New Law Ensures Pathway to Essential Healthcare for Transgender Minors

Governor Mills Signs LD 535, An Act Regarding Consent for Gender-affirming Hormone Therapy for Certain Minors

A new law signed by Governor Mills today will allow transgender minors who have reached a minimum age of 16, have a diagnosis of gender dysphoria, and are being harmed or will be from being denied medically necessary health care, to have a medical pathway to receive such care.  LD 535 authorizes 16- and 17-year-olds in those circumstances and who meet detailed requirements of counseling and informed consent to receive evidence-based, medically recommended non-surgical care if they are deemed competent to give such consent and their parents refuse to provide the required care. 

Broad medical consensus recognizes that puberty-blocking medication and/or cross-hormone therapy is the standard of care for minors in appropriate circumstances. Evidence shows that minors who have been diagnosed with gender dysphoria have better life outcomes and more successful treatment when they receive timely care and are able to go through puberty congruent with their gender identity.

While many transgender minors receive care with the support and involvement of their parents, LD 535 ensures minors capable of informed consent and who have had detailed counseling with a physician and some other health care providers are not denied necessary and timely care.

“Getting real information about transgender people, and the process of acceptance and understanding, can be challenging and complex for families of transgender youth. Pediatricians strive to create a safe environment for parents to better understand and listen to the needs of their children while receiving support, and for adolescents to understand their parents’ concerns as well – but unfortunately parental acceptance isn’t always attained by adolescence,” said Joe Anderson, DO, Advocacy Chair of the American Academy of Pediatrics, Maine Chapter. “Gender dysphoria is a well-recognized medical diagnosis with an established and effective treatment and delaying access to care can have harmful consequences. LD 535 will help ensure that mature transgender minors receive the care they need when they need it, which will lead to better long-term outcomes.”

LD 535 was introduced by Representative Sheehan and cosponsored by Senator Tipping and Representatives Malon, Moonen, Osher, and Rana. It creates a pathway for a limited set of 16 and 17-year-olds with diagnosed gender dysphoria and who are experiencing harm to access care in line with existing avenues under Maine law regarding other kinds of medical treatment such as mental health care and substance use treatment.

“LD 535 will protect the lives of young transgender people who will certainly be harmed by a delay in receiving the medical care recommended by their providers,” said Representative Sheehan. “Parents of trans youth may withhold consent for care for a variety of reasons, including out of a desire to protect their children from possible adverse consequences, yet medical research makes clear that for some youth there are grave risks associated with delaying or denying gender-affirming care. This law assures that transgender young people can be spared harmful long-term consequences of delayed care while allowing the family the opportunity to continue the work of developing mutual understanding and support.”

The legislation received wide support from parents, youth, medical providers, and youth advocates who testified at House and Senate hearings. It passed by significant margins in the House and in the Senate.

“Despite broad medical consensus and well-established standards of care, transgender healthcare remains highly stigmatized, and as a result youth don‘t always get the care they need,” said Quinn Gormley, Executive Director, Maine TransNet. “It is completely understandable that parents may have fears and questions about what their transgender kids are going through, but the fact is that choosing not to act is not neutral – delaying access to care can have serious consequences for transgender young people. LD 535 will ensure that mature minors who have worked through an extensive evaluation with their healthcare team and whose providers recommend that they begin hormones are not denied medically necessary care simply because the care they need is misunderstood and stigmatized.”

LD 535 requires that a minor seeking care be at least 16-years-old and that a health care professional establishes that they meet the following thresholds: the minor has been diagnosed with gender dysphoria; the minor is experiencing or will experience harm if the care is not provided; and the minor is mentally and physically capable to consent and has provided informed written consent.

“A strong relationship with parents is a protective factor for young people, and parents have an important role in loving, supporting and guiding decisions for their children, including healthcare decisions consistent with medical standards of care. But young people who are 16 or 17 and capable of informed consent as determined by a doctor and some other health care professionals and who need care should not suffer needlessly because other people, even the parents they love, do not understand their condition or support their care,” said Mary Bonauto, Senior Director of Civil Rights and Legal Strategies at GLBTQ Legal Advocates & Defenders. “Maine has been responsive to the needs of young people by enacting laws to allow them to get needed care, particularly for stigmatized conditions. In that tradition, LD 535 provides specific guidelines to allow transgender young people to access necessary care that will allow them to thrive, while limiting disruption to family relationships.”

“Young people should have access to the health care they need,” said Meagan Sway, Policy Director, ACLU of Maine. “While state law recognizes that health care decisions for minors typically involve the consent of a parent or guardian, it also allows that some forms of life-saving care are so important that minors should be able to receive it, even in the absence of parental support. LD 535 will ensure older transgender teenagers who are 16 and 17 years old can access this life-saving standard of care.”