[Congressional Record Volume 170, Number 35 (Tuesday, February 27, 2024)]
[Senate]
[Pages S1003-S1006]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                            Gender Dysphoria

  Mr. KENNEDY. Mr. President, with me today is one of my colleagues 
from my Senate office, Mr. Matt Turner.
  Mr. President, not long ago, on February 23, in fact, an article 
appeared in one of my State's local newspapers. If it had appeared on 
the opinion page where it belonged, I wouldn't be saying a word because 
everybody in America has the right to their opinion. Instead, it 
appeared in the news section as a purportedly objective news article.
  In this article some reporter said, ``The state'' referring to the 
State of Louisiana, ``The state has already banned transgender young 
people from receiving gender-affirming medical care.''
  That is not true, and I want to spend a few minutes responding to 
this inaccurate statement in the news as opposed to the opinion section 
of one of my newspapers.
  It is very hard to be a parent today, and it is even harder to be a 
kid. Between social media and cell phones, this generation is growing 
up in a way that we could not have imagined a few decades ago. Nowhere 
is this clearer than the issue of gender confusion among our children.
  Children today are facing an onslaught of identity-obsessed activism. 
Well before a child learns the difference between adjectives and verbs, 
activists in many government schools are teaching their pre-K students 
lessons on transgender pronouns--pronouns like ``ze'' and ``zir.'' 
Public libraries are hosting ``drag queen story time'' for ``children 
of all ages.''
  The American Federation of Teachers--one of our largest, if not the 
largest, national teachers unions--actually runs a website with a 
lesson on how teachers can help children hide their transgender status 
from their parents. I kid you not. TikTok essentially functions as a 
``how to transition'' guide book.
  The issue of gender has morphed from a topic that only involved the 
personal decisions of private adults into a movement--a movement that 
seeks to inject questions about gender and sexuality into every aspect 
of a child's life with or without parental approval. In fact, parents 
who disagree with the notion that adults should be immersing young 
children in discussions about gender and sexuality fear being smeared 
as bigots. In more horrifying examples, parents risk losing custody of 
their children for refusing to adopt a particular--usually a pro-
transgender--ideology.
  It is not new for activists to target kids with their political 
rhetoric--unfortunately, we see it every day in America--but the gender 
and sexuality agenda goes far beyond the usual policy disputes that we 
see on a regular basis here in Washington. We are talking about giving 
children irreversible medical treatments before they can even 
understand the consequences of those medical procedures. I want to be 
very clear here. Eighty-five percent of the children who express some 
confusion about their gender--85 percent of the kids who say they are 
confused about their gender will outgrow it by the time they finish as 
adolescents. Now, that is just a fact. We have no idea, unfortunately, 
which 8-year-olds are going to outgrow their gender confusion, but we 
know it will be most of them--85 percent. Yet some activists in this 
country, particularly at Planned Parenthood, want to put kids under the 
knife or pump them full of hormones before these minors have a chance 
to grasp the consequences, and it is happening throughout our country.
  Like with a frog in a pot, gender activists have gradually turned up 
the heat, and we have all seen it. Now the United States is boiling 
over with some of the most radical pediatric gender policies on Earth--
on Earth. To understand just how extreme these policies are, I need to 
discuss a few of these so-called treatments and how they are 
implemented today.
  Today, many activists believe that the only way to respond to a child 
with gender confusion is by affirming whatever the child says about his 
or her gender, agree with the kids in all cases. Activists warn 
parents--we hear it all the time--not to question their child's gender 
proclamation. If a first grade boy tells his parents on a Tuesday that 
he is a girl, these activists say parents are just supposed to agree 
with the child until the child changes his mind on a Thursday.
  Now, if you have ever raised a child, first, thank you, but if you 
have ever raised a child, there was probably a point during which your 
child told you that he or she was--I don't know--a

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lion, and that child would belt out a roar just to prove it. But I am 
guessing--just a wild guess--that if that happened to you with your 
child, you didn't call animal control and say: Hit him with a stun gun, 
and take him back to the zoo. Why? Because you knew he was a child.
  We can acknowledge that gender dysphoria is a real and difficult 
condition. Let me say that again. We can acknowledge that gender 
dysphoria is a real and difficult condition for a small subset of our 
population. At the same time, we can understand that it is foolish and 
dangerous--and, like a rock, only dumber--to blindly affirm whatever a 
child tells you about their identity, gender or otherwise. If a 13-
year-old kid tells you he is a NASCAR driver, you don't give him the 
keys to your sedan. He is a kid. She is a kid. Yet gender activists not 
only encourage parents in all cases, without question, to affirm their 
children's gender confusion, they also pressure parents to subject 
those kids to life-altering surgeries and life-altering hormone 
treatments--puberty blockers.
  Puberty blockers are often the starting point for these activists. 
Puberty blockers are hormone-based injections, and sometimes they are 
implants. They are given to kids in our country today who are as young 
as 8 years old. The purpose of a puberty blocker is to delay the onset 
of puberty. These drugs can prevent breast development and menstruation 
in kids--in girls. They can cause genital--or, rather, prevent genital 
growth in boys. They can also inflict lasting damage on a child's bone 
density. They can stunt bone growth, and they can harm future 
fertility. Those are all medically proven facts.
  The hormones used in puberty blockers are known as--let me say this 
carefully--gonadotropin-releasing hormone analogs. ``Gonadotropin-
releasing hormone analogs'' is the medical term. These are also the 
same hormones used to chemically castrate sex offenders. These hormones 
that some doctors are giving our kids are the same hormones used to 
chemically castrate sex offenders. I didn't misspeak there. They give 
confused kids drugs designed to castrate adults.
  The FDA hasn't approved the use of puberty blockers to treat gender 
dysphoria, but nonetheless some doctors have been prescribing these 
hormones off label to kids. In some parts of the country, children 
don't even need a formal psychiatric diagnosis of gender dysphoria 
before receiving puberty blockers.
  According to one estimate, from 2017 to 2021, the number of children 
prescribed puberty blockers--chemical castration for boys--increased by 
120 percent. At least 4,700 children underwent treatments during that 
period.
  Most States, as the Presiding Officer knows, require parental consent 
before they give children the same drug they use to castrate pedophiles 
but not all States. For example, in Oregon, children as young as 15 
years old can receive Medicaid-funded--taxpayer funded--puberty 
blockers and sex change surgery without ever asking their parents, 
without ever telling their parents. In other words, taxpayers help the 
State fund gender transitions in children while keeping it a secret 
from their mothers and their fathers. That same 15-year-old likely 
needs a signed permission slip to go on a field trip to pet llamas at 
the local zoo, but these kids can pump themselves full of life-altering 
hormones without mentioning it to Mom or Dad.

  If the child has already begun puberty, the next option that some 
radicals recommend is what they call cross-sex hormones--cross-sex 
hormones. These drugs begin physically changing the child to resemble 
the opposite gender. Young girls are given testosterone. This increases 
their muscle development. The testosterone lowers their voices; it 
broadens their jaw lines; and it creates coarse body hair. Young boys 
take estrogen. They are given estrogen. The estrogen shrinks their 
testicles, diminishes their sex drive, and it redistributes fat to 
their hips and their breasts.
  According to the Mayo Clinic, these changes usually cannot be undone; 
they are permanent. Boys who take estrogen often become infertile. They 
also risk blood clots, heart problems, and strokes. Girls who take 
testosterone also often become infertile. Cross-sex hormones can 
permanently hinder a person's sexual interest or function as well.
  It is undeniable--undeniable--that the decision to use cross-sex 
hormones can change a child's entire life. Yet Planned Parenthood 
offers cross-sex hormones to children as young as 16. Planned 
Parenthood even brags that individuals can begin cross-sex hormone 
treatment--I am quoting; this is what Planned Parenthood says--``the 
same day as your first visit.'' No letter from a mental health provider 
is required. Come on down and get the drug.
  Children can begin taking cross-sex hormones at age 13. Thirteen-
year-olds can't even drive, for God's sake. They can't get a tattoo. 
They can't see an R-rated movie. Are we supposed to believe that a 13-
year-old can make an informed decision about whether he or she wants to 
have children or whether he or she should risk their ability to 
function sexually with their future spouse? No child--no child--is 
mature enough to make that decision, so no child should be able to opt 
into cross-sex hormones.
  The surgeries that activists are pushing on our children are even 
more disturbing. The World Professional Association for Transgender 
Health--this is a group known for its support of pediatric transgender 
policies--has said that girls as young as 15 should be able to get 
double mastectomies to remove their breasts. By age 17, this group that 
purportedly cares about kids says that boys should be allowed to 
receive vaginoplasties.
  In a vaginoplasty, surgeons remove a boy's penis; they remove the 
child's testicles; and they remove the child's scrotum. Then the boy's 
remaining genital tissue is stitched together to create something that 
mimics a vaginal canal. If the boy doesn't have enough spare tissue to 
complete the procedure, the doctor may slice a skin graft from his 
abdomen or his thigh. In other words, the doctor cuts up healthy skin, 
leaving significant scarring, just to finish the vaginoplasty. Some 
boys never regain sensation in their reconstructed genital area.
  These medical extremists also offer a similar procedure to young 
girls. It is called a phalloplasty. During a phalloplasty, doctors 
carve off skin and veins, often from a young girl's wrist and thigh, to 
create a fake penis. The surgery is very complex. It is very risky. It 
often results in serious complications--complications, frankly, so 
disturbing that they will make you go weak in the knees. Because 
complications during phalloplasty happen so frequently, even the 
radical World Professional Association for Transgender Health does not 
recommend phalloplasty in girls under 18, but some States allow it. 
Some States allow it.
  These procedures mutilate and they sterilize America's sons and 
daughters. Doctors cut out healthy organs to build a pile of flesh that 
may never regain full sensation or function properly, and it is 
barbaric. No child has the psychological maturity, no child has the 
emotional maturity to make this life-altering decision.

  Now, one would think that if adults are willing to chop up a child's 
body and pump him or her full of sterilizing hormones, there must be a 
good reason for it. If you ask many gender activists, they will tell 
you that gender confusion is a matter of life or death.
  Now, to be clear, there are higher suicide rates among people who 
identify as transgender, higher than among the general population. 
Gender activists know this, and they misuse those statistics. That is 
why they often ask parents who are worried about the extreme gender 
treatments--they will say to a parent: Would you rather have a dead son 
or a live daughter?
  Have you heard that? It scares parents half to death, and that is on 
purpose.
  What you won't hear these gender activists ask is whether these 
extreme measures actually improve a child's mental health. They don't 
ask that question because they don't like the answer. They know the 
answer, but they don't like it.
  Studies show that cross-sex hormones and reassignment surgeries have 
little to no effect on the long-term mental health of folks with gender 
dysphoria. A study was published in the American Journal of Psychiatry. 
It found that there was no significant reduction in mental health 
issues or suicidal ideation among adults following hormone treatments. 
This study also

[[Page S1005]]

``demonstrated no advantage of surgery''--``no advantage of surgery''--
as it relates to reducing anxiety, to reducing depression, or to 
reducing suicidal thoughts--no advantage to the supposedly lifesaving 
cross-sex treatments.
  Activists are mutilating and sterilizing children, and they don't 
even have a good reason for it. Still, thousands of children in the 
United States are receiving these treatments. A report from Reuters 
found that at least 4,700 American children took puberty blockers from 
2017 to 2021. More than 14,700 children took cross-sex hormones. From 
2019 to 2021, nearly 800 girls received double mastectomies. And that 
only includes girls whose insurance covered the procedure.
  And I am worried this is only the tip of the iceberg. The population 
of people diagnosed with gender dysphoria, including adults, by the 
way, increased in every State except South Dakota from 2018 to 2022. In 
Louisiana, my State, the population of people diagnosed with gender 
dysphoria has increased by 72 percent in 4 short years.
  If we look exclusively at gender dysphoria among children, the 
population of transgender children in the United States nearly doubled 
between 2017 and 2020. In Louisiana, 13- to 17-year-olds are nearly 
three times more likely to say they identify as transgender than adults 
aged 25 to 64. From 2018 to 2022, children's share of the total--often, 
of course, self-reported--transgender population in the United States 
increased from 17.5 percent to 20.4 percent. And that is over the 
entire population.
  Now, here is a fact that should make everyone who cares about our 
society's more vulnerable members stop and think. A significant portion 
of these often confused children struggled with severe autism and 
mental illness. A study out of the United Kingdom found that 35 percent 
of children receiving care at the nation's transgender youth clinic 
suffered from moderate to severe autism. Children diagnosed as 
transgender are up to 13 times more likely to have ADHD, depression, or 
anxiety than nontransgender children. They are also more than four 
times more likely to have bipolar disorder than the general population.
  These kids who say they have gender dysphoria face enough challenges 
without gender activists rushing them into irreversible treatments--
cutting off their breasts, removing their penises--based on what 
statistically will probably be temporary confusion.
  Young girls appear to be driving the surge, quite frankly, in 
adolescent gender dysphoria. One 2022 study found that girls are up to 
7.1 times more likely to present with gender dysphoria than boys, and I 
think we know that, just as a practical matter.
  In the United Kingdom, once again, the National Health Service--the 
NHS--reported that it had 250 gender dysphoria referrals about a decade 
ago. Most of them were boys. By 2022, the NHS reported 5,000 gender 
dysphoria referrals, two-thirds of whom were girls.
  That is why many fear that gender dysphoria has become a social 
contagion among young girls. In the same way that groups of girls 
developed eating disorders such as anorexia and bulimia in the 1990s 
and early 2000s, girls today are developing gender dysphoria in groups 
as well. One key difference, though, exists. One key difference between 
disordered eating in the 1990s and 2000s and the gender dysphoria we 
are seeing today is that educators and policymakers didn't blindly 
affirm eating disorders. Even today, we are not so foolish. Even today, 
doctors wouldn't give an anorexic teenager Ozempic or staple her 
stomach because she thinks she looks fat. We wouldn't do that. Yet 
activists rush to inject girls with irreversible cross-sex hormones and 
inflict double mastectomies on them, all in the quest--all in the 
quest--to affirm their gender confusion.
  Thank God, other countries are proving themselves wiser than America. 
Thank God. The United Kingdom, Sweden, Luxembourg, Finland, Denmark, 
and Belgium have all prohibited sex reassignment surgeries for 
children, for minors. Before doctors can prescribe children cross-sex 
hormones, many European countries require years of extensive 
documentation from a panel of psychiatrists, a panel of pediatricians, 
a panel of endocrinologists.
  In the United States, however, Mr. President, children can access 
irreversible hormone treatments without so much as a second opinion 
from doctors. A former caseworker from the Washington University 
Transgender Center at St. Louis Children's Hospital--that is the 
foremost pediatric transgender medical center in the United States--
said some kids at that facility were eligible for cross-sex hormones 
after a single visit--one visit--to a therapist.

  Federally funded insurance programs won't pay for a woman to elect to 
tie her tubes, not until she is 21 years old, and most insurance 
companies require a 30-day waiting period because it is important that 
a woman is certain before she consents to her own sterilization. Yet 
many activists are comfortable allowing children to take sterilizing 
medications at 13 years of age after a single appointment with a 
therapist--all because adults are supposed to trust children when they 
claim they are a different gender.
  I am very thankful to say that Louisiana is full of compassion and 
common sense, and we don't do that. We know that this agenda is 
dangerous, and we know it is outrageous. And so does the United 
Kingdom.
  The United Kingdom used to have a similarly misguided policy until 
one brave woman came forward with her story: Keira Bell. Keira Bell was 
15 years old when she first attended the Tavistock clinic, which was 
then the UK's transgender youth clinic. Ms. Bell had a pretty rough 
childhood. Her mother struggled with alcoholism. She regularly faced 
bullies at school. And in her own words, she said: I was ``very 
mentally ill.'' And she struggled with depression.
  Ms. Bell attended just a few appointments at the Tavistock Hospital 
before they put her on puberty blockers. Shortly thereafter, she began 
cross-sex hormones, and she eventually received a double mastectomy.
  A few years went by. By age 22, Ms. Bell realized she regretted these 
changes, but the damage was done. The Tavistock clinic took her 
breasts; the Tavistock clinic lowered her voice; the Tavistock clinic 
jeopardized her fertility--all before she even understood the 
consequences of those treatments. She was a kid.
  Her story horrified the people of the United Kingdom. Ms. Bell 
brought a claim against the Tavistock clinic to argue that kids were 
not psychologically mature enough to make irreversible medical 
decisions. The NIH investigated, and it found that the clinic had put 
young people ``at considerable risk'' of long-term mental distress. And 
the UK Government then deemed that the treatments Tavistock offered 
were not a ``safe or viable long-term option,'' and the Tavistock 
clinic no longer exists today. The NHS shut them down.
  There is a growing population of young people like Ms. Bell who 
regret receiving irreversible treatments when they were kids. They are 
generally known as detransitioners. A study out of Sweden followed 
adults who received treatment for gender dysphoria from 1960 to 2010. 
It found that roughly 2 percent of those in the study detransitioned. A 
new study in 2022, however, found that roughly 10 percent of people who 
received treatment detransitioned. And that number may be growing.
  Given the nature of these types of studies on regret, we won't know 
for many years what percent of the boys and girls receiving 
irreversible treatments today will regret it when they enter adulthood. 
We just don't know. But if the 10 percent figure holds, gender 
activists will have wrongfully mutilated or sterilized more than 1,500 
American children between 2017 and 2021 alone. And there is good reason 
to believe that the rate of detransitioning will be much higher than 
current studies indicate because the majority of children who present 
with gender dysphoria at a young age outgrow it. Eighty-five percent 
outgrow it.
  A 2017 study published in the Journal of Clinical Endocrinology and 
Metabolism found that 85 percent of children with gender dysphoria 
outgrew it during adolescence. And you know what, Mr. President, this 
figure is only surprising if you have never met a kid. Children change 
their minds often. Duh. One week, they are obsessed with dolphins. The 
next week, they love race cars. A kid can morph from the sweetest boy 
you have ever seen into a

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honey badger within the course of one Sunday morning church service, 
and we have all had that experience, and that is normal.
  Kids don't typically have a mature sense of self or impulse control, 
and that is why God gave them parents. But today, if a little girl has 
a week where she thinks she is a boy because she hates wearing dresses 
and loves to climb trees with her brothers, some activists think we 
ought to pump her full of puberty blockers that destroy her bone health 
so she feels ``affirmed'' in her decision to play cops and robbers with 
the boys.
  Secretary Hillary Clinton once famously said it takes a village to 
raise a child. What she meant was it takes a Federal Government to 
raise a child. No, it doesn't. Kids need parents to succeed, and 
parents have the right to raise their children according to their 
values. Parents are here to protect kids from danger, from the kids' 
own immaturity, and from misguided government agents.
  And contrary to what these activists say, there are some sane ways to 
treat children who struggle with gender confusion. Many doctors in 
Europe and the United States recognize that permanently maiming and 
chemically castrating confused children is bone-deep, down-to-the-
marrow stupid. That is why many physicians have adopted the practice of 
``watchful waiting.'' That is a treatment plan--we offer it in 
Louisiana--whereby doctors and psychologists wait to implement any 
medical treatment to children with gender dysphoria while watching to 
ensure that they have all the responsible mental health support that 
they need.
  As I mentioned earlier, 85 percent of children will outgrow their 
dysphoria during puberty. Watchful waiting ensures that the child is 
well supported and protected from irreversible physical and 
psychological damage.
  Some activists, though, don't want to let doctors wait, and a lot of 
those activists work in the Biden administration. In 2021, the Biden 
administration announced that it would start requiring doctors to issue 
hormone treatments or surgeries to transgender individuals, even if 
such procedures--even if such procedures--run contrary to the doctor's 
medical judgment or religious beliefs. And, unsurprisingly, the Biden 
administration has been sued over that.
  It is not just doctors facing pressure to conform to the demands of 
gender activists. In some States, parents have lost custody of their 
kids for refusing to do it. Schools have fired counselors simply for 
wanting parents to be told about their kid's gender transition.
  I am terrified that our country is mass-producing a generation of 
mutilated and sterilized young people because policymakers in our 
schools and our cities and our State capitals and Washington are too 
afraid to stand up and say: Enough.
  And that is why, in conclusion, I am so proud of the Louisiana State 
Legislature. The Louisiana State Legislature passed HB648. HB648 
protects Louisiana's children and supports their parents. HB648 makes 
it illegal to use puberty blockers, cross-sex hormones, and surgery on 
children under the age of 18--period, full stop.
  It wasn't easy to get this bill passed. Our lawmakers faced strong 
opposition from gender activists, and our former Governor, John Bel 
Edwards, vetoed the bill. But in Louisiana, we will run into hell and 
back to keep our kids safe, and that is why senate and house members--
Democrats and Republicans--in the Louisiana State Legislature overrode 
the Governor's veto. They said: No, children are children.
  Congress should follow the leadership of the Louisiana State 
Legislature and so many European governments to ensure that parents--
not activists--have the power to make medical and moral decisions for 
their children. And that is why I am helping to lead the Families' 
Rights and Responsibilities Act, which would do that. This bill would 
require the Federal Government to pass the strict scrutiny test--that 
is the Supreme Court's toughest level of review--before it could 
infringe upon a parent's right.
  Nothing disturbs me more than the notion that a child's upbringing 
should be determined by some bureaucrat rather than the child's 
parents, especially when those bureaucrats use the power of the 
government to maim children. It makes me want to throw up. It makes me 
want to reach for the sick bucket.
  Congress must do more to protect parents and their kids from the 
zealots of the transgender movement and from newspaper reporters who 
inaccurately report the news.
  I yield to my colleague Senator Peters.
  The ACTING PRESIDENT pro tempore. The Senator from Michigan.