[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]




               THE DANGERS AND DUE PROCESS VIOLATIONS
              OF ``GENDER-AFFIRMING CARE'' FOR CHILDREN

=======================================================================

                                HEARING

                               BEFORE THE

        SUBCOMMITTEE ON THE CONSTITUTION AND LIMITED GOVERNMENT

                                 OF THE

                       COMMITTEE ON THE JUDICIARY

                     U.S. HOUSE OF REPRESENTATIVES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             FIRST SESSION

                               __________

                        THURSDAY, JULY 27, 2023

                               __________

                           Serial No. 118-41

                               __________

         Printed for the use of the Committee on the Judiciary




                [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
               



               Available via: http://judiciary.house.gov

                               ______
                                 

                 U.S. GOVERNMENT PUBLISHING OFFICE

53-170                    WASHINGTON : 2023










                       COMMITTEE ON THE JUDICIARY

                        JIM JORDAN, Ohio, Chair

DARRELL ISSA, California             JERROLD NADLER, New York, Ranking 
KEN BUCK, Colorado                       Member
MATT GAETZ, Florida                  ZOE LOFGREN, California
MIKE JOHNSON, Louisiana              SHEILA JACKSON LEE, Texas
ANDY BIGGS, Arizona                  STEVE COHEN, Tennessee
TOM McCLINTOCK, California           HENRY C. ``HANK'' JOHNSON, Jr., 
TOM TIFFANY, Wisconsin                   Georgia
THOMAS MASSIE, Kentucky              ADAM SCHIFF, California
CHIP ROY, Texas                      ERIC SWALWELL, California
DAN BISHOP, North Carolina           TED LIEU, California
VICTORIA SPARTZ, Indiana             PRAMILA JAYAPAL, Washington
SCOTT FITZGERALD, Wisconsin          J. LUIS CORREA, California
CLIFF BENTZ, Oregon                  MARY GAY SCANLON, Pennsylvania
BEN CLINE, Virginia                  JOE NEGUSE, Colorado
LANCE GOODEN, Texas                  LUCY McBATH, Georgia
JEFF VAN DREW, New Jersey            MADELEINE DEAN, Pennsylvania
TROY NEHLS, Texas                    VERONICA ESCOBAR, Texas
BARRY MOORE, Alabama                 DEBORAH ROSS, North Carolina
KEVIN KILEY, California              CORI BUSH, Missouri
HARRIET HAGEMAN, Wyoming             GLENN IVEY, Maryland
NATHANIEL MORAN, Texas               BECCA BALINT, Vermont
LAUREL LEE, Florida
WESLEY HUNT, Texas
RUSSELL FRY, South Carolina

                                 ------                                

        SUBCOMMITTEE ON THE CONSTITUTION AND LIMITED GOVERNMENT

                     MIKE JOHNSON, Louisiana, Chair

TOM McCLINTOCK, California           MARY GAY SCANLON, Pennsylvania, 
CHIP ROY, Texas                          Ranking Member
DAN BISHOP, North Carolina           STEVE COHEN, Tennessee
KEVIN KILEY, California              VERONICA ESCOBAR, Texas
HARRIET HAGEMAN, Wyoming             CORI BUSH, Missouri
WESLEY HUNT, Texas                   SHEILA JACKSON LEE, Texas
RUSSELL FRY, South Carolina          BECCA BALINT, Vermont

               CHRISTOPHER HIXON, Majority Staff Director
          AMY RUTKIN, Minority Staff Director & Chief of Staff








                            C O N T E N T S

                              ----------                              

                        Thursday, July 27, 2023

                                                                   Page

                           OPENING STATEMENTS

The Honorable Mike Johnson, Chair of the Subcommittee on the 
  Constitution and Limited Government from the State of Louisiana     2
The Honorable Mary Gay Scanlon, Ranking Member of the 
  Subcommittee on the Constitution and Limited Government from 
  the State of Pennsylvania......................................     3
The Honorable Jerrold Nadler, Ranking Member of the Committee on 
  the Judiciary from the State of New York.......................     5

                               WITNESSES

Paula Scanlan, Advisor, Independent Women's Forum; Former 
  University of Pennsylvania swimmer
  Oral Testimony.................................................     8
  Prepared Testimony.............................................    10
Chloe Cole, Detransitioner, Advocate, Opposes Gender-Affirming 
  Care for Minors
  Oral Testimony.................................................    13
Myriam Reynolds, Licensed Professional Counselor, Registered Art 
  Therapist
  Oral Testimony.................................................    14
  Prepared Testimony.............................................    17
May Mailman, Senior Legal Fellow, Independent Woman's Law Center
  Oral Testimony.................................................    19
  Prepared Testimony.............................................    21
Shannon Minter, Legal Director, National Center for Lesbian 
  Rights
  Oral Testimony.................................................    27
  Prepared Testimony.............................................    29
Jennifer Bauwens, Ph.D., Director, Center for Family Studies, 
  Family Research Council
  Oral Testimony.................................................    34
  Prepared Testimony.............................................    36

          LETTERS, STATEMENTS, ETC. SUBMITTED FOR THE HEARING

All materials submitted for the record by the Subcommittee on the 
  Constitution and Limited Government are listed below...........   123

The link for the podcast interview of Dr. Blair Peters, Oregon 
  Health Science University, Portland, submitted by the Honorable 
  Mike Johnson, Chair of the Subcommittee on the Constitution and 
  Limited Government from the State of Louisiana, for the record
Materials submitted by the Honorable Mary Gay Scanlon, Ranking 
  Member of the Subcommittee on the Constitution and Limited 
  Government from the State of Pennsylvania, for the record
    An article entitled, ``No, Washington Did Not Just Pass a Law 
        Allowing the State to Kidnap and Transgenderify 
        Children,'' Apr. 19, 2023, The Stranger
    A letter from leading medical organizations to Congress 
        opposing efforts to ban gender affirming care, Jul. 18, 
        2023
    A letter from the Leadership Conference on Civil and Human 
        Rights, Jul. 26, 2023
    An Opinion Dylan Brandt, et al. v. Leslie Rutledge, et al., 
        U.S. District Court, Eastern District of Arkansas, 
        Central Division, Jun. 20, 2023
    A fact sheet entitled, ``Get the Facts: Gender-Affirming 
        Care,'' Human Right Campaign
    A policy paper entitled, ``Participation of Transgender 
        Athletes in Women's Sports,'' Women's Sports Foundation
    An article entitled, ``How a Campaign Against Transgender 
        Rights Mobilized Conservatives,'' Apr. 17, 2023, The New 
        York Times
    An article entitled, ``California bill on youth mental health 
        services distorted on social media,'' Apr. 14, 2023, AP 
        News
Materials submitted by the Honorable Veronica Escobar, a Member 
  of the Subcommittee on the Constitution and Limited Government 
  from the State of Texas, for the record
    An article entitled, ``Gender-affirming surgeon speaks at 
        Jacobs School LGBTQIA+ event,'' Aug. 28, 2023, UBNow
    An article entitled, `` `I Don't Want to Live in This State 
        of Terror Anymore.' Some Families with Trans Children are 
        Leaving Texas,'' Jul. 24, 2023, Texas Monthly
Materials submitted by the Honorable Becca Balint, a Member of 
  the Subcommittee on the Constitution and Limited Government 
  from the State of Vermont, for the record
    An article entitled, `` `Social contagion' isn't causing more 
        youths to be transgender, study finds,'' Aug. 2, 2022, 
        NBC News
    An article entitled, ``Study finds no evidence of social 
        contagion among transgender youth,'' Aug. 3, 2022, 
        American Academy of Pediatrics
Materials submitted by the Honorable Sheila Jackson Lee, Ranking 
  Member of the Subcommittee on the Constitution and Limited 
  Government from the State of Texas, for the record
    An article entitled, ``Map: Attacks on Gender Affirming Care 
        by State,'' Jul. 13, 2023, Human Rights Watch
    An article entitled, `` `A hole in our hearts': Family, 
        friends mourn murder victim Chyna Gibson,'' Jul. 7, 2021, 
        NOLA
    An article entitled, ``Chyna Gibson Identified As The Fifth 
        Transgender Woman Killed In 2017,'' Feb. 27, 2017, Vibe
    An article entitled, ``Transgender Women Cyna Gibson Killed 
        in New Orleans,'' Nov. 6, 2017, Human Rights Watch
    An article entitled, ``Planned Parenthood Texas Affiliates 
        and PPFA Move for Decision in Baseless Medicaid False 
        Clams At Case,'' Jan. 7, 2023, Planned Parenthood
Materials from the Honorable Mike Johnson, Chair of the 
  Subcommittee on the Constitution and Limited Government from 
  the State of Louisiana, for the record
    A statement from Raheem Williams, Policy Analyst, Center for 
        Urban Renewal and Education, Jul. 27, 2023
    An article entitled, ``FDA sued for concealing information 
        about children's off-label use of puberty blockers, 
        cross-sex hormones,'' Feb. 28, 2023, Fox News
    An article entitled, ``The Truth About `Puberty Blockers,' '' 
        Jun. 7, 2023, Wall Street Journal
    An article entitled, ``As more transgender children seek 
        medical care, families confront many unknowns,'' Oct. 6, 
        2022, Reuters

                                APPENDIX

A statement from the Honorable Sheila Jackson Lee, Ranking Member 
  of the Subcommittee on the Constitution and Limited Government 
  from the State of Texas, for the record









 
               THE DANGERS AND DUE PROCESS VIOLATIONS
              OF ``GENDER-AFFIRMING CARE'' FOR CHILDREN

                              ----------                              


                        Thursday, July 27, 2023

                        House of Representatives

        Subcommittee on the Constitution and Limited Government

                       Committee on the Judiciary

                             Washington, DC

    The Committee met, pursuant to notice, at 10:06 a.m., in 
Room 2141, Rayburn House Office Building, Hon. Mike Johnson 
[Chair of the Subcommittee] presiding.
    Members present: Representatives Johnson, Jordan, 
McClintock, Roy, Kiley, Hageman, Hunt, Fry, Scanlon, Nadler, 
Cohen, Escobar, Jackson Lee, and Balint.
    Also present: Representatives Gaetz and Greene.
    Mr. Johnson of Louisiana. [Presiding.] The Subcommittee 
will come to order.
    Without objection, the Chair is authorized to declare a 
recess at any time.
    We open our proceedings here with a Pledge of Allegiance, 
and I will recognize the gentlelady from Georgia, Ms. Taylor 
Greene, to lead us for that purpose.
    All. I pledge allegiance to the Flag of the United States 
of America, and to the Republic for which it stands, one 
Nation, under God, indivisible, with liberty and justice for 
all.
    Mr. Johnson of Louisiana. Thank you.
    We welcome everyone to today's hearing on the dangers and 
due process violations--
    Ms. Scanlon. Point of order.
    Mr. Johnson of Louisiana. --of gender-affirming care for 
children.
    Ms. Scanlon. I have a point of order, Mr. Chair.
    Mr. Johnson of Louisiana. Yes, ma'am, what's the point of 
order?
    Ms. Scanlon. It is not the Committee's practice to allow 
folks who are not Members of this Committee to sit at the dais 
without unanimous consent, and we do not give it.
    Mr. Johnson of Louisiana. I was going to seek that 
unanimous consent. The gentlelady from Georgia was here for the 
purpose of merely introducing the Republican witnesses. It's 
common courtesy among colleagues to allow a Member the 
privilege of appearing for that purpose. I'm sorry that you 
object to that.
    Ms. Scanlon. I'm sorry, too.
    Mr. Johnson of Louisiana. You insist on the point of order?
    Ms. Scanlon. I do.
    Mr. Johnson of Louisiana. Unfortunately, it's not a 
debatable motion or one that is subject to a vote. So, I will 
provide the witness introductions after our opening statement. 
So, I thank our colleague for her willingness, anyway.
    I will recognize myself for an opening statement and we'll 
get the hearing going here.
    Before I provide a few opening remarks, I'm going to play a 
two-minute excerpt of a podcast interview with an individual 
named Dr. Blair Peters at the Oregon Health Science University 
in Portland.
    He calls himself the ``queer surgeon'' and he boosts about 
the shocking, fully experimental, irreversible, and life-
altering invasive procedures that he and others are performing 
on children to surgical modify their genitals.
    I want everyone to hear this in his own words, not mine, 
and take special note of the frank admission that no one has 
published any studies on these shocking procedures, and they 
are, quote, as he says, ``just kind of learning and figuring 
out what works.''
    Later in this video, he admits to performing, quote, ``huge 
reconstructive surgery rearranging anatomy,'' and then, 
acknowledges that they know almost nothing about the outcomes 
for these children. He says, quote, ``We'll know more in 5-10 
years,'' and quote, ``It will be fascinating to see how all 
these kids turn out.'' Wow!
    With unanimous consent, I will enter the link to this full 
video in the record of our hearing because everyone should 
watch it. It is absolutely nightmarish and surreal to hear the 
description of what these people are doing to the bodies of 
young children.
    Mr. Johnson of Louisiana. Please play that clip, and I will 
say viewer discretion is advised.
    [Video played.]
    Mr. Johnson of Louisiana. So, I'm going to speak the truth 
here plainly, and I think the vast majority of the American 
people understand and agree with what I'm going to say.
    What you have just heard there is a little sample of 
barbarism. This is the mutilation of children, and it should be 
prohibited by our law.
    This so-called ``gender-affirming care'' is anything but 
affirming and caring, and the language matters. This is adults 
deciding to permanently alter the bodies of children who do not 
have the capacity to make life-altering decisions on their own.
    Here's some more plain truth that everybody acknowledged 
until about five minutes ago. It's been plainly observed and 
fully respected by every culture for all recorded history. Sex 
isn't something you are assigned at birth. It is a natural, 
prenatal development that occurs when every unborn child is in 
the mother's womb. No one can surgically free themselves from 
this objective and obvious fact of life or free anyone else 
from it.
    Today, we see adults inflicting unspeakable harms on 
helpless children to affirm the adult's own world view: That 
gender is somehow fluid; that sex can be surgically altered; 
that there are no lasting consequences of all this madness, as 
a result of the sex change procedures.
    What is even more alarming is that the central tenet of the 
transgender movement and its allies is to exclude parents as 
much as possible from making decisions about the health of 
their own children. Medical professionals and schools 
increasingly see parents as, quote, ``transphobic bullies'' who 
must be prevented from standing in the way of the medical 
sexual transition of their own kids.
    We saw this in my home State of Louisiana recently, where 
Children's Hospital of New Orleans laughed in the face of a 
young girl's parents when they attempted to intervene, as 
doctors sought to transition their daughter without their 
consent.
    To the left, these aren't your children, see. They are the 
State's children, and the State should be making the parenting 
decisions.
    Let's also be clear about something else. Even a parent has 
no right to sexually transition a young child. Our American 
legal system recognizes the important public interest in 
protecting children from abuse and physical harm. No matter how 
liberated you may be, you still don't have the legal right to 
ignore seatbelt safety laws or minimum driving age laws or 
drinking and smoking laws for your kids. No parent has a 
Constitutional right to injure their children.
    Of course, the reach of radical sexual identity politics 
isn't limited to young children alone. We see this extended to 
young adults, especially at the university level now. The 
modern left applauds men competing in women's college 
athletics. We see universities captured by academics advancing 
this ideology on students across our country.
    Whether it's by scalpel or by social coercion from 
teachers, professors, administrators, and left-wing media, it 
is an aggressive attempt to transition the young people of our 
country. They are doing this psychologically, and now they are 
doing it even physically.
    Something has gone terribly wrong, and deep down everybody 
in this country knows it. Today, we want to shed light on what 
this problem is, and hopefully, how we can address the problem.
    Contrary to what some of my Democrat colleagues believe, 
the scourge of radical gender ideology is very real. The 
efforts to cover up what is being done to our children are 
extreme, and the science is on the side of what we all know 
deep down is morally and ethically right.
    I look forward to the testimony from our witnesses, as we 
unravel the narratives surrounding this so-called gender-
affirming care.
    I now recognize the Ranking Member, the gentlewoman from 
Pennsylvania, Ms. Scanlon, for her opening statement.
    Ms. Scanlon. Thank you, Mr. Chair.
    Let's be clear. Congress has no business interfering in 
parents' freedom to make decisions about appropriate medical 
care for their children. The idea that politicians are more 
qualified to judge the medical value or necessity of gender-
affirming care than every major medical organization is absurd.
    Holding a hearing to substitute far-right ideologies for 
parental judgment exposes the rank hypocrisy of the party 
claiming to value individual freedom and small government. So, 
here we are before the Subcommittee on the Constitution and 
Limited Government.
    Make no mistake; today's hearing is not about protecting 
children or parents' rights. It's a cynical and, frankly, 
dangerous political attack on transgender children and their 
families, driven not by science or facts, but by polling and 
political strategists determined to mobilize conservative 
voters through fear.
    So, let's start by setting the record straight. Gender-
affirming care is safe and effective. It is supported by every 
major medical association, including the American Academy of 
Child and Adolescent Psychiatry, the American Medical 
Association, and the American Academy of Pediatrics, among 
others, representing over 1.3 million American doctors. It's 
just not up for debate.
    The partisans who characterize gender-affirming care as 
``radical gender ideology'' are just repeating right-wing 
talking points to delegitimize critical healthcare. Access to 
gender-affirming care is essential to the mental health and 
well-being of trans youth. This care is tailored to both the 
mental and physical health needs of patients, as well as their 
developmental stage in life. The parents and guardians of these 
children are involved in every phase of decisionmaking. There's 
nothing radical about that.
    So, when our Republican colleague allege that gender-
affirming care raises particular dangers or due process issues, 
that is fearmongering at its worst--picking on already 
vulnerable kids to stir up chaos that they hope to ride to 
success at the ballot box, no matter how deceitful or dangerous 
those claims are.
    As a mother of three, I certainly never found myself at my 
children's pediatric appointments wishing for medical advice 
from the House Judiciary Committee.
    As a Member of Congress, I'm appalled by the weaponization 
of our legislative process to inject politicians into the 
personal medical decisions of our constituents' lives.
    I strongly oppose any effort to impose ultra-conservative 
political or religious views on the medical decisions of 
American families, whether on matters of reproductive 
healthcare or parental decisions to seek gender-affirming care 
for a transgender child.
    I know that Americans can be trusted to make their own 
healthcare decisions without politicians invading their 
doctors' offices, and I believe parents and doctors when they 
say that gender-affirming care has changed children's lives for 
the better, and in many cases even saved those lives.
    Parents like the mother of a trans teen from Ohio who 
shared her family's story with the Committee, she told us that, 
because her 17-year-old trans daughter had access to evidence-
based, medically necessary, gender-affirming care, puberty was 
just another phase of a normal and healthy adolescence. She 
said, and I quote,

        Forcing her to go through the wrong puberty and seeing the 
        impact on her body and her mental health would have been 
        agonizing for all of us. I don't understand why we would allow 
        politicians to make medical decisions for our children.

    She is right. Banning access to gender-affirming care would 
violate parents' due process rights, and the Federal Courts 
agree. They agree that banning gender-affirming care for minors 
violates Constitutionally protected parental rights, and that 
politicians should stay out of those decisions.
    I want to close by reminding my colleagues how much their 
words matter. By endorsing falsehoods and bullying tactics, 
Members of Congress are helping to promote a culture of 
discrimination that has increased violence against trans kids 
and their parents. Cynical political opportunists should not be 
allowed to use the megaphone of the House Judiciary Committee 
to promote cruelty and disinformation, particularly when we 
know that it invites discrimination and abuse of trans children 
and their families. I must object to this callous and reckless 
use of this Committee's time.
    With that, I yield back.
    Mr. Johnson of Louisiana. I now recognize the Ranking 
Member of the Full Committee, Mr. Nadler, for an opening 
statement, if he wishes.
    Mr. Nadler. Mr. Chair, today's hearing is an all-time low 
for the Republican majority. In my three decades in Congress, I 
have taken part in plenty of hearings where I did not agree 
with the choice of topic, to say the least, but I am absolutely 
disgusted by the Republican majority's bullying, bigoted 
framing of an issue that would otherwise be worthy of serious 
discussion.
    What we are witnessing today is nothing less than a 
taxpayer-funded platform for Congressional Republicans to bully 
trans-
gender kids who are already some of the most vulnerable members 
of our community.
    Things are already tough enough for these kids and their 
parents. A mental health survey conducted by the Trevor Project 
found that transgender youth experience high risk of 
depression, anxiety, and suicidal thoughts. It can't help that 
they are under siege by Republican-dominated State legislatures 
hellbent on passing antitrans bills.
    According to the Human Rights Campaign, more than 76 of 
these bills have been signed into law, resulting in transgender 
youth losing access to lifesaving medical care, comprehensive 
and inclusive education, and activities, spaces, and 
facilities.
    That is why it is so infuriating that Congressional 
Republicans are using their megaphone to single out transgender 
kids and their parents by labeling their very existence to be a 
social problem, practically accusing their parents of being 
criminals for seeking safe, lifesaving, mainstream medical 
treatment for their children.
    The last thing trans kids and their parents need in their 
lives is for politicians in Washington to jump on the antitrans 
bandwagon, just so that they can fearmonger for their five 
minutes of fame.
    Let me be crystal-clear. Government should not stick its 
nose into a parent's decision to seek gender-affirming care for 
their children. Indeed, it is almost comical that the 
Republican majority of what they have named the Subcommittee on 
the Constitution and Limited Government is holding a hearing, 
allegedly, on due process to argue that politicians, not 
parents, should make decisions as to what medical treatment is 
best for their children.
    The legal theory underlying this farcical hearing is bogus, 
but you don't have to take my word for it. Every Federal 
District Court that has considered the Constitutionality of 
State laws banning gender-affirming care has ruled that such 
bans violate parents' Constitutional rights. These decisions 
were issued by courts in different parts of the country and by 
judges from across the ideological spectrum, including three 
judges appointed by former President Trump.
    I trust parents and medical professionals, not politicians, 
to make decisions about their children's health when it comes 
to gender-affirming care, and so does the Constitution.
    That said, judging from the lineup of witnesses, it appears 
that there is no limit to the topics over which Republicans 
want to bully trans kids and their parents today. Undoubtedly, 
transgender youths' participation in sports will be discussed 
because Republicans think it is a winning political topic 
point. The facts do not justify the fears that Republicans and 
their political allies gin up over the fairness of trans girls 
participating in girls' athletic teams, nor the further stigma 
it attaches to transgender children.
    What recently happened in Utah illustrates my point. Last 
year, Republican Governor Spencer Cox vetoed a complete 
categorical ban on transgender kids from participating in 
athletics matching their gender identity, which the Utah 
legislature, sadly, overruled.
    In vetoing the law, Governor Cox noted in a letter 
explaining his decision that, of the 75,000 high school kids 
participating in high school sports in the State, only four--
four--were transgender, but only one transgender student was 
playing girls' sports--one out of 75,000.
    Governor Cox also noted a study that showed that 86 percent 
of trans youth reported suicidality and 56 percent of trans 
youths have attempted suicide. Let those numbers sink in for a 
moment. A majority of trans youth in this study reported that 
they had attempted to kill themselves. Out of 75,000 high 
school student athletes in the State, only four were 
transgender--an infinitesimally small minority of all high 
school students in Utah.
    Governor Cox's letter further described a sentiment that I 
sincerely wish his Republican colleagues on this Subcommittee 
shared. The Governor wrote, quote,

        Rarely has so much fear and anger been directed at so few. I 
        don't understand what they are going through or why they feel 
        the way they do, but I want them to live. And all the research 
        shows that even a little acceptance and connection can reduce 
        suicidality significantly.

    Parents of transgender kids want the same things every 
parent wants for their kids: To go to school without fear of 
bullying; to participate in extracurricular activities like 
sports, if they wish, and to be accepted by their peers and 
their community.
    This hearing will only further put those things out of 
reach for those parents and their children. Far from protecting 
children, this hearing will only further stigmatize and 
endanger them because it sends a message that transgender kids 
and their parents do not deserve the law's protection.
    To any transgender people or family members who may 
watching this hearing, I want to say that Democrats on this 
Committee see you; we appreciate you; we value you, and we will 
continue to fight for you.
    This hearing is a despicable exercise and a contemptible 
use of the Subcommittee's time and power.
    I yield back.
    Mr. Johnson of Louisiana. The gentleman yields back.
    Without objection, all other opening statements will be 
included in the record.
    Mr. Johnson of Louisiana. We will now introduce today's 
witnesses.
    Ms. Paula Scanlan is a spokeswoman and an Advisor to the 
Independent Women's Forum and the Independent Women's Voice. 
She is a former collegiate swimmer at the University of 
Pennsylvania, and she speaks out about what it was like for 
girls competing alongside and sharing a pool and locker room 
with a transgender woman.
    Ms. Chloe Cole is an advocate and someone who has 
experienced gender transition procedures. After being diagnosed 
with gender dysphoria, she began to transition, and then, she 
detransitioned at age 17, and now speaks about her experiences.
    Ms. Taylor Greene had wished to note today that she had the 
pleasure of meeting and speaking with Ms. Cole last year, when 
you bravely spoke out and spoke in support of her bill, the 
Protect Children's Innocence Act, in front of the whole Nation 
at a press conference. So, thank you for your courage.
    Dr. Jennifer Bauwens is serving as the Director of the 
Center for Family Studies at the Family Research Council. Her 
research focuses on identifying and advancing policies that 
will best serve the health and well-being of families and 
communities.
    Ms. May Mailman is a Senior Fellow at the Independent 
Women's Law Center. She previously served as the Deputy 
Solicitor General for the State of Ohio.
    Mr. Shannon Minter is the Legal Director for the National 
Center for Lesbian Rights. The NCLR advocates for lesbian, gay, 
bisexual, and transgender people.
    Ms. Myriam Reynolds is a Licensed Professional Counselor 
and an Art Therapist, and she is the mother of a transgender 
son and resides in the State of Texas.
    We welcome all our witnesses and we thank you for your time 
and appearing today.
    We will begin by swearing you in. So, if you would rise and 
raise your right hand?
    Do you swear or affirm under the penalty of perjury that 
the testimony you are about to give is true and correct to the 
best of your knowledge, information, and belief, so help you 
God?
    Thank you.
    Let the record reflect the witnesses have answered in the 
affirmative.
    You all can be seated.
    Please know that your written testimony will be entered in 
the record in its entirety. Accordingly, we ask you to 
summarize that testimony in five minutes.
    You have a light system there and you need to push the 
button to speak, so we can all hear your voice.
    Ms. Scanlan, we will begin with you. You can go first.

                   STATEMENT OF PAULA SCANLAN

    Ms. Scanlan. Good morning. Good morning, Chair Johnson and 
Ranking Member Scanlon, and Members of the Subcommittee.
    I am Paula Scanlan, a spokeswoman and advisor for the 
Independent Women's Forum, and a former NCAA athlete. I am here 
today to share my personal story.
    I started swimming at a very young age, and by age eight, I 
was swimming competitively. By late middle school, I was 
devoting at least 20 hours per week to swimming. I gave up 
countless Christmas holidays, weekends, and social events to 
work toward my goal of swimming Division 1--a dream that came 
true when I began swimming for the University of Pennsylvania.
    While I am not an NCAA champion, I hold the New England 
Independent School League record in the 400-yard freestyle 
relay, a record that has stood since March 2017.
    In September 2021, Lia Thomas began participating as a 
member of the Penn women's team. Lia, formerly Will, had 
personal best times in every freestyle event that were faster 
than the women's world records.
    Once the season began, Thomas was leading the country in 
multiple events, while only placing in the top 500 in those 
events on the men's team. Thomas later became an NCAA champion 
in the 500-yard freestyle, the first NCAA champion in our 
women's team history program.
    While many of you already know this, what you do not know 
is the experiences of the women on the University of 
Pennsylvania swim team. My teammates and I were forced to 
undress in the presence of Lia, a 64" tall, biological male 
fully intact with male genitalia 18 times per week.
    Some girls opted to change in bathroom stalls and others 
used the family bathroom to avoid this. When we tried to voice 
our concerns to the athletic department, we were told that 
Lia's swimming and being in our locker room was a nonnegotiable 
and we were offered psychological services to attempt to re-
educate us to become comfortable with the idea of undressing in 
front of a male.
    To sum up the University's response, we, the women, were 
the problem, not the victims. We were expected to conform, to 
move over and shut up. Our feelings didn't matter. The 
University was gaslighting and fearmongering women to validate 
the feelings and identity of a male.
    As an attempt to voice my concern about the situation we 
were forced into, revealing the unjust and unfair treatment, I 
wrote an op-ed for The Daily Pennsylvanian, the student-run 
newspaper. I approached this from a scientifically, scientific, 
statistical perspective where I used my engineering background 
to discuss how Y chromosomes cannot be changed by any surgical 
procedure or systemic therapy.
    This biological fact lends itself to athletic advantages 
that cannot be mitigated by lowering testosterone levels, which 
are readily apparent in sports competitions and locker rooms.
    The Daily Pennsylvanian published my article on the evening 
of February 10, 2022. Only a few hours later, my piece was 
retracted. I was given no notice, nor reasoning. Again, I was 
silenced from my dissenting viewpoint and felt my First 
Amendment rights were denied by my university.
    This is representative of a greater issue, the destruction 
of free speech. Today, any discussion maintaining the sanctity 
of women's spaces is labeled transphobic, bigoted, and hateful.
    What's bigoted and hateful is the discrimination against 
women and the efforts to erase women and our equal 
opportunities, dignity, and safe spaces.
    One might ask, why do I speak so passionately about issues 
that seem hypothetical, or some may perceive as only impacting 
a small number of women? This is not hypothetical. This is 
real.
    I know women who have lost roster spots and spots on the 
podium. I know of women with sexual trauma who are adversely 
impacted by having biological males in their locker room 
without their consent.
    I know this because I am one of these women. I was sexually 
assaulted on June 3, 2016. I was only 16 years old. I was able 
to forgive my attacker, but violence against women still 
exists.
    Let us not forget the viral #MeToo movement that empowered 
female victims to speak up. It cast a spotlight on the 
widespread prevalence of sexual assault and abuse, including in 
scholarly and educational institutions.
    Individuals on this Committee have previously stated 
violence against women is all too common. I am grateful for 
those Members who have brought awareness to the violence 
against women in the past, but, unfortunately, there is still 
much to be done.
    As a sexual assault survivor, many policies pushed today 
completely ignore my experiences and many women like me. I ask 
the Members of this Committee, please consider this issue 
outside the lens of political affiliations and understand the 
true impact of ignoring the realities of womanhood. Future 
generations depend on us.
    Thank you for the opportunity to speak here today.
    [The prepared statement of Ms. Scanlan follows:]

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    Mr. Johnson of Louisiana. Thank you for being here and for 
your courage, Ms. Scanlan.
    Ms. Cole, you are next, and you can begin.

                    STATEMENT OF CHLOE COLE

    Ms. Cole. Good morning. My name is Chloe Cole, and I am a 
detransitioner.
    Another way to put that would be I used to believe that I 
was born in the wrong body, and the adults in my life, whom I 
trusted, affirmed my belief and this caused me lifelong, 
irreversible harm.
    I speak to you today as a victim of one of the biggest 
medical scandals in the history of the United States of 
America. I speak to you in the hope that you will have the 
courage to bring this scandal to an end and assure that other 
vulnerable teenagers, children, and young adults don't go 
through what I went through.
    At the age of 12, I began to experience what my medical 
team would later diagnose as gender dysphoria. I was well into 
an early puberty, and I was very uncomfortable with the changes 
that were happening to my body. I was intimidated--I was 
intimidated by male attention, and when I told my parents that 
I felt like a boy, in retrospect, all I meant was that I hated 
puberty; that I wanted this newfound sexual attention to go 
away; that I looked up to my brothers a little bit more than I 
did to my sisters.
    I came out as transgender in a letter I sat on the dining 
room table. My parents were immediately concerned. They felt 
like they needed to get outside help from medical 
professionals, but this proved to be a mistake. It immediately 
set our entire family down a path of ideologically motivated 
deceit and coercion.
    The gender specialist I was taken to, taken to see, told my 
parents that I needed to be put on puberty-blocking drugs right 
away. He asked my parents a simple question: ``Would you rather 
have a dead daughter or a living transgender son?''
    That choice was enough for my parents to let their guard 
down, and in retrospect, I can't blame them. This is the moment 
that we all became victims of so-called gender-affirming care.
    I was fast-tracked onto puberty blockers, and then, 
testosterone. The resulting menopausal-like hot flashes made 
focusing on school impossible. I still get joint pains and 
weird pops in my back, but they were far worse when I was on 
the blockers.
    A month later, when I was 13, I had my first testosterone 
injection. It's caused permanent changes to my body. My voice 
will forever be deeper; my jawline sharper; my nose longer; my 
bone structure permanently masculinized; my Adam's apple more 
prominent; my fertility unknown. I look in the mirror sometimes 
and I feel like a monster.
    I had a double mastectomy at 15. They tested my amputated 
breasts for cancer, and I was cancer-free, of course. I was 
perfectly healthy. There was nothing wrong with my still-
developing body or breasts, other than that, as an insecure 
teenaged girl, I felt awkward about it.
    After my breasts were taken away from me, the tissue was 
incinerated. Before I was able to legally drive, I had part, I 
had a huge part of my future womanhood taken from me. I will 
never be able to breastfeed. I struggle to look at myself in 
the mirror at times.
    I still struggle to this day with sexual dysfunction, and I 
have massive scars across my chest and skin grafts that they 
used, that they took from my nipples, are weeping fluid today, 
and they were grafted into a more masculine positioning, they 
said.
    After surgery, my grades in school plummeted. Everything 
that I went through did nothing to address my underlying mental 
health issues that I had. My doctors with their theories on 
gender thought that all my problems would go away as soon as I 
was surgically transformed into something that vaguely 
resembled a boy.
    Their theories were wrong. The drugs and surgeries changed 
my body, but they did not, and could not, change the basic 
reality that I am, and forever will be, a female.
    When my specialists first told my parents that they could 
have a dead daughter or a live transgender son, I wasn't 
suicidal. I was a happy child who struggled because she was 
different. However, at 16, after my surgery, I did become 
suicidal. I'm doing better now, but my parents almost got the 
dead daughter promised to them by my doctors. My doctors had 
almost created the very nightmare they said they were trying to 
avoid.
    So, what message do I want to bring to American teenagers 
and their families? I didn't need to be lied to. I needed 
compassion. I needed to be loved. I needed to be given therapy 
to help me work through my issues, not affirming my delusion 
that, by transforming into a boy, it would solve all my 
problems.
    We need to stop telling 12-year-olds that they were born 
wrong; that they are right to reject their own bodies and feel 
uncomfortable with their own skin. We need to stop telling 
children that puberty is an option; that they can choose what 
kind of puberty they will go through, just like they can choose 
what clothes to wear or what music to listen to. Puberty is a 
rite of passage to adulthood, not a disease to be mitigated.
    Today, I should be at home with my family celebrating my 
19th birthday, and instead, I'm making a desperate plea to my 
elected, my elected Representatives: Learn the lessons from 
other medical scandals, like the opioid crisis; to recognize 
that doctors are human, too, and sometimes they are wrong.
    My childhood was ruined, along with thousands of detransi-
tioners that I know through our networks. This needs to stop. 
You alone can stop it. Enough children have already been 
victimized by this barbaric pseudoscience. Please let me be 
your final warning.
    Thank you.
    Mr. Johnson of Louisiana. Today is your birthday?
    Ms. Cole. It is.
    Mr. Johnson of Louisiana. You're a beautiful, brave woman. 
Thank you for being here.
    Ms. Cole. Thank you.
    Mr. Johnson of Louisiana. Ms. Reynolds, you're next. You 
may begin.

                  STATEMENT OF MYRIAM REYNOLDS

    Ms. Reynolds. Good morning.
    My name is Myriam Reynolds. I'm a licensed professional 
Counselor, a fifth-generation Texan descending from a long line 
of conservative Christians, and I'm the mother of a transgender 
son.
    I am honored to be here today to give my testimony and tell 
you the story of my incredible child. He recently became an 
adult, and I will still refer to him as a child.
    His name is Cameron, and he is 18 years old. He recently 
graduated from high school and is embarking on, embarking on 
adulthood with a gap year before college.
    Cameron told us he was transgender when he was 11 years 
old. He was clearly dealing with something, but we didn't know 
what it was or how to help him. Then, he told us.
    My husband and I had the same instinct to tell him that we 
love him, no matter what, and always will be there for him. We 
needed--we knew we needed to affirm him from our years in 
working with foster youth. We had no idea what to do next. We 
were scared. We didn't know anyone who had a trans child. We 
had never even heard of gender-affirming care.
    I prayed that it was a phase, but already knew that it 
wasn't. The signs had been there all along. We just didn't 
understand them. We thought he was a tomboy. He refused to wear 
anything pink or girlie and was the only girl on the boys' 
football team for many years. His best friends were always 
boys. There were a lot of signs, looking back.
    As parents, all we really want for our children is for them 
to be happy and healthy. Prior to receiving gender-affirming 
care and socially transitioning, my child was not happy and was 
not able to be his true self.
    I didn't want him to have to face the struggles of being 
transgender, but I did want him to be happy and himself. At 
times, I grieved my little girl and felt as if she were gone. 
It was hard on me at first, but I was able to put my child's 
needs before my feelings and find him the care he needed. I 
could see that my child was happier and felt more and more 
comfortable the more he was affirmed.
    We were living in Colorado at the time, and through some 
research, found a comprehensive program at a local hospital 
that provided healthcare to trans kids. We found him a 
counselor, immediately began trying to provide him with the 
best healthcare we could find.
    We felt very fortunate to have access to a 
multidisciplinary team of professionals who could help us 
figure out what options we had for Cameron's healthcare. I 
could not imagine having to manage legal restrictions of 
medical care, in addition to talking to our extended family, 
all while learning ourselves about treatment options and caring 
for our child.
    Later that year, we decided to move to Texas. We began 
researching leading programs in the field of trans healthcare 
and were able to find a similar program. We chose to move to a 
town based on proximity to the clinic. We knew we needed the 
support of experts. We had an appointment scheduled before we 
even arrived in Texas or had any idea of our health insurance 
coverage.
    Our multidisciplinary team at the clinic consisted of 
physicians, nurses, social workers, psychologists, medical 
students, my son's counselor, the school counselor, my husband 
and I as parents/decisionmakers, and my son as a patient.
    We filled out many, many surveys and questionnaires. 
Myself, Cameron, and his dad were all required to do so. We had 
extensive interviews with social workers and psychologists who 
had requested a letter from Cameron's previous provider prior 
to our first appointment.
    The intake process was lengthy and meticulous. The process 
was daunting, but I was grateful that the team was so thorough. 
I want to make it clear that the care we received was slow, 
very thoughtful, provided with the utmost care and 
consideration. There was no rush, absolutely no coercion, lots 
and lots of double-checking and making sure we were all on the 
same page.
    At the time, Cameron felt it was all moving too slowly. In 
retrospect, we can see clearly that it was the best thing for 
us to move so slowly on medical interventions, so we could 
properly weigh the pros and cons.
    My son was asked at every appointment if he wanted to stop 
treatment or if he had any concerns about treatment whatsoever. 
Counseling was taking place the entire time. Cameron's 
counselor would also meet with the doctor and my husband and I, 
before medical interventions were decided on.
    The interventions my son has had--with extreme 
consideration, consent, and discussion--have been counseling, 
first and foremost; puberty blockers, and hormone therapy. We 
have not even considered any kind of surgery and my child is 
18. If any physician or member of the treatment team had 
suggested surgery to us when Cameron was a child, we would have 
said, ``No, thank you,'' and immediately gotten a second or 
third opinion.
    With the benefit of hindsight, I have no doubt that the 
healthcare of my son accessed was lifesaving. I am grateful 
that we have had access to this incredibly crucial, medically 
necessary healthcare for our son without the interference of 
our government.
    Cameron is thriving now. He is doing better than he ever 
has. He has wonderful friends. He is dating a little. He has 
spoken out publicly and has the love and support of his whole 
family, including two grandparents who are staunch 
conservative, Christian Republicans.
    We can all see that this is who he is. The grandparents 
don't fully understand what being transgender really means, but 
they love and accept him.
    I'm asking you today to please allow parents the right to 
access and consent for healthcare for their children. This 
decision should be made with parents, the child, and the 
child's medical providers without government interference.
    Thank you.
    [The prepared statement of Ms. Reynolds follows:]

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    Mr. Johnson of Louisiana. Thank you, Ms. Reynolds.
    Ms. Mailman, you're next. You may begin. Push that button 
for me.

                    STATEMENT OF MAY MAILMAN

    Ms. Mailman. I'm May Mailman, Senior Fellow with the 
Independent Women's Law Center, the legal advocacy arm of 
Independent Women's Forum and Independent Women's Voice. I am 
also a mother to my eight-month-old daughter. I am testifying 
here today in support of her future, her freedom, and her equal 
opportunity.
    My fellow panelists have covered the pernicious effects of 
gender ideology on children and their futures. I am here to 
address another way in which gender ideology destroys women and 
girls, and that is by dissolving legal protections for women in 
athletics.
    Until recently, female student athletes might have thought 
that they were protected by Title 9 of the Education Amendments 
of 1972, and they were. That's because Title 9 is very simple. 
It prohibits discrimination on the basis of sex in programs run 
by schools that accept Federal money, and that's, basically, 
all of them, and those programs include sports.
    Title 9 recognizes that providing equal opportunity for the 
sexes can mean recognizing inherent differences between the 
sexes. That's why the Title 9 statute explicitly allows schools 
to provide different living arrangements for the sexes. So, 
too, in sports.
    In introducing Title 9, Senator Birch Bayh explained that 
Title 9 would not require sticking women on men's football 
teams. That's why Congress explicitly asked that the initial 
Title 9 regulations include, ``reasonable provisions 
considering the nature of particular sports.''
    So, for 50 years, the Title 9 athletics regulation has 
explicitly permitted sex-based teams, ``where selections for 
such teams is based on competitive skill or involves a contact 
sport.'' Importantly, the regulations also require that schools 
must provide equal opportunities for members of both sexes.
    Unfortunately, in April of this year, the Department of 
Education proposed a rule that, if adopted, would flip Title 9 
on its head. The proposed rule would modify the athletic 
regulation to let schools compete on teams consistent with 
their gender identity, unless a particular school can 
demonstrate to the satisfaction of the Department of Education 
that this policy would be too unfair or unsafe. In other words, 
women are no longer granted female sports teams as a given. We 
have to prove that we need it.
    Of course, we do need it. Studies show that even 
testosterone suppression cannot eliminate the male advantage--
except schools are not to be allowed to say that, as a general 
matter, post-pubescent biological males playing women's sports 
puts female athletes at risk of injury and losing playing time, 
medals, and privacy. No, schools are going to have to prove to 
Federal bureaucrats that allowing a biological male on a 
women's team would be unfair or unsafe in this particular sport 
with respect to these particular athletes.
    No school is going to want to take on that litigation risk. 
So, schools are going to allow biological males to compete on 
women's sports. This will directly and overwhelmingly harm 
female athletes who are far more likely to be displaced by a 
male athlete, than vice versa, and far more likely to face 
risks in private spaces like locker rooms.
    Even if it were a good idea to reduce educational 
opportunities for women like this, the Department of Education 
may not do so unless this body has authorized it, but Congress 
has done no such thing.
    The Department of Education says that the Supreme Court's 
decision in Bostock v. Clayton County means it can pretend that 
Title 9 addresses gender identity, but the Department of 
Education is wrong. In Bostock, the Supreme Court said that 
Title 7 of the Civil Rights Act prohibits employers from firing 
someone just because they are transgender. The decision says 
that an employee's sex is not relevant to the selection, 
evaluation, or compensation of employees.
    Athletes in education, however, is governed by a different 
law, Title 9. When it comes to athletes, sex is not only 
relevant, but also often dispositive. As superstar Serena 
Williams said, ``Men's and women's tennis are completely 
different sports.''
    We live in a Nation of laws and not bureaucratic command. 
That means the Department of Education must find its 
authorities in the laws that this legislative body has 
considered and passed. It may not use gender ideology to twist 
a simple antidiscrimination statute into a statute that reduces 
opportunities for women.
    Thank you.
    [The prepared statement of Ms. Mailman follows:]

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    Mr. Johnson of Louisiana. Thank you, Ms. Mailman.
    Mr. Minter, now you may begin.

                  STATEMENT OF SHANNON MINTER

    Mr. Minter. Thank you.
    My name is Shannon Minter. I am the Legal Director of NCLR. 
It's a legal organization that represents LGBTQ people.
    In my 30 years with NCLR, 20 years as its Legal Director, 
I've represented many transgender young people in cases 
involving discrimination and harassment in schools, in the 
child welfare system, the healthcare system, other areas. 
Recently, I've been involved in Federal challenges to State 
laws that ban medical care for transgender younger people and 
completely banned them from school's sports.
    I really appreciate the opportunity to address this 
Committee.
    Parents should have the freedom to make healthcare 
decisions for their transgender children. Parents want what's 
best for their children. Americans differ about a lot of 
things, but there is one point on which we strongly agree, and 
that is that parents, not the government, are best situated to 
make medical decisions for their own children.
    There's a lot of misinformation about transgender children, 
youth, and adolescents. Gender dysphoria is very rare, less 
than one percent of the population. Most people in this country 
don't know a transgender person, much less have they met 
parents with transgender children.
    For most people and most legislators, this seems like a new 
issue, but medical care for transgender adolescents has been 
available for more than 20 years. The very same medications 
being prescribed for transgender youth have been prescribed for 
other young people for other conditions for more than 40 years.
    There is a substantial body of research that shows these 
treatments work; they improve mental health outcomes, quality 
of life, social relationships, and family relationships. They 
dramatically reduce suicidality. One Federal judge, after a 
full trial, said there is now extensive clinical evidence 
showing excellent results for these treatments.
    The medical standards for these treatments, as has been 
noted, have been endorsed by every major medical association in 
this country: The American Medical Association, the American 
Academy of Pediatrics, the American Psychological Association, 
and many more.
    These standards, they're evidence based. They require a 
rigorous, multidisciplinary assessment before diagnosing the 
child with gender dysphoria. They take a conservative approach 
to treatment.
    Those standards have been in place for a long time. They 
are not new. What is new is this recent massive overreach by 
State lawmakers to ban medical care for transgender youth. 
These laws, these recently passed State laws, they prevent 
doctors from doing their job. They prevent parents from getting 
the medical care that their children need.
    That is why every Federal District Court, all six of them, 
after hearing all the evidence, have concluded these bans 
violate parents' rights. They violate equal protection. The 
claims they put forward to justify, justify the bans have no 
basis.
    These decisions, as has been noted, have been issued by a 
wide range of judges: Arkansas, Alabama, Florida, Indiana, 
Kentucky, and Tennessee. In every case, the State officials 
supporting these bans had every opportunity to back up their 
false claims with actual evidence. In each case, they have 
failed.
    These bans pose a serious threat to the health and safety 
of transgender young people across the country, and I urge the 
Members of this Committee to reject any Federal attempts to 
replicate that harm.
    As a transgender person myself, I have benefited from 
decades of access to healthcare, legal equality, support. I've 
been able to marry, have a family, pursue a career, participate 
in my local church, and community.
    It is very disheartening to see the protections that have 
given me and other transgender people so many opportunities to 
thrive and to succeed now just being needlessly taken away from 
young people.
    Healthcare bans conflict with medical expertise. They rob 
parents of their right to make decisions for their children. 
They have devastating consequences for young people's lives.
    Decisions about children's medical care should be made by 
the parents who love them, not by politicians who know nothing 
about a child's life or history or circumstances, and who won't 
be the ones having to watch a young person they love suffer the 
devastating consequences of going without needed medical care.
    Thank you.
    [The prepared statement of Mr. Minter follows:]

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    Mr. Johnson of Louisiana. Thank you, Mr. Minter.
    Dr. Bauwens, last, but not least, you may begin.

                 STATEMENT OF JENNIFER BAUWENS

    Ms. Bauwens. Chair Johnson, Ranking Member Scanlon, Members 
of the Subcommittee, thank you for the opportunity to speak 
with you today.
    My name is Dr. Jennifer Bauwens, and I'm a licensed 
therapist, clinical researcher, currently serving as the 
Director of the Center for Family Studies at Family Research 
Council.
    Based on over 25 years of experience as a clinician 
providing trauma therapy to children, and as a researcher 
investigating the psychological effects of trauma stress, I'm 
here to express my concern about what has been termed gender-
affirming care.
    I've considered it a privilege to practice, research, and 
train future clinicians, and be a part of a discipline aimed at 
protecting and bringing healing to the most vulnerable in our 
society, which are children. When it comes to gender transition 
procedures, my field is not operating as a helping profession. 
Instead, it is actively causing harm.
    Historically, children have been treated as a special and 
vulnerable class in the psychological and research fields. 
Caution has been applied to children, in light of the fact that 
they do not have the neurological capacity to understand 
lifelong decisions.
    Professional and research ethics tell us that we should 
proceed very cautiously with regards to interventions for 
children when empirical evidence is weak or the research 
methods are in the early phase, as with this case. We should 
avoid interventions that pose unnecessary risks, particularly 
when the symptoms are known to change with maturation.
    Risk avoidance is not what's happening with gender 
transition procedures. Instead, we have too many cases like 
Mike. Mike was nine years old when he first saw a gender 
therapist. I was deeply saddened when I read his gender 
therapist's case notes, where it was reported that Mike 
couldn't distinguish between fantasy and reality.
    Instead of investigating these symptoms, the therapist 
wrote in the treatment plan, which included puberty blockers, 
guidance on social transition, and education for future 
hormonal and surgical procedures. This treatment plan was 
enacted without regard for this child's known diagnoses of 
autism, possible OCD, and possible parental diagnoses which 
were reported in the case notes.
    Mike is just one example of how so-called gender-affirming 
care is in direct opposition of knowledge, of our knowledge 
regarding development and our understanding of good research 
and treatment. There are many reasons why I have concerns, but 
I will just share a few with you:
    (1) These interventions are being endorsed based on 
consensus, not evidence. In the case of gender-affirming care, 
the term ``evidence-based'' does not mean that this practice is 
standing on the merits of solid research findings addressing 
gender dysphoria. Instead, it refers to a vote by those who are 
ideological supporters of the practice. Compared to other 
psychological disorders found in the DSM-5-TR, gender dysphoria 
is currently being treated with the most invasive, invasive 
interventions connected to a psychological issue with the 
lowest quality of evidence to support that practice.
    (2) The success rates of nonintervention for gender 
dysphoria for children already exceed what most psychological 
interventions have. In most cases, 85 percent or more of those 
experiencing gender dysphoria will desist if they are left 
alone. This is a higher rate than most well-established and 
researched psychological interventions. With success rates this 
high, it is actually unethical to intervene.
    (3) The research and practice around this issue does not 
properly account for competing diagnoses and variables. So, in 
one example, a report from the UCLA Williams Institute found 
that 45 percent of transgender-identifying people reported 
childhood sexual abuse.
    As a trauma clinician, I can tell you that, when someone 
experiences sexual trauma, it is not uncommon for that person 
to hate parts of their body or want to get rid of those aspects 
of themselves that made them vulnerable to abuse.
    (4) It is often claimed that a failure to provide these 
interventions increases the risk for suicide. This approach is 
actually unethical and it's a clear departure from the practice 
of empowerment and self-management, which are important goals 
of mental health practice.
    This claim is, also, not supported by the literature. 
Despite years of empirical study, there is no definitive 
understanding of the etiology in the suicide literature.
    (5) After review of the literature, other countries have 
actually backed away from gender transition procedures, and the 
list now includes the United Kingdom, France, Finland, Norway, 
Australia, and Sweden.
    (6) Gender-affirming care has created a monopoly on 
treatment options, as it demands that it is the only way to 
treat gender dysphoria. By comparison, we can look at Cochrane 
Collaboration, for example. There are 245 meta-analytic reviews 
of varied treatment options for depression. Yet, when it comes 
to gender dysphoria, there is only one path currently 
prescribed to help someone, and that's to become someone else.
    Researchers and clinicians should be innovating solutions 
to heal the stress, not coercing kids onto a path that tells 
them that they need to remove or change physical parts of who 
they are to be whole. This is why I'm calling on you to act on 
behalf of children.
    Thank you.
    [The prepared statement of Ms. Bauwens follows:]

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    Mr. Johnson of Louisiana. Thank you.
    I'm sorry for that buzzer background noise. It didn't 
rattle you at all.
    We will now proceed under the five-minute rule with 
questions, and the Chair recognizes, first, the gentlewoman 
from Wyoming for five minutes.
    Ms. Hageman. First, I want to say thank you for being here. 
You are four incredibly brave women and you're my heroes.
    You have been willing to put yourselves out there to 
address something that many people want you to stop talking. 
They want to prevent you from talking. Don't listen to them. 
Make sure that you continue to use your voice to educate us, to 
educate the American people, because these children are worth 
saving.
    Dr. Bauwens, I want to thank you for being here.
    In your testimony, you reference what I think is one of the 
more important points in this debate, in that children are 
treated as special and a vulnerable class in the psychological 
and research fields. You reference the experience at Tuskegee. 
To me, the important takeaway here is that controversial so-
called healthcare practices, treatments, and experience have 
not always withstood the test of time.
    Outside of your reference, I think of how lobotomy was once 
a form of care we wouldn't even consider today and, in fact, 
has been banned in countries throughout the world.
    In this debate, I have wanted to replace the misleading 
terminology ``gender-affirming care,'' especially as it relates 
to children.
    (1) It replaces the biological reality of sex, and
    (2) It falsely suggests that, using term ``affirming,'' 
that there is anything good going on here.
    There are only two sexes. Boys are girls--or boys are boys 
and girls are girls, and one cannot become the other.
    In fact, and especially when it comes to children, it seems 
to me that gender-affirming care is better described as 
``sexual lobotomy.'' It is treatment that is fundamentally and 
permanently--that fundamentally and permanently alters the 
sexuality and medical and psychological well-being of these 
patients. It causes irreversible sterilization and serious 
long-term medical complications and long-term reliance on 
pharmaceuticals.
    These treatments and surgeries are controversial medical 
practices that seek to change a person in a manner which is not 
actually achievable, and they will not withstand the test of 
time.
    Dr. Bauwens, are there medical professionals in the United 
States and abroad already rejecting these surgeries as any form 
of serious medical care?
    Ms. Bauwens. Yes. Thank you for your question--or your 
question.
    We are seeing an increase of medical professionals speaking 
out. Just this past week, there were 21 doctors that came out 
and said, ``We are very concerned about this.''
    The AAP, American Academy of Pediatrics, was referenced 
earlier. Eighty percent of their membership has been asking for 
a review of the literature, and they've been denied that review 
by the upper echelon. So, there are--and I've listed many other 
countries--there are people who are standing up because they're 
seeing the harms done to these kids like Chloe Cole.
    Ms. Hageman. Can you discuss why referring to these 
treatments as lifesaving treatment is so extremely misleading?
    Ms. Bauwens. Yes. It's misleading for a number of reasons. 
Because, for one, the whole impetus of the scientific method is 
that we're discovering things. We're supposed to be in a 
process of, ``Isn't this the right approach, or not?''
    This whole discussion about saying that it's lifesaving 
automatically says there's no room for discussion; there's no 
room for scientific inquiry because the science is settled, 
which it's an amazing statement because the suicide literature 
has been around far longer than the transgender literature, and 
the suicide literature is not conclusive.
    So, we have where the right hand doesn't know what the left 
hand is doing in this case.
    Ms. Hageman. It seems to me what we've been living through 
for the last couple of years is a government that wants to 
suppress any type of speech that it disagrees with. We're 
seeing that with the industrial censorship complex that we've 
been talking about.
    It seems--it appears that's exactly what's going on here. 
They want to stop the debate because they know that they can't 
win it.
    Dr. Bauwens, my last question is, what is the success rate 
of sex change operations?
    Ms. Bauwens. Well, we have--it's hard to find longer-term 
data with children. What the data that we do have, which is 
probably the most reliable data point available, is from the 
Swedish study. It looked at over 10 years, which is really 
important because regret doesn't just happen a year after some 
sort of transition. What you see is a suicide rate that's 
associated with 19 times higher than the general population.
    Ms. Hageman. Well, actually, there is a zero percent--
there's a 100 percent failure rate for sex change operations, 
isn't there, because it's not possible to change your sex?
    Ms. Bauwens. That's right.
    Ms. Hageman. A hundred percent failure rate for these 
procedures?
    Ms. Bauwens. That's right, you can't change your sex.
    Ms. Hageman. Thank you, and I yield back.
    Mr. Johnson of Louisiana. Thank you.
    The gentlelady yields back.
    The Chair recognized the gentleman from New York for five 
minutes.
    Mr. Nadler. Thank you, Mr. Chair.
    Mr. Minter, a Federal court has stated that, quote,

        Under the WPATH standards of care and Endocrine Society 
        guidelines, before puberty, treatments focused on support for 
        the child and family. Some prepubertal children may socially 
        transition. No medical interventions are indicated or provided 
        for the treatment of gender dysphoria in prepubertal children.

Do you understand this to be a correct statement?
    Mr. Minter. Yes.
    Mr. Nadler. Talk to the mic. Yes.
    Mr. Johnson of Louisiana. It's actually not--is the button 
red? Sorry.
    Mr. Minter. OK, there you go. My apologies.
    Yes, sir, that is 100 percent correct. Before puberty, 
there are no type of medical or medication interventions 
whatsoever. We're talking about transgender adolescents who's 
hit puberty and who would be eligible to be considered, when 
it's medically appropriate.
    Mr. Nadler. Thank you.
    What does the Federal court mean in saying that, quote, 
``No medical interventions are indicated or provided for the 
treatment of gender dysphoria in prepubertal,''--actually, you 
just answered that.
    What does the Federal court mean in saying that, ``Some 
prepubertal children may socially transition.''?
    Mr. Minter. Yes, the only type of medical support or 
support offered to a transgender youth before puberty is to 
just let them be who they are. I can't stress enough; this 
isn't about kids becoming someone they're not. This is about 
kids being who they are. So, just allowing them to live with a 
name, clothing, et cetera, that reflects who they really are.
    It's remarkable; they found that when--research has found 
that, when children are supported in that way, they are 
indistinguishable in terms of their mental health outcomes from 
nontransgender kids. They're just as healthy and really thrive 
when they get the support, that simple support that they need.
    Mr. Nadler. Thank you.
    Mr. Minter, what have courts said about laws that restrict 
transgender individuals' access to medically necessary care?
    Mr. Minter. That they severely burden parents' fundamental 
rights to make medical decisions for their own children, and 
that they're blatantly discriminatory; that they violate the 
guarantee of equal protection, because they do something that 
has just never been done before in this country, which is 
single out a particular group of people, transgender young 
people to deny them medical care.
    Mr. Nadler. Thank you.
    Mr. Minder, a Federal court has stated that, quote,

        The risks of gender-affirming medical care are not 
        categorically different than the type of risks that other types 
        of pediatric healthcare pose. For many adolescents, the 
        benefits of treatment greatly outweigh the risks.

Do you agree with this statement?
    Mr. Minter. Absolutely.
    Mr. Nadler. What are the benefits of receiving gender-
affirming care?
    Mr. Minter. They're enormous. They produce positive mental 
health outcomes for these young people. They dramatically 
improve their quality of life. They do better in school. They 
develop positive social relationships. We heard that with Ms. 
Reynolds' testimony. Their relationship with their family 
improves. Their gender dysphoria is alleviated, and any 
depression, anxiety, suicidality is dramatically reduced. 
There's a study from 2022 that found a 73 percent reduction in 
suicidality among kids who had received this treatment.
    Mr. Nadler. Ms. Reynolds, thank you very much for being 
here today.
    Is there anything about you, your son, and other families 
like yours that you think this Subcommittee and the American 
people should know?
    Ms. Reynolds. I would like to just add one thing, if I 
could. That is, with the sports debate, I just want to share my 
son's process was with that.
    So, as I mentioned, he was the only girl on the boys' team 
for many, many years when he was a child. When he transitioned, 
he completely dropped out of playing sports altogether. So, 
that left a big hole in his life. That's nothing that he did 
anymore, and it was because he felt the pressure from all this 
kind of political discussion around this, and dropped out 
completely. I think that story is probably way more common than 
the isolated cases.
    Mr. Nadler. Thank you.
    Mr. Minter, what would you say about what we heard from Ms. 
Cole about her experience with gender care and her unfortunate 
experience?
    Mr. Minter. I thank her for sharing that story.
    How I'd respond, the most important thing to understand, 
that story is the exception, not the rule. The vast majority of 
young people who receive these treatments are getting them 
after careful assessment and because they really need them.
    This has actually been studied. We know that 98 percent of 
young people who receive these treatments continue to receive 
them into adulthood. What that reflects is the care behind 
these standards of care and the assessment process, and the 
care with which gender specialty clinics in this country are 
providing this care.
    Mr. Nadler. So, she is part of the two-percent?
    Mr. Minter. Apparently so.
    Mr. Nadler. Thank you.
    My time is expired. I yield back.
    Mr. Johnson of Louisiana. The gentleman is out of time. 
Thank you.
    The Chair recognizes the gentleman from California for five 
minutes.
    Mr. McClintock. I wonder, first, if Ms. Cole would like to 
respond to that.
    Ms. Cole. I didn't see a trans-identifying child who had a 
positive outcome with their transition.
    The reason why most children who are affirmed continue on 
in transition, either as adolescents or as adults, is because, 
once you've either socially transitioned or gone on blockers, 
or started the other interventions, like surgery or hormones, 
it's incredibly difficult to go back. The social ramifications 
are--
    Mr. McClintock. So, it's irreversible and they have no 
choice at that point, is what you're saying?
    Ms. Cole. In every single way.
    Mr. McClintock. There are two aspects to the question. Let 
me dispose of the first one involving sports, the fairness of 
allowing biological males to compete against females in sports. 
The second is a more complicated one, whether children should 
be subjected to irreversible transgender surgical or chemical 
procedures at all.
    Ms. Scanlan, can you tell me if a female claiming to be a 
male has ever dominated in men's sports?
    Ms. Scanlan. No. Actually in my league, there isn't two 
instances where the female athlete transitioned to the men's 
side.
    Mr. McClintock. So, this is very much a one-way street.
    Ms. Scanlan. Yes.
    Mr. McClintock. It is biological males competing against 
women dominate those sports. There is not a case of a 
biological female going transgender and dominating a male 
sport. Am I correct?
    Ms. Scanlan. Yes, you're correct. It's obvious that would 
be the case because--
    Mr. McClintock. In this case, it is simply--this is an 
attack on the integrity of women's sports. I wonder why my 
Democratic colleagues who often posture as feminists can't see 
this plain truth.
    Ms. Scanlan, what would be wrong with simply allowing 
transgender men and women to compete in their own sports 
competition while we preserve the fairness of women's sports?
    Ms. Scanlan. Yes, I believe all individuals should have a 
right to play sports. I think sex-based categories make the 
most sense.
    Mr. McClintock. So, transgender males should be allowed to 
compete with other transgender males in their own sports 
category. Nobody's got a problem with that, I think.
    Ms. Scanlan. Yes. If that's what governing bodies decide is 
a fair solution, then I'm for that. I believe that female 
sports should be protected, and female sports teams should be--
    Mr. McClintock. Now, the more weighty question is who 
should make the decision to subject a child to such a procedure 
on behalf of that child?
    Ms. Scanlan. Nobody.
    Mr. McClintock. Well, long before governments existed, 
there were mothers and fathers who had children. So, the family 
is the most fundamental governing unit. It's established by 
nature itself. So, I think it therefore follows that parents 
have a fundamental natural right to raise their children 
according to their own best judgment.
    It can't be absolute, of course. You can't kill them. You 
have to feed them and clothe them and shelter them. Society has 
a role to play in being sure that you do. It is intrusions into 
the decisions of parents over the raising of their children. 
That needs to be very cautious, very limited, and very humble.
    Now, the Ranking Member, in her opening statement, makes 
this point, once you strip all of the partisan rhetoric. It 
seems to me there are two issues here. The first is the effort 
in States like California to bypass parent's judgment and 
subject their children to transgender procedures against the 
parent's judgment or even to hide this from the parents. That 
is going on in California right.
    So, I want to be sure I understood the Subcommittee's 
Ranking Member correctly. It sounded like she, too, opposes 
government replacing parent's judgment over the decision on 
transgender procedures for their children. Am I correct on 
that? Am I correct on that? I yield to the gentlelady to 
answer.
    Ms. Scanlon. I'm sorry. I was--
    Mr. McClintock. It sounded like you opposed government 
replacing parent's judgment over the decision of transgender 
procedures on their children. Am I correct on that?
    Ms. Scanlon. What I said was that parents have the ultimate 
right to make the decisions concerning appropriate medical care 
for their children.
    Mr. McClintock. Then I think we're in agreement. We can 
take that off the table. Both parties oppose the government, 
any government, making decisions over whether a child will be 
subjected to transgender procedures contrary to the wishes of 
the parents. Do I understand that correctly?
    Ms. Scanlon. I believe that is generally the legal 
standard, yes--
    Mr. McClintock. OK. That's great. Then we need to take it--
    Ms. Scanlon. --over what is appropriate apparently.
    Mr. McClintock. If both parties support a law that forbids 
performing these transgender procedures on a minor without the 
full and informed consent of the parents, then Mr. Chair, I 
believe we should advance such a bill right away. I think that 
would address the fears that I hear from a lot of parents that 
their desire to protect their child is at risk from various 
State governments like California who are trying to usurp that 
decision. We have complete agreement on that.
    Ms. Scanlon. I think you are mischaracterizing the complete 
agreement.
    Mr. McClintock. Well, I thought we had just arrived at that 
agreement until it comes down to actually doing it and then you 
seem to have a change of heart. Mr. Chair, let's put that to 
the test. I see I'm out of time. I think the sooner we move on 
that the better.
    Mr. Johnson of Louisiana. A very keen observation. The 
Chair now recognizes Ms. Balint, the gentlelady from Vermont.
    Ms. Balint. Thank you, Mr. Chair. I want to start by saying 
these issues are typical for most Americans to talk about. I 
want to bring us back to the basic dignity and humanity of all 
Americans full stop.
    Ms. Reynolds, I really appreciate you being here today. I, 
too, am a parent. I know that I would do anything that I could 
to get my children the care that they need. Implied in what 
you've said is that journey was not always easy for you.
    I'm wondering if we could bring it back to the experience 
of real parents, real Americans right now who are trying to 
wrestle with these issues. Just tell us a little bit more, if 
you could, about your experience of trying desperately to get 
your child to support that you felt like they needed, and you 
didn't always know what that was.
    Ms. Reynolds. So, when my child came out as transgender 
there was not sort of the hysteria that there is now about 
this. So, there was not a lot of information. We didn't know 
anyone. We didn't know other parents. We didn't know other 
kids.
    So, if you can imagine late nights on the internet trying 
to find any information. Lots and lots of tears, lots and lots 
of discussions with my husband, what are we going to do? How 
are we going to support our child. Then we sort of put to the 
test the social transition. Then we spoke with experts, right?
    We took our time, and we learned, and we grew. As our child 
matured, that sort of changed things, too. It was painful. I 
don't want to--I sort of don't want to focus on the negative of 
all this, but it was extremely painful for us. It wasn't an 
easy choice. It wasn't anything that we took lightly. We took 
this extremely seriously. We were trying to get it right.
    Ms. Balint. So, is it fair to say that you tried to put the 
needs of your child at the center of all the decisions that you 
were making, difficult decisions in the face of a lot of 
stigma, and a lot of misunderstanding, and you said recently, 
the hysteria around this. Does the added stigma make it more 
difficult for parents in this situation to have the courage to 
stand up for their children? Like what is that when you feel 
like you are trying desperately to do the right thing, and 
you're hearing all these voices that you are not being a good 
parent?
    Ms. Reynolds. It's absolutely heartbreaking actually. I've 
spent my entire career trying to help people, particularly 
children. That is what I do. To sort of be looked at as a child 
abuser or an indoctrinator or something like that, it's 
extremely painful and just adds a whole other layer to this. It 
feels very hateful and divisive.
    Ms. Balint. I really appreciate you saying that because I 
think there are a lot of parents across the country right now 
that are trying their level best to do right by their children. 
This kind of heightened hysteria around this issue is making it 
very difficult for them to do that. So, I wanted to bring this 
hearing back to basic humanity and dignity because I feel like 
we have gone astray. That's the first thing I want to say. So, 
thank you for being here.
    For Ms. Cole, I also want to thank you for being here. I am 
very sorry you feel like you didn't get the care that you 
needed and deserved.
    Ms. Cole. Thank you.
    Ms. Balint. You're welcome. Mr. Minter, if you could talk 
to us about gender-affirming care, what does that look like for 
young kids? What are we talking about when we talk about 
gender-
affirming care for young children?
    Mr. Minter. For young children, we are simply talking about 
parental love and support, not trying to change the child, 
recognizing that the child is transgender, and allowing them to 
be who they are, and encouraging others, family members, to do 
the same. It's really just loving and supporting a child.
    Ms. Balint. I really appreciate that. Again, let's get back 
to the basic humanity and dignity of all. The last thing I want 
to say, in his opening statement, the Chair said, ``there is no 
such thing as gender assigned at birth.''
    I just want to be on the record here as standing up for the 
5.6 million Americans who are in intersex. Actually, that is 
exactly what the experience that they had was they were having 
their gender assigned at birth, and they are Americans, too. 
They are trying to navigate this.
    There are atypical chromosome patterns, gonads and 
genitals, that do not fit typical binary notions of male and 
female. That does not make them less American or less 
legitimate or less worthy of dignity and respect. I yield back.
    Mr. Johnson of Louisiana. The gentlelady yields back. The 
Chair now recognizes the gentleman from Texas, Mr. Hunt.
    Mr. Hunt. Thank you, Mr. Chair, and thank you brave ladies 
for being here today. I greatly appreciate it, and I admire 
your bravery in these times. Many of my colleagues on the left 
like to discuss gender-affirming care and claim that puberty 
blockers and hormone therapy and sex reassignment surgery are 
the only ways to treat gender dysphoria.
    Once a child expresses a feeling of gender dysphoria, 
instead of questioning the root cause of that feeling, that 
child will more likely than not be on a fast track to gender 
reassignment surgery, or otherwise known as genital mutilation.
    I want you to imagine something. What if we affirmed every 
thought that our children have? I would like to show you a food 
pyramid. Now, I know what you are thinking. This is not the 
FDA's approved food pyramid although many of you probably wish 
it was.
    This is the food pyramid according to my four-year-old and 
my two-year-old daughters. By the way, in the Hunt house, we 
don't do Ben and Jerry's. It's Blue Bell only. If my children 
had their way, they would have ice cream for breakfast, lunch, 
and dinner, and for every single meal in between. Oh, the 
wisdom of children.
    In the same country, we know that children are mature 
enough to make adult decisions that will impact the rest of 
their lives. That is why we have parents. Children cry for ice 
cream, but as parents, we have the wisdom to know that ice 
cream is not in their best interest, particularly their long-
term interest.
    I want to thank my parents, Willie and Diane Hunt. They had 
three children. All of us three went to West Point. All three 
of us served our country. All three of us earned multiple 
master's degrees from Ivy League schools. Do you know why? 
Because my parents did not give in to the thoughts of an 
adolescent Wesley Hunt.
    I am a United States Congressman because my parents didn't 
listen to me when I was eight years old. They raised us. They 
cared for us. They taught the ways of being successful people.
    As an adult, you can do whatever you want with your body 
and with your own money. You are mature. You are fully grown. 
You can make adult decisions.
    I am a combat veteran. I fought for the right for you as an 
adult to make your own decisions. In my opinion, children are a 
different story. It is our obligation to protect them.
    When it comes to gender dysphoria in children, many in the 
American medical establishment have absolutely lost their 
minds. A child will tell their parent they have thoughts of 
gender dysphoria, and the parent may take that child to a 
doctor. The doctor, instead of questioning the root cause of 
the dysphoria, will instead affirm the child's thoughts and 
proceed with gender-affirming care.
    Is many of my colleagues on the left want you to believe, 
there isn't widespread agreement on how to treat gender 
dysphoria. I can assure you that child mutilation is not the 
answer. In fact, Finland, Sweden, France, and the UK, are 
reversing course and asking questions. In the UK, their only 
national gender clinic for children shut down last year by 
court order, what do their doctors know that our doctors don't?
    I am sorry we are here right now. I am sorry, Ms. Cole. We 
failed you. Ms. Scanlan, my daughters are going to watch this 
because you have become their new hero. I can assure you that 
my four-year-old and my two-year-old daughters will not change 
in front of biological men. This is ridiculous.
    I don't care what party you are a part of. If you think 
that we are all equal and the same biologically, you have 
literally lost your mind. When my two daughters work hard in a 
sport, work hard in their craft to be the best that they can be 
among other women, they will compete against other women. I owe 
Victoria and Olivia and every other young lady in this country 
that.
    If you think I am wrong, I am not the problem. I can assure 
you. We have an opportunity in this country to get this right 
in 2024, so we can stop all this foolishness. I cannot thank 
you ladies enough for bringing this up. I apologize that we 
live in America when this is happening. Thank God for the 
American spirit fire and thank God for brave women like you, 
because it's brave women like you that are going to turn the 
tide so that future women won't have to suffer in the same way 
that you have. God bless you.
    Thank you so much for being here. I yield back the rest of 
my time.
    Mr. Johnson of Louisiana. Thank you. The gentlemen yields 
back. The Chair next recognizes the gentleman from Tennessee, 
Mr. Cohen.
    Mr. Cohen. Thank you, Mr. Chair. First, I would like to 
quote Judge Moody from Arkansas, a Federal judge. He said,

        The diagnosis of gender dysphoria is made by a clinician who 
        assesses whether a patient meets criteria based on a clinical 
        interview, the clinician's observations of the patient, and the 
        reports of the minor's parents.

This is how diagnosis of other mental health conditions are 
generally made.
    Gender dysphoria is a serious condition that if left 
untreated can result in other psychological conditions 
including depression, anxiety, self-harm, suicidal behavior, 
and impairment of functioning.
    So, these things need to be discussed and determined in a 
scientific manner and a logical manner, not emotion, not 
behavior and attitudes that appeal only to voters in trying to 
gain votes at the ballot box. This should be done responsibly.
    Transgender people have been around for a long time. They 
have rights, and they need to be respected. I read Ms. 
Scanlan's testimony. I wasn't here to hear it, and I think Penn 
didn't deal with your situation like they could have and should 
have in putting up some type of different barriers in the 
women's area of the locker room, but that's another issue. 
Things should be dealt with in a different way.
    This is an easy way for people to try to get points. Pick 
on a minority group that is the most minority and least 
understood in our country. It's gone on for centuries. A 
hundred years ago, it was African Americans. Later it was 
Hispanics, then it was gay people, and now transgender people. 
Find a group that is not understood and is easy to use to gain 
political power. If it is bad for politics, it is bad for 
people, you should use science.
    Parents have rights in raising their children. Athletes 
have rights. There is a connection. We need to figure out the 
right answer. To get the right answer, we need to ask the 
medical association and the psychiatric association to choose 
the people that come before us to testify and give us their 
opinions on the right way to deal with this issue. Not each 
group picking people that are favorable to them to put out 
divergent issues, but people who are experts based on the AMA, 
the American Psychiatric Association, and maybe another 
association similar where they pick the witnesses and send them 
to us to talk about the issue and to suggest a response that 
would be both fair to the transgender's parent, the transgender 
child, and the society at large.
    The Republicans didn't want vaccines and face masks, and 
they argued that parental rights were sacrosanct then, and 
parents had a right to direct healthcare decisions for 
children. Well, a lot of people died, tens and hundreds of 
thousands of people died because they didn't get vaccinated.
    Gender-affirming surgery, the Republicans think the 
government should make these sensitive decisions. It's not 
necessarily the case.
    They also believe Americans only have access to healthcare 
if their healthcare match Republican radical beliefs. 
Republicans fought against the Affordable Care Act. They fought 
and refused to expand Medicaid in States leaving millions 
without healthcare coverage, 120,000 in my State, Tennessee not 
getting healthcare coverage when the Federal Government would 
have funded.
    They passed countless abortion bans depriving women of safe 
reproductive healthcare. They spread misinformation to try to 
undercut medical experts during the COVID pandemic, 
particularly in Florida. Now, they are trying to limit gender-
affirming care for transgender youth. Limiting access to 
healthcare, wedging the right-wing ideology into the exam room, 
and substituting their personal beliefs for the professional 
judgment of doctors, they are causing needless suffering.
    In the past two Congresses, I Chaired this Subcommittee. 
When the Republicans took control, they changed the name, which 
used to be the Constitution, Civil Rights and Civil Liberties 
Subcommittee. They changed it to Constitution, I imagine with a 
small c, and limited government. Civil rights and civil 
liberties were out the window.
    I was disappointed, not totally surprised, that civil 
rights and civil liberties were removed. What I didn't 
understand, is how this has anything to do with limited 
government. This does not have to do with a limited government. 
There is nothing limited about asserting the preferences and 
beliefs of Federal legislatures into individual healthcare 
decisions about young people. It is intrusive, and it is 
dangerous. I yield back the balance of my time.
    Mr. Johnson of Louisiana. The gentleman yields back. The 
Chair now recognizes the gentleman from South Carolina. First, 
seeking unanimous consent to allow the gentleman from Florida, 
a Member of the Full Committee, to participate and have the 
time waived to him for the Subcommittee proceeding.
    Mr. Nadler. Mr. Chair, I object. I withdraw the objection.
    Mr. Johnson of Louisiana. Thank you. Thank you. The Chair 
recognizes the gentleman from South Carolina, Mr. Fry.
    Mr. Fry. Mr. Chair, I would like to yield my five minutes 
to the gentleman from Florida, Mr. Matt Gaetz.
    Mr. Gaetz. I thank the gentleman for yielding. Ms. Scanlan, 
we just heard my Democratic colleague, Mr. Cohen, say that your 
circumstance could have been fully resolved if we would have 
just had some barriers up in the women's showers. Do you think 
that this is a sufficient way to resolve what we are dealing 
with here?
    Ms. Scanlan. I think by Representative Cohen admitting that 
we need barriers acknowledges there are biological differences 
between men and women. By acknowledging that we need to have 
private spaces that are separate from each other, why can't we 
just use the locker rooms that we have always used, the men's 
and the women's locker rooms? If you are acknowledging that we 
need protection and privacy from these men, then you are 
acknowledging that the locker rooms we have always used are the 
correct ones.
    Mr. Gaetz. My next question is for Shannon Minter. Are you 
familiar with the changes in law recently in Washington State 
regarding transgender youth?
    Mr. Minter. Yes.
    Mr. Gaetz. As I understand it, it used to be the case in 
Washington State that if a youth showed up at an emergency 
shelter, there was a legal requirement to notify the parent 
within 72 hours in the absence of some abuse or neglect. Is 
that your understanding of what the law was then?
    Mr. Minter. I believe that is correct.
    Mr. Gaetz. Then the law changed where now in Washington 
State if someone shows up to one of these shelters who is a 
minor and says that their parents don't agree with them 
changing their gender that the shelter no longer has to notify 
the parents within 72 hours and can instead notify a government 
authority. Do I have that right?
    Mr. Minter. The parents will be notified. There is no 
question about that. This simply allows for a delay to allow 
them to investigate to make sure this child is going to be 
safe. There is no question that the parents will be notified.
    Mr. Gaetz. How long should parents have to wait not knowing 
where their child is, while a government process is playing out 
to make a gender determination?
    Mr. Minter. There is no reason to treat these situations 
with transgender young people who may be in danger or at risk 
of abuse at home any differently than we would treat any other 
child where we would have reasonable basis to worry about that 
and to investigate that.
    Mr. Gaetz. It does treat them--
    Mr. Minter. A short delay to protect the safety of young 
people is always--
    Mr. Gaetz. Hold on. How long is the delay? How long do you 
want a parent not knowing where their kid is, because the kid 
says they want to change their gender? Just tell me how long a 
delay you think is appropriate?
    Mr. Minter. I want authorities to treat these kids with the 
same care they treat all other children.
    Mr. Gaetz. That's--
    Mr. Minter. It will be a short delay, and the parents will 
be notified.
    Mr. Gaetz. Hold on now because--well, you won't tell us how 
long a delay. So, if you are watching this, just imagine you 
are that parent, and you don't know where your child is. The 
law now says there is a 72-hour period where the shelter has to 
notify you. That 72-hour period for any child of any gender or 
any circumstance is a period to investigate whether there is 
abuse in the home. Beyond that, beyond 72 hours, you have got 
to tell the parent.
    So, it is really important to understand here what the 
proponents of radical gender ideology want. They want to stand 
between a parent and a child on these important decisions. I 
don't think it is abuse if a parent says, I am not going to get 
my child gender blockers.
    It is odd to hear you advocate for the law because just 
moments ago, in testimony, you said, and I wrote it down, 
``parents have a fundamental right to make healthcare decisions 
regarding their children.''
    If in Washington State today, the parent makes the decision 
that they are not going to provide that gender affirming care, 
what it does it unlocks for the government a window of time to 
keep the child away from the parent and to not tell the parent 
where the kid is.
    Participant. Murderer.
    Mr. Gaetz. Oh, please. Get over yourself. What's terrible 
is when you have this incongruent desire of the government to 
restrain the ability of parents to parent. I can only imagine 
the terror that a parent must go through not knowing where 
their child is. So, I think that is really challenging.
    We have also seen in the State of Alaska, Title IX, which 
was established for girls' sports to be used as a justification 
to socially transition a child against their wishes. Ms. 
Scanlan, as a beneficiary of Title IX, as a female athlete, do 
you think Title IX should be used in that way?
    Ms. Scanlan. Absolutely not. Swimming did a lot of really 
good things for my life. I am a sexual assault survivor, and 
swimming was the only things that I had to keep me going when I 
was struggling with that. To think about young girls that are 
not going to be given those same opportunities because Title IX 
is being reworked and rewritten for these new people that have 
different definitions of what a woman is.
    Mr. Gaetz. Yes. I am against transitioning children against 
the will of their parents, and I am against transitioning Title 
IX away from an asset for women's sports through this strange 
social justice cause that is deeply misguided. Thank you, Mr. 
Chair, I yield back.
    Ms. Scanlon. Mr. Chair, I seek unanimous consent to 
introduce into the record an article entitled, ``No, Washington 
Did Not Just Pass a Law Allowing the State to Kidnap and 
Transgenderify Children.''
    Mr. Johnson of Louisiana. Without objection.
    Ms. Scanlon. Thank you.
    Mr. Johnson of Louisiana. The Chair now recognizes the 
gentlelady from Texas, Ms. Escobar.
    Ms. Escobar. Thank you, Mr. Chair. Before I begin my 
questioning, I have to say this has been so deeply disturbing 
on a number of levels. What we have seen today is what we have 
been seeing this entire Congress, which is an effort by my 
Republican colleagues, and indeed some of the more extreme 
voices in the Republican party, to keep Americans on a 
treadmill of rage. Whatever the latest issue is that they want 
people to be angry about, they do their best to keep Americans 
on a treadmill of rage.
    They get their Fox or Newsmax or whatever right-wing media 
outlet of the moment is, they get their viewers. They get a 
clip from this hearing that gets displayed, it gets put on 
Twitter, and they make money. That's what all this is all 
about, unfortunately.
    I would like unanimous consent to enter into the record a 
couple of articles. The first is, ``Gender Affirming Surgeon 
Speaks at Jacobs School Event,'' dated June 9, 2023.
    Mr. Johnson of Louisiana. Without objection.
    Ms. Escobar. That article, we saw a clip earlier of Dr. 
Blair Peters. Had Dr. Peters actually been here, he could have 
helped dispel some myths. In fact, in the article you will find 
Dr. Peters saying very explicitly transgender kids do not get 
surgery, Dr. Peters said, ``directly refuting a key talking 
point for those trafficking in antitrans rhetoric.''
    The other article I would like to enter--I would like 
unanimous consent, Mr. Chair, to enter into the record, is an 
article entitled, ``I Don't Want to Live in this State of 
Terror Anymore. Some Families with Trans Children are Leaving 
Texas.'' If I could have unanimous consent to enter that into 
the record.
    Mr. Johnson of Louisiana. Without objection.
    Ms. Escobar. Thank you. Mr. Minter and Ms. Reynolds, thank 
you for being here to dispel some of these myths and to fight 
back against this effort to keep Americans on this treadmill of 
anger and rage.
    I would also--Ms. Reynolds, I want to apologize to you. One 
of my Republican colleagues made some really demeaning and 
belittling comments meant to humiliate and minimize the parents 
of trans children by comparing the very difficult, painful 
journey, and conversation with children about transitioning to 
allowing kids to eat ice cream all day every day. So, I want to 
apologize on behalf of what happened. I want to congratulate 
you for your courage to speak on behalf of your child and other 
children.
    I would like to ask you, Ms. Reynolds, I entered into the 
record this article about Texas. Texas has been a very hostile 
State to vulnerable populations. Can you tell me--and I 
listened very carefully to your journey. Can you tell us what 
happens when the government marshals all its energy and 
resources to harm families like yours?
    Ms. Reynolds. It is absolutely terrorizing is what it does. 
It is very--it creates another level of stress. I really can't 
even underState that, overState that. It is terrorizing. It 
really is.
    It is extremely stressful. It is extremely distracting. It 
produces all kinds of fear. I would have left Texas already if 
that were something that was financially feasible for my 
family, and it is not. My career is in Texas. My children are 
established there. They have their friends. They have their 
schools. They are there. We are here.
    Because of this, I would have been a political refugee to 
another State if I could afford to do that. So, we have no 
choice but to try to at least tell our story and see if anybody 
can hear sort of something a little more rational, something a 
little more like what families like mine are experiencing.
    Ms. Escobar. Thank you so much, Ms. Reynolds. I would be 
remiss if I didn't say, if Congress really wanted to protect 
children, my colleagues on the other side of the aisle would 
have joined with us in passing robust comprehensive gun 
violence prevention legislation. That would truly protect 
children. Thank you, Mr. Chair. I yield back.
    Mr. Johnson of Louisiana. The gentlelady yields back. The 
Chair recognizes the gentleman from California, Mr. Kiley.
    Mr. Kiley. I yield back to the Chair.
    Mr. Johnson of Louisiana. Thank you for yielding the time. 
Dr. Bauwens, can you define what gender dysmorphia is?
    Ms. Bauwens. Dysmorphia or dysphoria?
    Mr. Johnson of Louisiana. Well, there are two different 
terms?
    Ms. Bauwens. Yes. So, gender dysphoria is a diagnosis in 
the DSM, which is what we are talking about, I think.
    Mr. Johnson of Louisiana. Yes. So, is it increasing among 
our children now, this gender dysphoria?
    Ms. Bauwens. Yes, yes. The diagnosis has increased. I 
believe even from 2021 to current, there was like a 40 percent 
increase. The other thing is that we have also had a 
proliferation of gender clinics. So, 10 years ago, there was 
just maybe a few. Now, all of a sudden there are tons of gender 
clinics with a really steep curve of surgical markets expected 
to increase.
    Mr. Johnson of Louisiana. So, do you think social media has 
any role in this increase in gender dysphoria?
    Ms. Bauwens. Absolutely. We know that kids are being 
influenced. I have a list of--there are 40,000 subscribers to a 
detransi-
tioning site. I have a list of people who are willing to 
testify, not to mention those who are silent. I'm sorry. What 
was the question again?
    Mr. Johnson of Louisiana. Well, just about the role of 
social media and the influences there.
    Ms. Bauwens. Social media, yes. So, social media, 
especially with this age cohort has a very important role. The 
unfortunate thing, and which is actually the compassionate 
thing, would be if we were to begin to research why is there 
such an increase in diagnoses of gender dysphoria, and not just 
our pat answer of more people feel comfortable coming out.
    Why has the demographic flipped from mostly biological 
males experiencing gender dysphoria to biological females? So, 
we don't have answers to those questions, and yet we are 
plowing ahead with these procedures anyway.
    Mr. Johnson of Louisiana. Well, the evidence seems to show 
that there is sort of a rush to force gender transition or sex 
change procedures on children. Are we imagining that, or do you 
think that's actually happening?
    Ms. Bauwens. No, I don't think we are imagining that. I 
wish that some of the experiences that we have heard reported 
today were accurate for the population as a whole, but that is 
not what we are seeing. You can go on Planned Parenthood's 
website and see that if you want a testosterone or estrogen 
prescription, you can go there and get it in an hour. You you 
don't have to go through a rigorous assessment.
    I think if we had those markers in place, then you would 
see kids not running toward this kind of transition because I 
think the number is around 78 percent come to a clinical 
setting with at least three other--or at least some kind of 
diagnosis other than gender dysphoria.
    Mr. Johnson of Louisiana. I think it is an obvious fact 
that there are some industries that stand to benefit 
financially from all these procedures and all this 
experimentation. Are you aware of European nations putting a 
pause on gender transition procedures for minors?
    Ms. Bauwens. Yes. I think that is the issue that we are 
asking for. This is the compassionate issue. Let's review the 
literature.
    Mr. Johnson of Louisiana. Yes.
    Ms. Bauwens. Let's review, what does the science actually 
say? Not just from people who are supporters, either way, but 
what does the science say? Then what we are seeing is where 
countries, like the UK that shut down the Tavistock Clinic, you 
are seeing other countries like Finland, Norway, et cetera, 
that once they actually look at the science that is used to 
support these procedures, they back away from it because the 
evidence is actually very weak.
    Mr. Johnson of Louisiana. There are no reliable studies on 
long-term effects. We don't know.
    Ms. Bauwens. The longest one we have is Sweden because it 
goes 10 years. The reality is that a lot of people don't 
experience regret until like five-seven years after they have 
gone through these procedures.
    Mr. Johnson of Louisiana. I will have more time for 
questions for the panel. I know Ms. Cole is about to hit that 
button. I am coming back to you because I will have more time.
    I just want to note that on May 13, 2021, a Subcommittee 
Member here on the Judiciary, our colleague, Ms. Sheila Jackson 
Lee who walked in the room, I am going to quote because you 
said, I think it is up on the screen there, in essence, ``the 
brain doesn't fully mature until at least 25 years old.'' Does 
that tell us about high school students, middle schoolers and, 
yes, young people who make rash or irreverent or spontaneous 
decisions? Should that be their life? Now, admittedly she was 
saying this in the context of a criminal Subcommittee hearing. 
I think that is a truism. I think she stated an obvious fact 
that everybody should acknowledge.
    Unfortunately, I am out of time. I will have some more in a 
bit. The Chair now recognizes Ms. Jackson Lee. How about that 
introduction?
    Ms. Jackson Lee. Mr. Johnson, thank you for giving me that 
gift. You are absolutely right. That hearing, if I might quote 
it specifically as the Chair of the Committee, it was made 
during a Committee hearing entitled, ``The Juvenile Justice 
Pipeline and the Road Back to Integration.''
    The idea, Ms. Reynolds and Mr. Minter, was to save lives 
from young people being incarcerated for life. It was the 
individual young person making rash actions that would draw 
themselves into criminal life or criminal acts should that be 
the rest of their life.
    So, let me not step away from the idea that we want to save 
lives in many instances. Let me get to the point of this 
hearing since that was not relevant to this hearing, and it was 
on a completely different topic. Let me get to this point. Let 
me apologize for a hearing that frightens me.
    I have dealt with this issue for decades. I dealt with a 
young man named David Ritcheson, who was a gay young man, a 
young, young, young man, who in the place he lived, Texas, his 
life was not affirmed. He lived in a skin of concern and fear 
and, ultimately, he was sodomized. We introduced legislation of 
the David Ritcheson Anti-Hate Legislation because as a gay 
young man who lived life differently, he was not affirmed. 
Ultimately, even though he got past this case, he ultimately 
committed suicide.
    So, let me, as I begin my questioning, tell you how fearful 
I am that the intervention of this Committee on issues of 
private healthcare determination frighteningly label the trans 
community in a way that someone is being intimidated in fear 
and concern for their life or their personal thinking is that 
they are not worthy. They are not entitled to good healthcare 
and that their life is not worth it.
    I insist on pronouncing today, your life is worth it. Your 
son's life is worth it. Your daughter's life is worth it 
however they are transitioning and as they live their life. I 
plead and beg for those who might be listening know that we do 
not believe that this is a question for this Committee. It is a 
question for healthcare, for your parent or loved one or 
guardian and as well your personal determination.
    I will not pretend to be a scriptured person. I am not 
ordained. I am not in any leading religious organization as a 
religious leader, but I have spoken to persons who lead. They 
have given me no evidence that this issue speaks to anyone's 
religion.
    Again, I don't pretend to know every aspect of everyone's 
faith. In this country, you practice as you desire. I will not 
sit here and allow the trans community to be abused or in 
essence to be rejected. For someone somewhere, let me say your 
life is worthwhile.
    Mr. Minter, let me provide you with a question very 
quickly. My time is short. The due process clause of the 14th 
Amendment forbids States to deprive any person of life, 
liberty, or property. The Supreme Court has stated this clause 
includes a substantive component that provides heightened 
protection against government interference. What does this mean 
to the interests of parents in the care and custody and control 
of their children is important. Please give what this means to 
you as you lead out in this community.
    Ms. Reynolds, please let us know what this meant to you for 
your son, for his coming together and how you needed the 
support of your community, your surroundings, and how important 
this is for the trans.
    Let me go to Mr. Minter, please. I would ask the Chair for 
his indulgence as I had to respond to his commentary. Yes, Mr. 
Minter.
    Mr. Minter. Thank you so much for your statement of support 
for this community. Kids need to hear that. Yes, these State 
bans are an unthinkable intrusion on the traditional, deeply 
rooted authority of parents to make medical decisions for their 
own children, who are talking about obtaining established care 
through parents who know there is an effective treatment. They 
see their child suffering. To have the government come in and 
say, no, you cannot obtain this healthcare for your children is 
a shocking violation of parent's rights.
    Ms. Jackson Lee. Psychologically, Ms. Reynolds, if you can 
just bring it home to us what it really means and to somebody 
who is not in this room that might be seeing what's going on 
here.
    Ms. Reynolds. I just want to highlight how incredibly 
difficult all this was. This was, again, nothing that we 
arrived on easily. There was nothing, nothing impulsive about 
any of this decision. It was made collaboratively with a team 
of trained professionals.
    There was a ridiculous amount of assessment that happened 
prior to that. This is not just some kind of fly by night, my 
kid said this one day, and this whole thing launched. That is 
not how this went down. It was very, very, very careful.
    Ms. Jackson Lee. Are others impacted by listening to this--
    Mr. Johnson of Louisiana. The gentlelady is out of time.
    Ms. Jackson Lee. --quickly, can you just say what impact 
hearing that they are not affirmed?
    Ms. Reynolds. It is devastating.
    Mr. Johnson of Louisiana. The gentlelady is out of time.
    Ms. Jackson Lee. I yield back. Thank you.
    Mr. Johnson of Louisiana. Thank you. The Chair yields next 
to the gentleman from Texas, Mr. Roy.
    Mr. Roy. Thank you, Chair. I thank the witnesses for being 
here. Ms. Scanlan, is Lia Thomas a man or a woman?
    Ms. Scanlan. Lia Thomas is biologically male.
    Mr. Roy. Did the University of Pennsylvania attempt to 
silence or sensor you or any of your teammates when the news 
broke about a member of the team, the swim team, would be 
joining your female swim team?
    Ms. Scanlan. We had already known at this point that Thomas 
would be joining our team. The university advised us to seek 
counseling if we objected.
    Mr. Roy. Did they try to silence you all in terms of 
voicing your opinions?
    Ms. Scanlan. Yes. In fact, I wrote an opinion piece for the 
school newspaper that was quickly retracted because it was too 
offensive to be written and published.
    Mr. Roy. Offensive that you were concerned about a 
biological male competing against you and undressing in a 
locker room with you and others? That would be ``offensive''?
    Ms. Scanlan. Yes.
    Mr. Roy. What steps did the University of Pennsylvania take 
to platform Lia Thomas over you and your female teammates?
    Ms. Scanlan. The University of Pennsylvania nominated Lia 
Thomas for NCAA Woman of the Year. In fact, I found this to be 
very offensive because there are plenty of other female 
athletes at the University of Pennsylvania that are very strong 
and very worthy of that nomination.
    Mr. Roy. Are you familiar with the International Swimming 
Federation?
    Ms. Scanlan. Yes.
    Mr. Roy. Do you consider it to be some bastion of right-
wing conspiracy or somehow a conservative right-wing 
organization?
    Ms. Scanlan. No.
    Mr. Roy. Did the International Swimming Federation ban Lia 
Thomas from competing at the 2024 Paris Olympics?
    Ms. Scanlan. Yes. The governing body of swimming put in 
laws to say that individuals that have gone through male 
puberty are not permitted to compete in women's competitions.
    Mr. Roy. So, a question for you, Ms. Cole, and first, thank 
you for being here. I have heard some of my colleagues on the 
other side of the aisle use words like this frightens me, this 
hearing. They are frightened by us having a hearing, in which, 
you are able to speak to the world about what you have gone 
through.
    I have heard colleagues on the other side of the aisle say 
life is worth it in the context of pushing a particular world 
view and saying life is worth it. I would just ask to say that 
I just want to make sure that you know, like from our 
standpoint, that your life is worth it. That the people that 
have gone through this, that your lives are worth it.
    I have wondered if you would like to comment on the worth 
of your life, the social pressures, and the pressure placed on 
you to pursue a path that you now believe was not the correct 
path.
    Ms. Cole. I think we are on the same page here, that 
everybody's life, the right to happiness, is worthy. That is 
what we are all fighting for even if we don't necessarily agree 
on what that means.
    If I may ask, would I be able to address another witness?
    Mr. Roy. Through the Chair, you may. So, you may speak to 
me and reference any other testimony you wish to.
    Ms. Cole. OK. Well, Ms. Reynolds--
    Mr. Roy. You can direct it to me and say that what Ms. 
Reynolds talked about, you want to respond to and go ahead.
    Ms. Cole. Well, I understood that Ms. Reynolds is scared 
for her child. I just want to set the record straight that I 
don't hate her. I don't think anybody in this room hates her. 
In fact, I see my own mother and my own father in her. That 
clearly, she really loves her child, and she is doing the best 
with what she has been given, and unfortunately it is not much. 
For that I am sorry. I mean, I think every parent deserves the 
utmost grace and guidance with how to help their child.
    With that being said, I don't wish for her child to have 
the same result as I did. I don't wish for anybody to regret 
transition or detransition because it is incredibly difficult. 
It comes with its own difficulties, and it is not easy. I hope 
that her child gets to have a happy and fulfilling adulthood, 
however that may look like.
    Mr. Roy. Well, thank you for that, Ms. Cole. I think that 
was heartfelt. I know that a number of us share your view.
    One last question as my time is winding down, do you 
believe that the American healthcare system failed you?
    Ms. Cole. On every single level.
    Mr. Roy. Thank you.
    Ms. Cole. My doctors and systemically.
    Mr. Roy. Thank you for being here. I yield back.
    Mr. Johnson of Louisiana. Thank you. The gentleman yields 
back.
    Ms. Balint. Mr. Chair, I ask unanimous consent to enter 
into the record two articles, first, ``Social Contagion Isn't 
Causing More Youth to be Transgender,'' that is NBC News, 
August 2, 2022, and, ``Study finds No Evidence of Social 
Contagion Among Transgender Youth,'' August 3, 2022, American 
Academy of Pediatrics.
    Mr. Johnson of Louisiana. Without objection. Another?
    Ms. Jackson Lee. Yes, Mr. Chair. Thank you. ``Human Rights 
Watch Attacks on Gender Affirming Care by State,'' but I just 
want to show this map and just indicate how personal I think 
these decisions are. Ms. Cole has indicated how personal it is, 
and you have, too, Ms. Reynolds, thank you. Unanimous consent.
    Also, ``A Hole in Our Heart. Family and Friends Mourn 
Murder Victim Chyna Gibson'', another unanimous consent. 
``Chyna Gibson is the fifth transgender woman killed in 2017.'' 
This is related, and I am introducing the ``Chyna Gibson Stop 
Murdering Trans Today and Planned Parenthood, Texas Affiliates 
and PPFA Move for Decision in Baseless Medicaid False Claims 
Act,'' particularly, attacked because of their work in trans 
affirming healthcare. I ask for unanimous consent for those to 
be placed into the record, Mr. Chair.
    Mr. Johnson of Louisiana. Without objection.
    The Chair now recognizes the Ranking Member, Ms. Scanlon, 
for five minutes.
    Ms. Scanlon. Thank you. Thank you to our witnesses. We 
appreciate you being here to share your experiences and help 
everybody understand both the very personal stories that are 
implicated in this issue as well as some of the political 
agendas that are being pushed.
    It is remarkable that our majority colleagues were not able 
to find any medical professionals to back their claims in 
today's hearing other than an edited video of someone who 
actually has refuted their conclusions. Much of what we have 
heard today really is playing to and from some of the furthest 
extremes of right-wing ideology and fearmongering.
    Mr. Minter, our colleagues and witnesses have expressed 
concern about the participation of transgender students on 
athletic teams aligning with their gender identities even while 
conceding several times now that to the extent this is a 
concern in competitive athletics, the athletic governing bodies 
are addressing this issue for competitive athletes. Can you 
further comment?
    Mr. Minter. Yes. Transgender students, transgender girls 
and women have been playing on sports teams for a long time 
now. Only recently has this become weaponized as a political 
issue.
    Sports associations, high school athletic associations, 
governing sports bodies, and local school districts have long 
been able to deal with this issue as they should by looking at 
relevant factors like age, sport, level of competition, and 
individual circumstances.
    This is a classic solution in search of a problem. The real 
problem, if there is one, is the one Ms. Reynolds identified, 
which is still so difficult for transgender kids to participate 
at all or to receive any encouragement and support.
    Ms. Scanlon. Right. That has been one of the primary 
concerns that we have been hearing from families as they have 
kids who just want to be kids and participate in sports and 
because of the weaponization of this issue, it has become a 
problem. So, thank you for that.
    We have also heard conservative lawmakers and activists 
argue that bans on gender-affirming care are necessary to 
protect minors with many labeling gender-affirming treatments 
experimental. As we have seen here today repeatedly 
deliberately confusing gender-affirming care with gender 
transition surgery. Can you speak to that issue?
    Mr. Minter. Again, surgery is an adult treatment. That is 
not what we are talking about with children and youth. There 
have been now six court cases, including two complete full 
trials, where these States have had the opportunity to 
substantiate the claim that this treatment is experimental. 
They have no evidence of that.
    Again, courts across a wide of variety of judges have 
concluded that this is not experimental care. It is well-
established. It is well-founded. There is extensive clinical 
research showing the benefits. This is just what ordinarily 
happens in our healthcare system, which is parents with their 
children and their healthcare providers making reasonable 
medical decisions to help their own children.
    Ms. Scanlon. Thank you. If you had about 30 seconds to 
address any additional concerns, what would you say?
    Mr. Minter. The UK still provides healthcare to transgender 
young people. They shut down the one clinic that used to 
provide all the care to open up multiple regional clinics to 
serve more children.
    The Swedish study has been referred to here, a number of 
times today. It is so important. That study lends zero credence 
to the notion that these treatments are not effective. The 
author of that study has repeatedly expressed great distress at 
the way her study has been misrepresented. She strongly opposes 
bans on healthcare for transgender youth.
    Ms. Scanlon. Thank you. We have heard a lot of 
misinformation probably firmly held personal beliefs, but that 
may be at odds with the facts. So, I want to correct some of 
that for the record, Mr. Chair.
    I would seek unanimous consent to enter the following items 
into the record. A letter from leading medical organizations to 
Congress opposing efforts to ban gender affirming care.
    A letter from the Leadership Conference on Civil and Human 
Rights in support of laws and policies that promote 
transgender, nonbinary, and intersex people from 
discrimination.
    An Opinion by the U.S. District Court in Arkansas which was 
later affirmed by the 8th Circuit Court, which has a very 
complete assessment of the legal and factual basis for this 
discussion. It found a statewide ban on gender-affirming care 
to be in violation of the 14th Amendment.
    A human rights campaign FAQ on gender-affirming care for 
anyone who has questions about what is actually going on.
    A policy paper from Women's Sports Foundation entitled, 
``Participation of Transgender Athletes in Women's Sports.'' 
I'm almost done.
    A The New York Times article entitled, ``How a Campaign 
Against Transgender Rights Mobilized Conservatives.''
    Mr. Johnson of Louisiana. Without objection.
    Ms. Scanlon. Thank you. I yield back.
    Mr. Johnson of Louisiana. Thank you. The gentlelady yields 
back. The Chair recognizes the Chairman of the Full Committee, 
Mr. Jordan.
    Chair Jordan. Thank you, Mr. Chair. Ms. Scanlan, the 
Ranking Member just said this is simply about letting kids 
compete and that the sport's governing bodies are addressing 
this.
    So, I would just ask you two questions. Is Lia Thomas a 
kid?
    Ms. Scanlan. No.
    Chair Jordan. Is the NCAA appropriately and in the right 
way in your judgment addressing the situation?
    Ms. Scanlan. They did not during our season. They said that 
Olympians deserve protections, but collegiate level athletes, 
grassroot level athletes, middle schoolers, and high schoolers 
did not deserve those same protections.
    Chair Jordan. So, in your judgment, the Chair calling this 
hearing is not waste of time as the Ranking Member said. We are 
trying to get to the bottom of a real concern that is impacting 
all kinds of young ladies who participate in collegiate 
athletics.
    Ms. Scanlan. Yes. I would like to say that while there has 
been a lot of notions that this is such a minority group of 
people, this one transgender athlete, Lia Thomas, affected 
hundreds of girls.
    There were hundreds of girls at the NCAA championship that 
were in tears over the situation, whether it be getting bumped 
out of their spots in competition, failing to qualify for the 
meet or having to change in the locker room next to a 64" 
biological male. This not a minority group that is being 
affected by this.
    Chair Jordan. Well, I thank our witnesses for being here 
today, and I thank the Chair for his work. I yield to the 
Chair.
    Mr. Johnson of Louisiana. Thank you for yielding. A quick 
question for Mr. Minter. You, yourself, transitioned at age 35 
and not as a child, correct?
    Mr. Minter. That is correct. I wish I had been able to do 
so earlier.
    Mr. Johnson of Louisiana. All right. Ms. Cole, I want to 
thank you again for being here today and for sharing your 
powerful testimony, especially on your 19th birthday. That has 
been very helpful to us.
    Ms. Cole. Thank you, sir.
    Mr. Johnson of Louisiana. I want to acknowledge what you 
said earlier, tearfully, as appropriate. Everyone here, as you 
said, our hearts go out to everybody, the families, everybody 
affected. We are trying to strike the right balance. We do 
believe Congress has a role here. I appreciate your testimony 
for providing evidence of that.
    I wanted to ask you first about your parent's involvement 
in your transition process, and then ask you about some of the 
hormone treatments you underwent because I think all that is 
important.
    First, were you or your parents informed of the long-term 
effects of the procedures and hormones that you were subjected 
to?
    Ms. Cole. We had consent forms with a list of some of the 
side effects. We did do consultations where we did speak about 
some of them. It was in very vague terms. As a child, it was a 
lot for me to process because I was perfectly healthy. Children 
tend to think that they are invincible, that nothing can get 
them. With all these things being listed, it was hard to know 
which of these things I would experience.
    Most of the side effects that I experienced, most of the 
ones I am experiencing today actually, were not even listed on 
this form, so I had no idea. Children just don't know what 
permanence is because they have only been in the world for so 
many years.
    Mr. Johnson of Louisiana. It is an important legal 
principle that we have informed consent, fully informed 
consent, for life altering medical procedures. Are you then 
suggesting that it was not really fully informed consent?
    Ms. Cole. No matter how much information they would have 
given me as a child, I just would not have been able to consent 
to this. My parents were required to sign off on these. It was 
under duress. I don't think there was really consent. It was 
coercion. They were told--they were given the false dichotomy 
of either your child transitions or she dies, but transitioning 
almost killed me.
    Mr. Johnson of Louisiana. The evidence suggests that this 
is a common practice, regardless of what has been said here 
today. There are some other things that are very disturbing. 
One aspect of the current child movement about this sex change 
movement that is particularly pernicious is the so-called off-
label medications. One that is well-known is leuprolide 
acetate, which is commonly known as Lupron, to chemically 
altering boys and girls, not by surgery, but chemically--
    Ms. Cole. Yes.
    Mr. Johnson of Louisiana. --it is the same thing. There is 
a long list of pharmaceutical drugs that medical personnel 
across the country are using to, for example, shut off the 
testosterone production in young boys to make them more 
feminine looking or to shut off the estrogen production in 
young girls to make the more masculine looking. So, I am going 
to say for the record, post-hearing, we have five days I will 
enter some of the articles that detail a list of these chemical 
drugs being used on children for purposes that are not approved 
by the FDA.
    Ms. Cole, was one of those puberty blockers that you 
prescribed Lupron?
    Ms. Cole. Yes, I was put on Lupron.
    Mr. Johnson of Louisiana. What was the purpose of that in 
your hormone treatment?
    Ms. Cole. Just to stop the natural production of my 
hormones to make way for the exogenous testosterone.
    Mr. Johnson of Louisiana. Does it concern you as it does us 
that some pharmaceuticals are being used to chemically mutilate 
some children today that were never explicitly approved for 
that purpose by the FDA?
    Ms. Cole. Incredibly so.
    Mr. Johnson of Louisiana. To my knowledge, there is 
currently no effort underway by the FDA to explicitly approve 
these pharmaceuticals for a child for these purposes.
    Ms. Cole. They shouldn't.
    Mr. Johnson of Louisiana. They shouldn't. The time has 
expired for the time that was yielded to me. I thank the Chair. 
Now, I recognize myself for my five minutes finally. So, I will 
keep going here.
    The last time I checked, it was still illegal under Federal 
law to use FDA approved pharmaceuticals for an underapproved, 
or off label use and yet we are seeing that very commonly in 
this field.
    Ms. Cole, do you find it concerning that medications that 
were used on you or on countless other children across the 
country for a reason contrary to the original purpose they were 
approved for--you said that is something that concerns you, 
disturbs you, shouldn't be allowed, right?
    Ms. Cole. Very much so.
    Mr. Johnson of Louisiana. Ms. Mailman, let me go to you. 
There has been a lot of talk here in the recent few minutes 
about legal precedents, et cetera. I saw you sort of biting 
your lip as some of that was presented. I will give you a 
moment here to refute any of that or to respond to it if you 
will.
    Ms. Mailman. Right. Well, we have heard a lot about the 
parent's rights to put drugs into their kids, which the 6th 
Circuit has just very recently said that there is no Supreme 
Court case that extends this idea of parental rights to a 
general right to receive new or experimental drug treatments.
    In general, this idea of substantive due process would 
strip people, would strip parents, would strip voters, and 
would strip doctors of a say and push all those decisions into 
our courts, which are not medical experts.
    So, as the 6th Circuit also recently said,

        Life tenured Federal judges should be wary of removing a vexing 
        and novel topic of medical debate from the ebbs and flows of 
        democracy by construing a largely unamendable Federal 
        constitution to occupy the field.

    So, that is what people are asking for. They are asking for 
judges to create medical law rather than voters informed by 
medical science.
    Mr. Johnson of Louisiana. That's right. I think you have 
touched on a really important issue here, and it is one that 
has been discussed a little bit today, and that is, as Mr. 
McClintock said eloquently, ``we are conservatives. We are 
limited government conservatives,'' right?
    We obviously recognize that parents have a natural and 
fundamental right to the upbringing of their children, to make 
decisions with regards to their care, custody, and control. At 
the same time, our legal system in this country, our law, does 
not allow a parent to physically or mentally abuse or harm a 
child, right?
    So, what we are all trying to do here in a very reasoned 
way is to strike the balance, to make sure that we are not 
doing life-altering harm to young people who are not prepared 
for that.
    In some of the States, like in California, Mr. McClintock's 
home State, they are pushing the parents out of the room. They 
are doing this without their consent. That is alarming, and it 
should be obviously unlawful.
    Let me switch the subject here. If doctors are using 
chemical castration drugs in an off-label fashion that is for a 
purpose other than what they were approved for by the FDA, 
should doctors face legal consequences? What do you think about 
that?
    Ms. Mailman. So, that is subject to medical malpractice 
charges. Also, States regulate the practice of medicine. So, 
States are perfectly entitled to regulate what drugs that 
people can access themselves. If you can regulate what people 
can access themselves, obviously that would confer to the child 
as well. Unfortunately, I think you are seeing this movement 
that States should not be able to regulate the practice of 
medicine and somehow Federal judges should.
    Absolutely, medical practice suits should be available 
here. Unfortunately, you've seen the politicization of medical 
associations creating standards that are then informing 
doctors. So, I think that what this body could and should do is 
make sure that there is research, that there is science that 
are informing States so that their medical boards can make 
better decisions.
    Mr. Johnson of Louisiana. That's well said. Early in my 
legal career, I did medical malpractice defense was one of the 
areas. The medical standard was a big thing. We had medical 
review panels in the State of Louisiana, as most States do, and 
they would look to the medical standard. If the standard itself 
is not fully informed by studies that back it up, we have a 
broadscale concern here.
    Can you define quickly, changing subjects, what a sanctuary 
is in the context of gender transition procedures for children?
    Ms. Mailman. So, California has bragged that it is a 
sanctuary State as far as gender transition for minors. It has 
SB-107. There a copycat bill being introduced in other States, 
and it has two main provisions.
    First, is that if a child goes to California to have a 
gender procedure, the California courts will take over the 
custody proceedings. So, one parent can take a child away from 
the other parent and then the California court can assert 
jurisdiction. That's one provision.
    The second provision is that in California, they will not 
give over any medical information if it relates to another 
State's transgender procedure laws. So, California is priding 
itself on ripping families apart when you would think that if 
they have 170,000 homeless people living in the State that they 
would focus on the benefits and improving the lives of 
Californians.
    Mr. Johnson of Louisiana. That is very well said. In seven 
seconds, I can't do any justice to any of you asking another 
question. I want to thank you all sincerely. This is an 
important hearing. It was not an easy one for anybody, but it 
is a really important issue that we have to wrestle with on 
both sides of the aisle and in every State across the country. 
Many legislatures are doing that right now. In my view, some 
are doing some really important work.
    So, we have to determine what we are going to do at this 
level. So, your testimony, all of you, your testimony today was 
valuable for that purpose.
    This concludes--
    Ms. Scanlon. I have one--
    Mr. Johnson of Louisiana. One more, one more.
    Ms. Scanlon. I have one more UC. Thank you. An article 
entitled, ``California Bill on Youth Mental Health Services Has 
Been Distorted on Social Media,'' discussing the fact that 
California law does not authorize gender-affirming surgeries 
without parental consent.
    Mr. Johnson of Louisiana. I am going to defer to the wisdom 
of my witness, but without objection, we'll admit that for the 
record.
    This concludes today's hearing. We thank our witnesses for 
appearing today. Without objection, all Members will have five 
legislative days to submit additional written questions for the 
witnesses or additional materials for the record. Without 
objection, this hearing is adjourned.
    [Whereupon, at 12:17 p.m., the Subcommittee was adjourned.]

    All materials submitted for the record by Members of the 
Subcommittee on the Constitution and Limited Government can
be found at: https://docs.house.gov/Committee/Calendar/ByEvent 
.aspx?EventID=116284.

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