A proposal to make technical revisions to a 2022 shield law reignited debate over gender-affirming care for minors and puzzled lawmakers who did not recall protections for such treatments applying to the original legislation.
Senate Bill 214, introduced by the Judiciary Committee, would essentially split the state’s existing definition of “reproductive health care services” to create a separate definition for “gender-affirming health care services.”
It would amend the state’s 2022 abortion shield law, a first-in-the-nation statute designed to protect Connecticut doctors and patients who perform and receive abortion care from out-of-state litigation in anticipation of the overturn of Roe v. Wade.
Rep. Steven Stafstrom, a chair of the committee, said the bill came at the request of the Legislative Commissioners’ Office in order to make clarifying revisions to existing statute.
“That’s one of the things this committee does year in and year out,” Stafstrom said at a public hearing on the proposal. “One of our functions of government is to clean up where there are ambiguities in statute. My understanding is the bill before us does not change substantive Connecticut law. “
A representative of LCO confirmed that the bill simply removes duplicative statutes to consolidate existing laws.
While acknowledging Stafstrom and LCO’s assurances, several members of the committee expressed that, to them, the application of gender-affirming care to the shield law was an unfamiliar concept. Others argued that the proposed revision constitutes a substantive change.
“I don’t remember that being explored during our debate of the reproductive health care services (bill) on the floor of the House when this was done,” Rep. Tom O’Dea said.
“I don’t remember having the conversation either,” Rep. Cara Pavalock-D’Amato later echoed.
The reason why the lawmakers could not recall ever discussing gender-affirming care within the context of the 2022 reproductive rights shield law is because the language was never part of the bill.
When H.B. 5414, passed the House on April 19, and the Senate on April 29, 2022, the legislation made no explicit mention of any form of gender-affirming care.
At its passage, Public Act 22-19 defined “reproductive health care services” as “all medical, surgical, counseling or referral services relating to the human reproductive system, including, but not limited to, services relating to pregnancy, contraception or the termination of a pregnancy.”
Days later, between May 2 and 3, 2022, the definition was amended to include “all medical care relating to treatment of gender dysphoria” through a provision tucked into a 739-page budget implementer bill that was introduced for emergency certification.
Last session, the definition of “reproductive health care services” was updated once again, this time in a 878 page budget implementer, to include “all medical care relating to treatment of gender dysphoria as set forth in the most recent edition of the American Psychiatric Association’s ‘Diagnostic and Statistical Manual of Mental Disorders’ and gender incongruence, as defined in the most recent revision of the ‘International Statistical Classification of Diseases and Related Health Problems.’”
At a public hearing Monday, those who did and did not support the bill appeared to share a common ground in the idea that “gender-affirming health care services” should not fall under the definition of “reproductive health care services.”
Local and national opponents of gender-affirming care for minors testified against the proposal, citing concerns of parental consent, children’s health and what they described as a lack of mental health treatment for individuals exploring gender-affirming care.
Several spoke in support of amending the bill to have the definition of gender-affirming care only apply to adult patients.
In comments before the committee, Dr. Michelle Cretella testified that she is serving as a consultant to several attorneys in lawsuits against doctors who performed gender-affirming care on teens. Cretella said the litigants are “detransitioners,” patients who choose to reverse a gender transition.
Cretella, who identified herself as a pediatrician and consultant who practiced general pediatrics with a focus in behavioral mental health for 15 years in Connecticut and Rhode Island, is the former president and executive director of the American College of Pediatricians, an organization identified as a “fringe anti-LGBTQ hate group” by the Southern Poverty Law Center.
Cretella said the women in the lawsuit received gender-affirming care as teenagers who “sustained permanent damage” as a result of their medical transition.
“These young women had had their mental and physical health devastated by that care,” Cretella said. “Every detransition was first a minor, a child with gender dysphoria who fell prey to social contagion and doctors who pushed them into medical and surgical gender-affirming care despite a laundry list of a long history of multiple traumas and mental illnesses that they did not treat or resolve.”
Leslie Wolfgang, the director of public policy for the Family Institute of Connecticut argued that without a caveat restricting the gender-affirming care definition to patients over 18, out-of-state patients who received treatment in Connecticut as a child and later detransitioned would be limited in their ability to seek recourse against their doctors.
“At the root of every lawsuit is a hurting person in the matter of these lawsuits from out of state related to gender affirming health care services, there is likely a person who received gender-affirming services as a child and is now suing a medical provider,” Wolfgang said. “This law creates uncertainties and hurdles for them as they seek to have their legal claims fairly heard and investigated.”
Connecticut’s law could address out-of-state laws that deputize citizens to enforce bans on medical procedures that are legal in Connecticut by filing lawsuits against patients and doctors.
According to a summary of the law by the Office of Legislative Research, the shield protections would not apply in out-of-state lawsuits where the claim is “similar to one that exists under Connecticut law,” and is a “tort-, contract-, or statutory-based claim brought by a patient, or their authorized legal representative … for damages the patient suffered or from another individual’s loss of consortium with the patient.”
More than 20 states have enacted bans on pharmacological and surgical gender-affirming health care for minors. In five states, providing such treatment is a felony. Connecticut is currently one of 14 states with shield laws to protect patients and medical professionals who seek and provide this care.
Christy Olezeski, the director and co-founder of the Yale Pediatric Gender Program, said patients are fleeing their home states to access gender-affirming care in Connecticut.
In testimony submitted to the committee, Olezeski said this treatment can be “lifesaving for youth.”
Olezeski said Connecticut “must continue to uphold and strengthen” its shield laws to ensure that youth, families and providers can access and perform gender-affirming care.
“As threats against bodily autonomy are rising, we need to ensure that individuals can come to Connecticut to receive medically necessary care,” Olezeski said. “As the increased legislation taking away access to bodily autonomy is having a chilling effect on providers, shield laws are imperative to ensure that providers have protections to provide the treatment they have been trained to provide.”
In written testimony, several LGBTQ+ activists, allies, parents and physicians expressed their support for the proposal and gender-affirming health care.
The representatives of the Connecticut Office of the Attorney General, American Civil Liberties Union of Connecticut and Connecticut Hospital Association also submitted comments in support of the bill’s clarifications.
Tong praised the bill’s importance in protecting access to health care and underscored its clarifying role.
“Because of Public Act 22-19, Connecticut residents have protections from being subjected to litigation for providing or receiving reproductive health care and gender-affirming health care services that are lawful in Connecticut,” Tong wrote. “These protections are essential for individuals seeking the medical care they need without fear of intimidation or legal liability. S.B. 214 consolidates duplicative statutes that relate to those protections. Consolidation is important to reduce confusion caused by duplicative, but not identical, statutory provisions.”
The CHA said the technical revision would “reduce confusion, which in turn is likely to improve understanding and compliance with the laws” and that they support the bill “as part of the state’s efforts to protect patient rights.”
