank you for your testimony today are there any questions from committee Senator Hester you're recognized. Thank you for your Committee care for people of the State of Arkansas do you believe it is necessary that a minor has a say in in this process. I think that. A minor. I don't know what you mean by has to say yes of course that yes yes they do said and so then it would be your believe that a minor can make life altering decisions for themselves that are a choice and it's that they shouldn't be able to make as an adult I don't think a minor alone makes that decision we thank you and have a higher rental current consent for any type of procedure. On a minor okay but if a child is opposed in the parents are for it I don't see that circumstance. Okay. With the. For a parent is forcing their child to be transient or. I'm saying that a parent has undue influence on a child absolutely so what I'm saying what so let's So you work in this this field what what age can a child actually have influence on this decision can it can a six year old for an eight year old. Ten year old I think that our children always influence what we did I would like to you know we both agree that a child should have say. What what age can a child have say like. With like some actual ability to have say so like a one year old can have say so what what age can a child have say I think it's it's very well on the on the child I think that children as early as three or four have an awareness. Of what their agenda is so so three year old child should be able to have say and and you know you're you're you're. Taking what I'm saying. And change in it I don't know I just would you would you tell me at what age is appropriate because. I say it's eighteen years old at eighteen years old someone can have say on what happens with their you know with with how they choose to live the rest of their life not a seventeen not at fifteen out of ten can you tell me what age you think is appropriate that a child should have say. I think that. You know having raised two children I think that I was aware of what my children needed from the earliest time that they could communicate with me so you were aware of what your child needed I'm asking when your child is aware what do you do you have an an idea of what we as a society should believe is appropriate for a child to be able to have say I say it's not a child's middle today eighteen do you have any of the are you saying one I mean can we both agree that it's not one can we both agree to that yeah sure we can up okay now now okay because I mean. How early does a child communicate. A child I. What you're you're just arbitrarily setting this this eighteen was society set sets that as as an adult eighteen years old it is I agreed somewhat arbitrary but we we agree eighteen yep agree somewhere and we agree society eighteen years old okay okay that's what you thing thank you. Seeing. The Senator Clark you're recognized. Yes doctor you may need to help me with this because it's been awhile since I've looked at this name and I'll probably get it wrong is it the American child psychiatric association single can probably know a word out. Of I'm not in the field of psychiatry okay we'll it's something close to that American child psychiatric association of in reading. There are. Of. I don't know if the culture bobble but of. At. Bills. No I have no idea yeah you think I've not heard a word I do not know that statement you think they'd be wrong about that of that toddler males and they also. The. According to my reading and. That. The the spot treatment etcetera that these young males continue to believe that they were girls. Of throughout adolescence but that ninety percent. Upon reaching young adulthood eighteen to twenty five of. Decided that they were not in fact rules are you aware that that that I mean this is. The American child psychiatric association or whatever the exact name as I agree that most small children. That little boys that say I want to be a for all our little girls that say they want to be a boy. Most of them do not carry that into that's American child subject situation not dealing with any little boy in any little girl who says there will be a border they're dealing with gender dysphoria where old of young male really believes that he is a girl that's the subject mmhm right and that those. The. Those affected with gender dysphoria. Upon reaching young adulthood ninety percent according to them. Decided that they were in fact not. Correct you're unaware that. That may be true I don't see how that. Aphex. Well it is bill of what my concerns are about this current bill my concerns are standard of care my concerns is that you can someone can sue me until the day I die will people have different concerns so. Another study found another study from Sweden. the only exhaustive study that I know of bone adolescents who were started out on gender blockers. Okay that one hundred percent. When offered. Secretary did not keep in mind ninety percent. According to the this is this medical association decided in adults they worked. Actually. Transenterix. But that one hundred percent who started out on the. And these people were not there was not a study it's just a study they weren't guested of that this is what happened that one hundred percent decided to go on with this order are you aware that. There are a lot of different studies and again to pull back up out of content it's not acoustic totally I don't know manner that could not be possible anymore out of context then you might have that but will I am pulling from studies the most exhaustive study and the fact that you don't know about it and no absolutely I know about the sweeties questions. You can map out these excuse me despite his movie I'd like to answer the question you excuse me just me at the chair after ridge route I disparities are okay thank you what I want is a dialogue back and forth the question answer you're you're fine to ask questions but don't talk over each of the place thank you. Okay. I'm very familiar with the Swedish studies. My concerns about the bill. Our that it addresses medical malpractice. And when I am sued for malpractice they do not look at Swedish studies and standard of care in Sweden are in France are new pay. We look at standards of care in the United States of America. So if they discovered. That. Something worked. In Belgium. And it was published and everybody knew it for ten years and yet it has not become the standard here you would have no responsibility for well I know that. There are a lot of drugs used in Europe that are not FDA approved in the United States and we don't yes that was my question. Then I guess I don't understand your question my question was if we discover something that works you're aware of it. In another country you're not responsible it because again the Hippocratic oath about helping folks you're not responsible for it is if you're aware of it and that is working you're you're aware of it if it's not in the American if it's not standard of care within my community. How do things become the standard of care. If no one if they look at the the body of the evidence and the way medicine is practiced with in your area Stephen specialty even within geographic areas. So. So that would explain why the gender dysphoria a. Is we have a much higher percentage among adolescents in California then we don't know how. Which makes absolutely no scientific sense. I don't I don't think the. What necessarily. Thank you is in the bill senator Gramm or you're recognized for a question. Thank you Mr Dr I imagine you carry malpractice insurance yes. So and the reason for that insurance is what. Because sometimes and perceivable events occur. Great thank you so on page three of the bill the right of action is created in the new section it's added in sixteen dash one fourteen dash for two. states just under that subsection their health care professional performs a gender transition procedure on a minor is liable to the minor some minor is injured including without limitation any physical physiological emotional psychological injury. Basically stating what you just stated if there's an injury or something created as life altering then this creates a cause of action for which you as a physician have insurance would you not agree with that. I don't insurance is not supposed to make a difference on while I'm not of action would you have insurance and a law degree not a tiny bit but you Kerry insurance in the sense of. Things do happen so you are prepared as my point that if things happen or you wouldn't Kerry said insurance because procedures have a tendency at times to go wrong may not be anyone's control may be out of your control but things do happen we agree with things to happen that create long term effects. I absolutely thank you so we typically trust the court to sort through that correct cases are made a attorneys are hired cases are presented they look at all the evidence experts come in positions may come in to testify on behalf of the case one way or the other is that not correct. I would say that's correct but I don't know of anything else where part of that decision making process is what's in the law of the State. Okay and there's not any procedures where state law tells me how I have to practice. And and this building doesn't necessarily state that either it's a civil cause of action to be wrecked it does it it gives the standards of care tells exactly the way I'm supposed to treat a patient and what situations what criteria are set for me to care for some well I don't think that's what the bill stating but to to continue on my line of questioning so we generally trust the courts to be able to sort these things out correct. We what I. I'm not a lawyer. I mean I don't. no many of these things are sorted out well before they get to court. So when so when it repair our experts that address the standard of care and if you don't have experts. To say that. You deviated from that standard of care it's not going to go to the court Jerry. But if a lawsuit is brought and it goes to court as happens quite regularly. The courts do work through that process of bringing in next experts to testify and things of that nature thus malpractice cases do not go to court many of them do not do not okay can we trust have experience yes this two states that you deviate standard of care. And but we trust in many of those cases the courts to work through that process do not the court thank you have that's in my question okay and is for informational remind Committee is ten more signed up the the time is strictly the user's Committee sees fit next up is Senator Alan Clark and then after that Senator Clarke Tucker. Senator Clark. Ma'am did you you're still your questions are you through. Still questions to the committee. Many users the time is they see fit so I've got to. At least two more that have question I have is what you were saying I hope this isn't Senator Clark. Thank you Mr. Doctor of always had a great respect for the medical community have members of my family of that or doctors nurses and other things of. But according to family I wasn't there my great uncle I had the flu a hundred years ago of my grandpa's brother who's the one who really related to and of. He was begging for food and they didn't give me many of. Because the rule was the star of the river of and he died of would it would we've been wrong to. as a state to outlaw the practice. I I I don't think the state should dictate specific medical thank you. Senator Tucker you're recognized thank you Mr chair thank you Dr Kathy I want to spend a lot of time on this but I don't think there's the greatest clarity on the Committee of how medical malpractice lawsuits function I understand your position on a lawyer but I would just like to talk a little bit about that. First of all there's in a case that actually goes to trial there's expert testimony in one hundred percent of those cases correct absolutely. And those expert witnesses they're not brought in by the courts they're brought in by the plaintiffs who are bringing the lawsuit correct correct. And those experts are it are there of the same type of the of the medical negligence that's being pursued for example at one me clarify what I mean if you're serving a doctor. And you have to bring in another physician to establish what the standard of care is for the defendant doctor in and actually has to be within that specialty as an OB two in their expert witness has to be in a region that was at my that with that thank you you may my next point format can be any doctor it has to be within the same specialty. Correct correct correct and not only that and this goes to questions Senator Clark was asking before the locale also matters if I'm if I'm suing an OBGYN in Arkansas I can't bring in an OBGYN from California to establish the standard of care for the defendant Dr correct. And so it's that geography he made a point about conditions that present and California versus Ohio but that's not what matters to me what matters is the standard of care in the location where you're practicing medicine exactly and so in every case in Arkansas that standard of care is not established by a judge. For a lawyer. Or a statute it's established by a physician in that specialty from that location correct exactly. And this bill. Changes that for these health care procedures yes. Now. That term injury that senator Gilmore was asking you about. That's not defined in the bill now. In your experience as a physician and a healthcare provider. Did you see that term meaning at a wide variety of different things yes. As a physician would it be important to you for that term to be defined so you know what kind of liability you may be subject to. I. I don't think that. We can take. If I don't think we can take one diagnosis and one treatment. And subjected to law. And ignore everything else. I think that we already have current. Malpractice laws. that determine Determine the standards of you know that that malpractice law is adequate current law is adequate to protect. Children. Thank you doctor one more question that were. Some questions for you about toddlers and that sort of thing and and my question is if you can speak to the distinction between. People who may at some point in their lives I think that they are the other agenda whatever the case might be the distinction between that and people who actually. attempt to transition genders or seek gender affirming care can you speak to that please People At. Again I mean the. People who. Seek care. It is a process it's not an immediate decision it's not a reflex action. It is a process. It doesn't it's not as soon as someone decides when they're three or the seven are there ten. it's a process that involves a child their parents their health care professionals. There. And and all. Not all people do transition. There is not an. Devon at endpoint track to transition everybody has a different in point it's not it is a very complicated very thought out process. Thank you thank you sure thanks in no more questions thank you for your test while you're excused backstep I have Sir Evert. You go up to the in the table please state your name you're with. You're recognized for two minutes. Hi my name is Serra ever in the policy director for the ACLU of Arkansas and I wanted to respond to a few things to make sure we are clearer the care is still available in Sweden Finland and the UK Tavistock did not close because they thought it was a bad idea to provide care they close because they wanted to open regional clinics that were closer to their patients we have a medical malpractice statute providing claims for people injured by medical treatments it already provides for claims that arise from treatment that that came about without informed consent And even if we were to accept that no minor in the State of Arkansas is capable of understanding enough to make an informed decision about gender affirming care which I do not it cannot possibly be true that is the only treatment of the kids might not regret later. If you want to protect children by expanding medical malpractice claims you can do so by amending existing code you can expand the statute of limitations for all malpractice claims for minors make it easier to recover damages for emotional and psychological injury for all my patients instead this bill singles out trans minors to limit their treatment options even while continuing to allow all other types of treatment including genital surgeries on young people of all ages infants who have no choice whatsoever let alone informed consent. This bill it would not provide them a cause of action in fact the bill further singles out transgender minors with disabilities and those with mental health conditions preventing them from receiving any medical treatment for gender dysphoria this puts doctors in the impossible situation of having to choose either to discriminate against a patients with disabilities or lose the potential safe harbor defense thank you and time to the questions from the committee. Senator Clark you're recognized. Yes of thank you for your testimony thank you Mr of. According to my reading. Of. Then perhaps this is incorrect but I don't think so. Of. But when I was a child in the sixties of frontal lobotomies. On people with certain psychiatric illnesses was was widespread. Of something that later. People seem to think of as being widespread for those particular things as barbaric. If if there been a law passed at that time born that would we have been discriminating against those with mental illnesses. Because they couldn't choose that care. I don't think I can answer that the seeming medical questions I will say I think it's been pretty evident and actually was a legal question but I'd. Well I am I don't know enough about the medicine to to say whether that would've been proper at the time because care today is based on the medical standards we have today which as has been said in the United States overwhelmingly supports this medical treatment for gender dysphoria. You understand what brought up from the bottom these in the fact that now we think that a lot of that was barbaric is that medicine done always gonna have am I wrong no you're right okay thank you. The other questions. Thank you for being here today next up we have a Christian so we'll. The state your name who you're with you're recognized my name is Kirsten lar it so all right and a social worker in our state and I hope Sir to pediatric transgendered clients in our state I want to start off by saying that it was quite upset Senator Keith that you ask my friend if she had a **** and I would just like to tell you that even if you have a **** it doesn't mean that you have honor that you're a man. I want to say that when or the jurisdiction clinic. There were none of the kids that we saw that died by suicide or. Any medical wrongdoing there were three kids that I know of during that time that did die by suicide who are transgender. I know about one who shot themselves in the head. I know about another. You had a referral to the clinic and was not able to come because they die by suicide before her friend likely was able to come. And I know about another person who is in the US you twice who did eventually die by suicide. Jenner firming care is a life saving act and it is done with medical professionals mental health professionals parents and kids are part of the process but just like everything else they have to be eighteen to make quick decisions for their medical care that's why it takes all of the professionals working together it doesn't take actually centers or any legislators. The finished I am thank you for there questions for this witness. Senator. Mark. To Mister chair it's late now but mine was simply point of order of about the comments that were made at the beginning there obviously intended as of. An insult toward one of our members I have the same problem with one of your in order that I may have to do now don't do not speak over store shore thanks. Okay thank you for the border I I've I've given more leeway here because of the the device miss in this but we will not have more that saying no question for you thank you for testimony thank you next up we have. Alex Marshall. Please state your name and your with you're recognized for two minutes. My name is Dr Alex Marshall I have been in academia for over ten years now I'm not here on behalf of you a mess that is where I connect most of my research much of which involves being focused on health care and treatment of LGBTQ plus individuals and is experiencing is me confidence in speaking you today speak to you today I'm also a fifth generation or cans and a wife and mother and I'm not here behalf of myself but on behalf of friends and colleagues who would be negatively impacted by this bill if I understand correctly part of the bill creates an opportunity for malpractice suit to be brought up to thirty years after persons receive gender affirming care I cannot over after over my decade of experience speak to a single time and counter transpersonal who has regretted their decision but I'm not so bold to believe that it is never happened or could never happen I do think however we should create legislation based on the benefits of knowledge that we have from the committee the committee our Kansans and US citizens that we have and not based on just a few studies pulled from other places I'm not familiar with the research from the countries mentioned however what my research has shown is that gender affirming care here in Arkansas has positive outcomes and saves lives period. I could go on to provide other cities rebut rebut in many of the points made but I will save time first since we do already have the quote unquote safe act in place from twenty twenty one I do think this bill is not needed second I have collected survey and interview data from at least two hundred eighteen L. G. B. T. Q. identifying use in Arkansas among those at least a hundred twenty nine identified as trans or non binary but many and about half had not visited a gender affirming healthcare provider but that was because they did not feel like they needed one this means for this generation of trans youth many are identifying as on the spectrum which does exist there is a place for everyone on the gender spectrum. It does not mean that many of these youth want hormones or want to pursue transition because they are fine just the way they are as long as they have parental and family and friend support thank you time is the questions committees Senator Hester you're recognized. You said you spend the same amount of time on on this do you work off of individual grants or do you work off of taxpayer funded. Many of my grants are federally funded. Thank you we would you'd be somewhat of an expert on this state do you believe that a child one year old can can consent to this type of treatment. I don't think that my child at one year old would have consider this type of treatment but also I would not pursue this type of treatment without my child wanting it. As a medical professional do you think a one year old any one your old team consent to this type of treatment. I'd like to speak to the bill at hand and I don't think this is a point that we're going to resolve any. Conclusion on today as soon as much thank you. Seeing no other questions thank you for your testimony thank you thanks to Three o'connell you're recognized come to table. The state your name who you're with you're recognized for two minutes I'm Reverend Marie Maynard o'connell and I'm here today both as a pastor and a parent of a chance child as administer this bill emerges from a desire to protect our youth from harm but I perceive it as introducing harm to my child my family and the community that I minister with as a parent I have to specific concerns with this bill that I am going to ask to be struck from the bill the unnecessary delay of care can exacerbate the depression and anxiety that is caused by dysphoria prince I'd ask you to turn to page four line three of the bill. This requires a mental health professional to prove that there is in writing no common comorbidities no other mental health concerns and this list includes conditions that can result from gender dysphoria namely depression eating disorders and possibly anxiety which is the most common result of living with gender dysphoria but also this list of conditions he merry includes genetic and hereditary lifelong conditions autism and ADHD I'm I'm clear why they are included in this list it is seemingly to me that they are here because they would preclude an individual from being able to make decisions for themselves I request that this entire section be struck from this bill or that you otherwise vote now because it makes it impossible for my child to be able to receive continuing care if they already have conditions on this list this bill does not provide as well a an opportunity for minors to continue their current care including plans for an as yet started hormone treatment or surgery. And I'm my question regarding when one can make these decisions as a minister I wonder when one can choose a life altering decision at what age can a child choose Christ. My point here is this that this bill makes the assumption there some underlying Christian assumptions here and I speak to it I hope you have questions about it thank you and other questions from the committee. Not seeing any thank you for your testimony. Next up I have Courtney Frierson. You come to the in the table. This state your name and who you're with you're recognized for two minutes good morning from Corning Frierson a social worker and a secretary certified sex therapist and I speak on behalf of my trans siblings my clients and all our Kansans who believe in bodies autonomy. Imagine everyone you counter all day long telling you that you're not real there's something fundamentally wrong with you. Being constantly invalidated takes a toll forty percent of trans and gender nonconforming people have attempted suicide. When you constantly hear that you don't matter and you don't exist you sooner or later come to believe that a local admin on a non binary artist and activist I have so many concerns about this bill from the statute of limitations being extended from two years to thirty two is targeting a specific population to the government intrusion on bodily autonomy to the proposed mandatory statement of facts which is not based on robust medical research and does not cite the worldwide professional association of trans health initiate the standards of care since nineteen seventy nine. A mental health provider though so I'll stay in my lane and focus on the implications on the mental health of trans and non binary use. One part of this bill stipulates the trans minor must have no other mental health concerns this alone would make nearly all trans youth and eligible for any gender related care. Citing the Trevor project's twenty twenty two national survey which captured thirty four thousand LGBTQ youth response three fourths of trans gender non binary youth reported experiencing anxiety. Two thirds experience depression. Banning a person with the co occurring diagnoses from accessing healthcare is out right disability discrimination. Sixty percent of all LGBTQ youth who wanted mental health care were not able to get it including nearly three in five trans you. Transgendered Lee prone to suicide depression or anxiety because of their gender identity they're at a higher risk because how they are stigmatized in society which includes legislation like this thank you or other questions from the committee I I did allow a little extra time because you. Get your composure and I did more penalize you for that thank you senator di recognized. Thank you Mr just one question we heard that a statement earlier that suicide rates are the same. Regardless of whether. You can successfully transition or get treatment or not is it your understanding that for transgender teenagers the suicide rate is is much lower for those who undergo gender affirming care. To my knowledge in my fifteen years of experience serving trans people yes being able to access very cautious especially with trans youth being able to access the standards of care as they currently are outlined for the past forty four years there are considered to be irreversible I'm sorry reversible apartment blockers and they slowly proceed to reversible. I'm sorry your reversible which is cross sex cross gender hormones HRT and then finally surgeries which to my knowledge are not being done in the State of Arkansas to minors under eighteen so yes I B. L. access at least puberty brought blockers as a place holder to buy some time to sort out all of these things is essential in reducing suicide risk. Thank you. Senator Teague you're recognized. Thank you for testifying. So would it appears to me that the only reason we're discussing standard of care is because the senator who is against the bill brought it up to it appears to me that this bill is designed to help the very people who you say you represent because I myself I will never. Have the need to sue a doctor who. Through the fault of their own or not did gender affirming care as you call it on myself I will never have that need but it seems to me that it would only be those people who are going through that care that this would seek to protect. Where one of my missing I believe that this would protect I believe that medical doctors therapists that have been working with transgender people should establish the standards not a legislative body of the state of Arkansas I do not trust you for my medical wishing standards all we're seeking to do is provide those individuals that have unfortunately negative impacts because of these acts taken by medical professionals an opportunity to hold them accountable thank you I would like to answer questions there's the statement of facts that must be read thirty days prior to the first appointment and for the first six months at every appointment both in bread written form and verbally and that is essentially an informed consent form I researched informed consent forms throughout the country that are given to families and they do not cite the same things that this bill sites there actually citing medical evidence so if you insist on being a state that governs the body and it must have a informed consent standardized in the State of Arkansas to protect children from injury by all means use medical research and also use informed consent that already exist by people that serve this community I highly disagree with that because I believe in bodies autonomy in the government not regulating that but if you insist as this bill does you could use actual medical research. Are you through center okay Senator Hester you're recognized I think you've nailed the very very. Parkville this is like a child can't consent we're saying a child cannot consent and the argument the rooms the child should have a decision they cannot consent a parent can consent for them and we're saying that when a child becomes an adult and feels like they were wrong they never had the ability to consent because they were a child I think that you and I agree on the fact that families. In concert with that that interdisciplinary team should be the ones making decisions in addition to a child's wishes. To protect them from injury. Just like every other medical procedure that's done on a minor it's the children the doctors the professionals and interdisciplinary team can we agree on that. I do not believe a child can consent to being abused I also believe a child should never be abused. Thank you. Senator Clark you're recognized. Thank you Mr chair. Of you made a very ardent statement of on the subject of suicide that it was not. Because of other things but because of stigmatize the limitation of society. Of. You can use. Provides a citation for that I sure will I am earlier when you were citing the American psychiatric association I think you're talking about the DSM five and the DSM four actually had a diagnosis code gender identity disorder but the newer one the DSM five it changed to gender dysphoria to recognize that the pain and gender dysphoria is about being couched in a society that does not accept any gender variance not necessarily something fundamentally wrong with the person so that body which creates the standard of care for mental health diagnoses has already established that you can site open the DSM and read under gender dysphoria to to read more about that I didn't bring mine with me today. I think my question was you said that it was because the suicide was because of that no I said the suicide risk is not because of their gender identity it's because they're at higher risk of how they're stigmatized in society for example laws like this that create a public discourse and people who are uninformed uneducated making decisions about their bodies it's very threatening the even the conversation in today's room has been violence against my transgender siblings. So. So not only would be out of order to pass this bill it's out of order to have the discussion. I personally don't believe that our government should be creating laws to govern our body. That wasn't my question. My question was so not only would it be it out of bounds to pass this law it would be out of bounds to have this discussion if we can have a discussion and not be limited to two minutes our side and infinite minutes your side that might be a fair discussion that was it there was nothing about fairness years since it was that this was harmful. It is doing harm to my clients that come in the discussion is doing harm the the open exchange free exchange of dialogue is doing harm the content of this bill and the safe act and the bathroom bill is doing harm to my trans clients in my trans siblings yes I agree with you. No we don't agree the question was that can we or can we not discuss the subjects. Without causing harm. I don't think I can answer that without sarcasm so I'm going to defer I didn't think you could either. I don't see any other questions thank you for your testimony next up we have the and Skaggs. Under the under the table. The state your name and who you're with you're recognized for two minutes. Yes thank you for the allowing me to speak today I'm Diane Skaggs mental health professional social worker for over thirty years with currently not with an agency I retired last year I felt very strongly about this bill and felt that I should come today. The social worker part of me just wants to say that we use a multi disciplinary team to have discussions and to discuss things that are not necessarily pleasant but that we have to deal we ought to so that we can alleviate the pain of people that we serve. As a mother and as a grandmother. I want to make sure that my children and grandchildren are saying under the best medical practices and that the best medical practices are allowed and not. Hamstrung by the fear of of thirty year malpractice hanging over their head that and know whether discipline has that no other. Population has that except in this bill I think that malpractice insurance is malpractice alternatives are important to have a think that they're not everybody's a good actor. But I also believe that undue restrictions limited to a. Certain population. Is very harmful I have people that are dear to me that are trans gender and I have seen them suffer I've seen their parents suffer during interviews on a professional level I think that is a very complicated issue and I don't think it can be decided in a in these bills I think that there's other ways to go about it. Thank you. Questions. The senator thank you for your testimony next up I I and I'm this for Moore's guess Disney. You come down the table. The state your name who you're with you're recognized for two minutes. My name is. My name is Jessica Disney I'm thirty for thirty years old a trans woman and I've had access to medical care for my gender transition for over two years and socially transitioned prior to that. I want to take issue a momentarily with the use of the word mutilation and mention it the multiple mention of use H. consent by some of the people here on this committee right now when we are referring to the agenda care and whenever you do research into gender care for people under the age of eighteen most of that besides beauty blockers has to do with social transition and it is mostly a fear mongering to talking point to refer to it as mutilation and surgical interference when we have no bride cases nor any of the surgery is evidence of this being performed here in Arkansas. Many people spoke to things that I already wanted to talk about so I'm gonna take a second and say that over the last month of my time so I've spent years working with marginalized youth in our community here in Arkansas on the central Arkansas area over the last month I've had three transgender you reach out to me and discuss with me there increase and suicidal thoughts one of these individuals only one of these individuals is supported by their close family and friend sorry by their close family in addition to their friends two of these individuals have. Made unsuccessful attempts at their own suicide over the course this past month. Each one of these expressed to me that this conversation being had by our legislature and these laws that are trying to be passed by you guys is directly affecting their mental health and their concerns that the state that they were born and born and raised in that they must consider having to run away with their family and seek to find other places that can help them live their lives as themselves thank you thank you all questions from committee. Thank you for your testimony next up I have alley Tomlinson. Mystic CT ten the table state your name and who you're with you're recognized two minutes. Hello everyone Allie Thomas Tanner FOR and disability rights Arkansas and you've heard and a lot of individuals that you all represented here today that are against this bill and I just want to point out that there is a mental health crisis among trans youth and pieces of legislations like this do make it worse for children especially here in Arkansas because that is your audience I really want to point that out this bill introduces and nothing but the things that we've read on Facebook that sphere based and it's just full of misinformation of course I did have a long speech prepared to you today but I do want to head on and senator Clark I know how will we always love them all the information that you site for us so I have all of this for you and ready just to drop into your inbox and that this is from the standard medicines at the trans and non binary children are four to seven times more likely than their cisgender peers to experience depressive episodes and this study is also from two thousand twenty two and it shows us that trans and non binary used to receive gender affirming care are sixty percent less likely to develop moderate or severe depression in seventy three percent less likely to experience aside all thoughts and like I said I have all of that ready for you and. Everyone of this committee has talked about saving children and protecting children and that's the reason why we're here this bill is not needed in Arkansas they're actually quite there's quantitative data out here and ready for you to act on to help the children of Arkansas for instance the P. TRS that are here in Arkansas and the boards that are not doing anything about the abuse and neglect that's there now this data like I said is ready and I'll be happy to send that along to you but it is acceptable for you already there are children in Arkansas that need your help right now and this bill is not going to do anything because it's not needed so I will ask you to not lose sight of your principles and why you're on this committee and vote no so we can get to the real work thank you. Thank you questions from committee. Seeing thank you for being here next up I have Haley Prentice. Please state your name and who you're with you're recognized for two minutes. Yes my name is Haley Prentice and I'm a lifelong resident of the State of Arkansas I was educated here in the state of Arkansas in a rule school district. I attended college here in Arkansas. And I was raised by parents who were both born here in Arkansas. I am also trans gender. And I knew that at an early age but because of the time I had at the time I grew up in. Transitioning for somebody like and at my age was not possible as a as a teenager. So I request this I repressed it bites different ways by trying to act masculine by trying to buy a blue light or eating by a using smokeless tobacco to be more masculine. For five years I still have. Fite L. I used at and I quit fortunately quit so I have still have most of my teeth left. Senator Stubblefield of mentions something about transfused being in bondage. This. I was in bondage for. Here's. Of the nineteen who I will as. I'm. Was what I was and was trying to fit in society trying to fit into somebody's idea of society rely it took me a long time to realize that. Is not going to be queued of of bay and I could not be straight or or baby C. species agenda because I was assigned male at birth you know it doesn't matter how long you go to church it doesn't know how long you of how many people who Mary. Transgender and your true transgender you will be transgender it has to do with this and I don't want this the units of Arkansas to be in bondage and not be able to do something about their condition this wall is unnecessary and they needed I ask the committee to vote no thank you for your testimony questions from the committee. Thank you for trying to. Last one I have signed up is laughs and love my and I thank our levar read. If you give us your correct name at the end of the table and are you with you're recognized for two minutes thank excellent my name's last of our private citizen upper middle class Christian cisgender heterosexual male I am here to speak against this bill they've been great point that and may I just like to point out the things that were said Senator Hester spoke a lot about age of consent and how we determine that's an eighteen year old adult however we are able to try children as adults in addition we talk about refusing the the suit that happens out there are they also allowed to sue doctors refused to give this care when they become adults because of malpractice we talked earlier about the addition of the malpractice to fifty five years but also that says or three years from the discovery of whichever is the soonest so we need to be careful to compare different things we have to give the proper comparison of stuff in addition we talk about the difference between this law and the other law. One is by passing constitutional rights for civil rights whereas other child protection laws are not and finally I think the most important thing state it was stated from senators Stubblefield when he said I am not a doctor. And I say that because this is a dopp law that defines medical practice. I'm against it as Christian as a father as an uncle of a transgender woman. Thank you and I'm open to any questions having been an educator for many years and watch the kids struggle over these types of discussions that are not based in fact but conjecture. The question further with this. Not seeing any thank you for being here today. Senator Stubblefield we're back to you your. The end of the table. Where you're recognized close for your bill. Thank you Mr chairman thank you committee for Lucent. Your patience and thank for everyone to come today of. You know one of the one of the people testified said she didn't trust us as politicians I hear that a lot. But the fact of the matter is a twelve million people died last year because they were misdiagnosed and hospitals in the United States twelve million another five hundred to two hundred fifty thousand died of last year. Because of medical errors. And another seven to nine thousand die each year from the misdiagnosis of drugs that we give in pharmacy. So. We've rehashed agenda. One really this bill is about is not about to do this bill is about a cause of action for medical malpractice. So I would just I would. Hope for a good vote and I'm closed. Are you making your motion I make a motion I have a motion do pass do have second. Any discussion on the motion Senator Tucker. Thank you Mr chair. I will be too long there's just a few points I want to make based on the discussion we had a. We talked about a constitutional right to child abuse. I think there's a gross miscarriage is ation of what's happening in the field with gender affirming care. We're painting with a very broad brush we use terms like child abuse and that and utilization. There's not one case in Arkansas history that I'm aware of nor could anybody point two today of gender reassignment surgery for a minor two years ago when we passed the safe act in our former governor one on the Tucker Carlson show Tucker Carlson's talking about chemical castration of miners there's nothing like that that is taking place in Arkansas and I don't believe anybody would think that would be permissible. The type of care that's taking place to one of our witnesses talked about its placeholder. To delay a decision for teenagers who are experiencing agenda for the DYS Fauria there's nothing permanent taking place and beyond just. The place holder treatment through gender affirming care. That these teenagers receive or that they have been able to receive in the past beyond that it just lets them know that they are loved and affirmed for who they are. With this bill we want affect ninety nine percent of our Kansans are more ninety nine point nine but the people who it does affect the message they received from this is that the state they live in hate them. That's the message they received from us. Now if we were really concerned about kids and not concerned about transgender teenagers in this bill would read a lot of different. There's no legitimate explanation for prohibiting puberty blockers for teenagers experiencing gender dysphoria but not prohibiting it. For kids who per experience precocious puberty it's either dangerous to kids or it's not. So if it's a real problem for kids and the government needs to step in to protect them then by all means let's do it for everybody not just the ones who are expended experiencing gender dysphoria or as another witness talked about today their kids who were born I think we all understand and realize babies who are born with ge with Jenna tell your for both genders and there are surgeries that are performed when they're infants they're not consenting to that. That's life altering. Should we wait until they're eighteen. At beyond just gender specific issues there but a bunch of points they made about kids who experience medical treatment let's extend the statute of limitations for all forms of medical treatment for kids but we're not talking about any of that we're only talking about one very specific thing which is how you know this population is being targeted. There's no constitutional right to child abuse obviously. But there is a constitutional right. To equal protection under the law. In the spring United States recently including with all three of president trump's nominees confirmed that equal protection when the word sex is involved includes transgender. And I'm just taking us through how this bill targets folks based on their gender transgender so it does violate the equal protection clause the United States we already have a a case that's preliminary we decided that in Arkansas not permanently but we'll we'll see where that goes and I agree with Bragg Cavenaugh. That private rights of action for constitutional rights is a bad idea. We're opening Pandora's box when we do that not only in Arkansas but in other states but I'll wrap up Mister chairman I'm I'm voting against this because I believe it grossly mischaracterizes what's happening out there it ignores the experts in the field. Once again we spent two hours on this when there's about twenty kids in Arkansas who had been receiving this treatment prior to the safe act in twenty five percent of kids and in Arkansas don't know where their dinner's coming on tonight but these are the issues that we're focusing on and. The bill is. Are problematic for all these reasons and and I'll be voting now. Senator Ricky. I just want to go on record for all with all due respect Senator Tucker just about everything you said was either incorrect or misapplied. With respect to this bill and I'll be voting for. Okay and members of office much latitude that can we've got a motion on the table second all in favor aye aye opposed no. The Bill pass is is B. one nine nine. And we are out of time this will conclude Judiciary today. We are or through. We're Jr.