CHARLESTON – After passing a new-total ban on medication-based gender affirming care in West Virginia two years ago, state senators moved a bill Tuesday to tighten any remaining loopholes.

The Senate Health and Human Resources Committee recommended Senate Bill 299 – modifying state regulations on pubertal modulation, hormonal therapy, and gender reassignment – for passage Tuesday afternoon, sending the bill to the Senate Judiciary Committee for further review.

SB 299 aims to restrict gender affirming care for individuals under 18. The bill amends existing codes to prohibit physicians, physician assistants, and advanced practice registered nurses from providing gender reassignment surgeries and gender-altering medications to minors, with limited exceptions for certain medical conditions.

The bill removes a previous exception allowing hormonal therapy for severe gender dysphoria under specific conditions, such as multiple medical and mental health professional opinions, and parental consent.

The legislation establishes that violating these prohibitions constitutes unprofessional conduct, subject to disciplinary actions by licensing boards. The bill allows individuals to pursue legal recourse for actual or threatened violations, including compensatory damages and injunctive relief. Finally, the Attorney General is empowered to enforce compliance.

If it passes the Legislature and Gov. Patrick Morrisey approves, the bill’s changes would take effect on Aug. 1. There is no grandfather provision for individuals currently receiving treatment when the bill goes into effect.

The Legislature passed House Bill 2007 in 2023, prohibiting physicians from providing irreversible gender reassignment surgery or medication for gender-affirming care, such as hormones or puberty blockers, to a person who is under 18 with certain exceptions.

That bill included guardrails to limit use of medication gender affirming care to adolescents who have been diagnosed with severe gender dysphoria by multiple physicians in order to address psychological issues and prevent self-harm and as long as the medication is limited to the lowest doses necessary.

Gender dysphoria is defined as a sense of unease that a person may have because of a mismatch between their biological sex and what they perceive to be their gender identity. According to the UCLA Williams Institute, approximately 700 children between the ages of 13 and 17 identified as transgender in West Virginia in 2022, or approximately .7% of the state’s population in that age range.

Supporters for SB 299 argue for the bill as a means of protecting children from potentially harmful and irreversible procedures, while opponents raise concerns about the potential for increased suicide risk among transgender youth if access to care is restricted.

“We know in studies of transgender teens who are currently receiving gender affirming hormone treatment…that looking back in the prior year there are 40% lower odds of having serious depression and lower odds of attempting suicide in the prior year,” said Dr. Chantel Weisenmuller, a member of the board of directors of the West Virginia Psychological Association.

Christina Jackson, a licensed psychologist and professional counselor in Wood County, said during her nearly decade-long career, she has only had five clients diagnosed with gender dysphoria. Jackson said she has never had a client under the age of 18 who was receiving medication-based gender affirming care. Jackson said SB 299 would make it harder for her to do her job.

“When a bill like this comes through that goes against the standards of care that I have to follow for my professional license, it really puts this dissonance between my ability to practice in-line with my code of ethics and what I know the evidence to says, versus legislation and being a business owner involving the laws,” Jackson said. “That kind of dissonance causes distress. Of course, it has me worried for outcomes for my patients.”

Those in favor – such as Matt Sharp, an attorney with the conservative Alliance Defending Freedom – argue that gender affirming treatments are “dangerous, experimental, and unproven,” potentially causing “permanent sterilization” and long-term harm. Sharp cited the Cass Review, a report issued in England last year looking at gender affirming care.

“Multiple long-term studies show that when a young child who’s experiencing gender dysphoria is allowed to mature naturally, most of them…grow out of their gender dysphoria,” Sharp said.

“But there is no evidence that gender affirming treatments reduce (suicide). Such evidence…suggests that these deaths are related to a range of other complex psychosocial factors and to mental illness.”

The committee also heard from Simon Amaya Price, who identifies as a “desister,” or someone who had identified as transgender but decided to live as their biological gender instead.

“At the moment, the law in West Virginia says that if you get the sign-off from two doctors, you can receive puberty blockers and cross-sex hormones as a minor,” Price said. “In my case, I had four who would have done that. They believe that if you don’t give trans-identified kids puberty blockers, cross-sex hormones and surgeries that they will kill themselves. That is a damned lie, and I am living proof of that fact.”