Bloomington City Council to Vote on Safe Haven for Gender-Affirming Health Care Wednesday, June 12, 2024

Staff report

BLOOMINGTON, Ind. — June 12, 2024

The Bloomington City Council is set to vote Wednesday night on a resolution to designate the city as a “safe haven” for gender-affirming health care. The measure, sponsored by council members Matt Flaherty and Courtney Daily, aims to protect individuals seeking such care in response to restrictive state laws.

The vote requires approval from all five participating council members to pass. Council members Dave Rollo and Andy Ruff have chosen to abstain from the vote.

The resolution comes after the Indiana General Assembly passed Senate Bill 480 in 2023, banning gender-affirming healthcare for transgender and gender-diverse minors. This move prompted the Bloomington/Monroe County Human Rights Commission to advocate for local protections.

The resolution declares that the city will not impose penalties on individuals or organizations for providing, seeking, or assisting others in accessing gender-affirming healthcare. It also prioritizes non-enforcement of state or external jurisdiction laws penalizing such activities.

Supporters argue that gender-affirming healthcare is essential and lifesaving, backed by numerous medical institutions, including the American Medical Association and the American Academy of Pediatrics. They assert that access to such care improves mental health outcomes and reduces suicide risks among transgender individuals.

Opponents, including Rollo and Ruff, express concerns over the resolution’s rapid progression and the complexities surrounding gender-affirming care for minors. They call for further investigation into the associated medical and ethical issues.

The council meeting will begin at 6:30 p.m. at the Council Chambers in the Showers Building and can also be accessed online.

If passed, the resolution would align Bloomington with other cities that have adopted similar measures, reinforcing the city’s commitment to supporting and protecting its transgender and gender-diverse residents.


Bloomington City Council Agenda June 12, 2024
The official version can be found at this link: https://bloomington.in.gov/onboard/meetingFiles/download?meetingFile_id=13579 ]
City of Bloomington Common Council
Agenda for June 12, 2024
Start Time: 6:30 p.m.
Physical location: Council Chambers (#115), Showers Building, 401 N. Morton Street
Online location: The meeting can be accessed remotely at the following link: https://bloomington.zoom.us/j/87264778283?pwd=vULGhEwGK6zUa6spfKTtKIaViHLa1a.1

The text of the resolution:

RESOLUTION 2024-14
TO PROTECT INDIVIDUALS SEEKING GENDER AFFIRMING CARE
WHEREAS, in 2023, the Indiana General Assembly passed Senate Bill 480, banning gender-affirming
healthcare for transgender and gender diverse Hoosiers under the age of 18; and
WHEREAS, gender affirming healthcare has been proven to be evidence-based, medically necessary,
and lifesaving by the American Medical Association1, the American Academy of Child
and Adolescent Psychiatry2, the American Academy of Pediatrics3, the Endocrine
Society4, the American Psychiatric Association5, and the World Professional Association
for Transgender Health6, among other institutions; and
WHEREAS, studies have shown that gender transition, including access to gender-affirming
healthcare, improves the overall wellbeing of transgender people and that access to
gender-affirming healthcare for youth is associated with better mental health outcomes
and lower risks of suicide7; and
WHEREAS, multiple healthcare institutions across the country, including in Indiana, have scaled back
or have considered scaling back gender-affirming healthcare services in response to legal
challenges, perception of legal risk, harassment, or threats of violence; and
WHEREAS, it is necessary and appropriate to exercise the authority vested in the City of
Bloomington, including the coordinated and integrated direction, supervision, and control
of all City of Bloomington departments, boards, commissions, and other agencies, to
protect healthcare professionals and persons lawfully seeking, receiving, and assisting
another individual in seeking or receiving gender-affirming healthcare in the City of
Bloomington; and
WHEREAS, Bloomington Municipal Code Section 2.23.110 sets out the policy of the City of
Bloomington to not discriminate on the basis of sex, sexual orientation, or gender
identity; and
WHEREAS, the Bloomington/Monroe County Human Rights Commission is charged by the City of
Bloomington and by Monroe County with investigating complaints filed with the
Commission and with enforcing the respective Human Rights Ordinances of both the
City of Bloomington and Monroe County; and
WHEREAS, the Bloomington/Monroe County Human Rights Commission fully supports this
resolution, the draft of which was approved by the Commission on January 22, 2024;
NOW THEREFORE, BE IT HEREBY RESOLVED BY THE COMMON COUNCIL OF THE CITY
OF BLOOMINGTON, MONROE COUNTY, INDIANA THAT:
1 Advocacy Update, American Medical Association, AMA Fights to Protect Health Care for Transgender Patients, Mar. 26,
2021, https://www.ama-assn.org/health-care-advocacy/advocacy-update/march-26-2021-state-advocacy-update.
2 Policy Statement, American Academy of Child & Adolescent Psychiatry, AACAP Statement Responding to Efforts to Ban
Evidence-Based Care for Transgender and Gender Diverse Youth, Nov. 8, 2019,
https://www.aacap.org/AACAP/Latest_News/AACAP_Statement_Responding_to_Efforts-to_ban_Evidence-
Based_Care_for_Transgender_and_Gender_Diverse.aspx.
3 News Release, American Academy of Pediatrics, AAP Policy Statement Urges Support and Care of Transgender and
Gender-Diverse Children and Adolescents, Sept. 17, 2018, https://www.aap.org/en/news-room/news-releases/aap/2018/aap-
policy-statement-urges-support-and-care-of-transgender-and-gender-diverse-children-and-adolescents/.
4 Press Release, Endocrine Society, Discriminatory Policies Threaten Care for Transgender, Gender-Diverse Individuals,
Dec. 16, 2020, https://www.endocrine.org/news-and-advocacy/news-room/2020/discriminatory-policies-threaten-care-for-
transgender-gender-diverse-individuals. See also Position Statement, Endocrine Society, Transgender Health, Dec. 16, 2020,
https://www.endocrine.org/advocacy/position-statements/transgender-health.
5 News Release, American Psychiatric Association, Frontline Physicians Oppose Legislation That Interferes in or
Criminalizes Patient Care, Apr. 2, 2021, https://www.psychiatry.org/newsroom/news-releases/frontline-physicians-oppose-
legislation-that-interferes-in-or-criminalizes-patient-care.
6 E. Coleman et al., Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, International
Journal of Transgender Health, Sep. 15, 2022, https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644.
7 Diana M. Tordoff et al., Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care,
JAMA network open, Feb. 25, 2022, at 1, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423.114
Section 1. The Mayor and Council hereby declare the City of Bloomington a Safe Haven for Gender
Affirming Healthcare, adopting the following Gender-Affirming Healthcare Policy:
Gender-affirming healthcare is defined as any combination of medical, surgical, mental health,
and non-medical services designed to support and affirm an individual’s gender identity.

  1. City personnel shall not impose administrative penalties on an individual or organization
    for providing, seeking, receiving, or assisting another individual who is seeking or receiving
    gender-affirming healthcare, except as otherwise required by law.
  2. In the event any law or regulation is passed in the State of Indiana that imposes civil
    liability, administrative penalties, or professional sanctions on an individual or organization
    for providing, seeking, receiving, or assisting another individual who is seeking or receiving
    gender-affirming healthcare, city personnel shall make enforcement of said law or regulation
    a low priority.
  3. City personnel shall not enforce laws of other jurisdictions that impose civil liability,
    administrative penalties, or professional sanctions, on an individual or organization for
    providing, seeking, receiving, or assisting another individual who is seeking or receiving
    gender-affirming healthcare, except as otherwise required by law.
  4. City personnel shall not respond to any request for information from another jurisdiction if
    the request is related to that jurisdiction’s laws, rules, or regulations imposing criminal
    punishment, civil liability, administrative penalties, or professional sanctions, on an
    individual or organization for providing, seeking, receiving, or assisting another individual
    who is seeking or receiving gender-affirming healthcare, except as otherwise required by
    law.
  5. City personnel shall not enforce or facilitate the collection of any judgment of another
    jurisdiction to the extent the judgment arises out of a cause of action in that jurisdiction based
    on providing, seeking, receiving, or assisting another individual who is seeking or receiving
    gender-affirming healthcare, except as otherwise provided by law.
    Section 2. If any section, sentence or provision of this resolution, or application thereof to any person or
    circumstances shall be declared invalid, such invalidity shall not affect any of the other sections,
    sentences, provisions or application of this resolution which can be given effect without the invalid
    provision or application, and to this end the provisions of this resolution are declared to be severable.
    PASSED AND ADOPTED by the Common Council of the City of Bloomington, Monroe County,
    Indiana, upon this _ day of __________, 2024.

ISABEL PIEDMONT-SMITH, President
Bloomington Common Council
ATTEST:


NICOLE BOLDEN, Clerk
City of Bloomington
PRESENTED by me to the Mayor of the City of Bloomington, Monroe County, Indiana upon this
day of ____________, 2024.


NICOLE BOLDEN, Clerk
City of Bloomington115
SIGNED and APPROVED by me upon this day of ____________, 2024.


KERRY THOMSON, Mayor
City of Bloomington
SYNOPSIS
This resolution is sponsored by Councilmember Daily and Councilmember Flaherty and comes forward
on the recommendation of the Bloomington/Monroe County Human Rights Commission. The resolution
acknowledges the importance of access to gender affirming healthcare and notes that such access has
come under recent threat. The resolution adopts a Gender-Affirming Healthcare Policy to be followed
by city personnel.116

MEMO FROM COUNCIL OFFICE:
To: Members of the Common Council
From: Ash Kulak, Deputy Administrator / Deputy Attorney
Date: June 7, 2024
Re: Resolution 2024-14 – To Protect Individuals Seeking Gender Affirming Care
Synopsis
This resolution is sponsored by Councilmember Daily and Councilmember Flaherty and comes
forward on the recommendation of the Bloomington/Monroe County Human Rights Commission.
The resolution acknowledges the importance of access to gender affirming healthcare and notes
that such access has come under recent threat. The resolution adopts a Gender-Affirming
Healthcare Policy to be followed by city personnel.
Relevant Materials

  • Resolution 2024-14
  • Memo from Sponsors, Councilmembers Courtney Daily & Matt Flaherty
  • Bloomington/Monroe County Human Rights Commission Proposed Resolution
  • Community Advisory on Public Safety Resolution 23-01
  • Gender-Affirming Care Fact Sheet from HHS Office of Population Affairs
  • Report from UCLA Williams Institute on Trans Youth Health Care Bans
  • American Academy of Pediatrics News Release & Policy Statement on Gender-Affirming Care
  • Endocrine Society Position Statement on Transgender Health
    Summary
    This resolution, sponsored by Councilmembers Daily and Flaherty, comes at the request of the
    Bloomington/Monroe County Human Rights Commission (HRC). The Bloomington/Monroe
    County HRC considered this item at several of its meetings following the Indiana General
    Assembly’s passage of Senate Bill 480 in April 2023. The Bloomington/Monroe County HRC
    unanimously passed its Safe Haven from Anti-Transgender Laws Statement (included herein) at
    its January 2024 meeting. Subsequent HRC meetings this year included updates about the status of
    SB 480 in the courts and included discussions about bringing forward this resolution.
    The Community Advisory on Public Safety Commission also passed a resolution (included herein)
    at its November 2023 meeting calling for the city to declare itself a Safe Haven for Transgender
    Youth and adopt a policy consistent with formally condemning any state action to abrogate the
    fundamental liberties of gender diverse youth.
    Both commissions considered Kansas City, Missouri City Council’s Resolution No. 230385, entitled
    “Declaring the City of Kansas City a Safe Haven for Gender-Affirming Healthcare through adoption
    of a Gender-Affirming Healthcare Policy,” which was passed by the Kansas City Council on May 11,
    2023 in the wake of the Missouri General Assembly passing legislation prohibiting transgender
    youth from accessing gender affirming care. The language of proposed Resolution 2024-14 was
    modeled off of Kansas City, Missouri’s resolution.112
    Background on Indiana SB 480
    Indiana SB 480 was signed into law by Governor Holcomb on April 5, 2023. SB 480 was supposed
    to go into effect on July 1, 2023, with a weaning provision allowing transgender youth who already
    had access to gender-affirming healthcare to continue accessing such care until December 31,
  1. The ACLU filed a class action lawsuit against the bill on the same day it was signed into law.
    The ACLU argued for and received a preliminary injunction temporarily stopping the bill from
    going into effect before the case could be fully argued at trial. The state appealed. On February 27,
    2024, a panel of the 7th Circuit Court of Appeals stayed the injunction, which meant that SB 480
    went into immediate effect the next day. The 7th Circuit denied rehearing. The ACLU may choose
    to consider additional avenues for further litigation. At this time, SB 480 remains in effect.
    Effect of this Resolution
    This resolution would implement a city-wide Gender-Affirming Healthcare policy that clarifies, as
    permitted by law, the city’s priorities for enforcement of other laws or regulations passed by the
    state or other jurisdictions requesting information about; facilitating the collection of a judgment
    for; or imposing liability, penalties, or sanctions for receiving or assisting receipt of gender-
    affirming healthcare.
    The policy would define gender-affirming healthcare and would direct city personnel to follow the
    policies described below, with the caveat that all personnel must follow any requirements of state
    or federal law, including those that might conflict with these policies:
  • city personnel should not impose any penalties on people who provide, look for, receive, or
    help someone else receive gender-affirming healthcare;
  • clarify that the city’s priorities are low for enforcing any state law imposing various
    penalties for providing, looking for, receiving, or helping someone else receive gender-
    affirming healthcare;
  • city personnel should not enforce laws of other states that impose various penalties on
    people who provide, look for, receive, or help someone else receive gender-affirming care;
  • city personnel should not respond to requests for information from other states if those
    requests for information will be used to impose various penalties on people who provide,
    look for, receive, or help someone else receive gender-affirming healthcare; and
  • city personnel should not help collect judgments from other states when those judgments
    come from private causes of action established by those states against people who provide,
    look for, receive, or help someone else receive gender-affirming care.
    The sponsors are unaware of a fiscal impact to the City.
    Contact
    Councilmembers Courtney Daily & Matt Flaherty and the Office of the Common Council, 812-349-
    3409, [email protected]

Statement from Matt Flaherty and Courtney Daily:

To: Members of the Common Council
From: Councilmembers Courtney Daily & Matt Flaherty
Date: June 7, 2024
Re: Resolution 2024-14, To Protect Individuals Seeking Gender Affirming Care
Dear Council Colleagues,
Members of the Bloomington/Monroe County Human Rights Commission (BMCHRC)
approached us with the request that the Common Council consider and pass a Resolution
declaring the City of Bloomington a Safe Haven for transgender youth. This action came in the
wake of the Indiana General Assembly passing Senate Bill 480 in April of 2023, which prohibits
minors from accessing gender affirming care in the state. The BMCHRC has been working on
this item since mid-2023, when SB 480 was signed into law by Governor Holcomb, and the
BMCHRC unanimously passed a draft resolution at its January 2024 meeting to forward to the
Council for our consideration.
SB 480 was supposed to go into effect on July 1, 2023, but the ACLU sued and received a
preliminary injunction blocking the law until the 7th Circuit Court of Appeals struck it down
abruptly in late February of this year, making the law go into immediate effect. Transgender and
gender diverse youth and their families suffered an immediate end to life-saving care overnight.
The BMCHRC responded by continuing to put this item on its agenda even after passing its
statement in January.
Gender affirming care is defined by the World Health Organization to mean “any single
combination of a number of social, psychological, behavioural [sic] or medical (including
hormonal treatment or surgery) interventions designed to support and affirm an individual’s
gender identity.” Typically, minors under the age of 18 must receive parental consent to undergo
gender-affirming medical treatments. Treatment can commonly include recommendations for
establishing a relationship with a mental health provider. The Endocrine Society and the
American Academy of Pediatrics both recommend treatment of adolescents.
This resolution establishes a robust Gender-Affirming Healthcare Policy aligned with the City’s
commitment to non-discrimination based on sex, sexual orientation, or gender identity (BMC
2.23.110). Under this policy, the City will adjust its enforcement priorities to ensure that laws or
regulations penalizing individuals for seeking or providing gender-affirming healthcare are not
prioritized. This includes refraining from requesting information about such healthcare or
assisting in the collection of penalties related to it. By enacting this policy, the City underscores
its dedication to protecting the rights and well-being of its transgender and gender-diverse
residents.
In essence, this resolution serves as a beacon of inclusivity and support for transgender
individuals within our community. It reinforces the principle that all residents, regardless of
gender identity, deserve equal access to necessary medical care. By formalizing this commitment
through policy, the City aims to alleviate the concerns and anxieties of transgender individuals
and their families, ensuring they can reside in Bloomington with confidence, knowing they will
be supported in living authentically and receiving the healthcare they require.
We have been in touch with members of the Bloomington/Monroe County Human Rights
Commission, as well as pertinent City staff including Legal about the potential legal
ramifications of any such policy. We ask for your support of Resolution 2024-14. Thank you.117

Memo from Rollo/Ruff on Resolution 2024-14.
As strong supporters of the LGBTQ+ community and equal rights for all, we took it very seriously
when we recently became aware of significant high-profile controversy involving the
organization WPATH (World Professional Association for Transgender Health), and also that the
governments of several European nations had recently enacted restrictive and prohibitive
positions and policies towards certain kinds of gender-affirming care for minors.
Recognizing how extremely important the implications of these issues are, especially as they
pertain to minors, and how thoroughly complex the issues are, with the highest level of due
diligence being demanded in taking up a City resolution on gender-affirming care that includes
minors and promotes the use of such methods as puberty blockers and surgeries, we requested
that the sponsors of the resolution take Resolution 2024-14 off of a fast-track to allow time to
investigate. The sponsors of this resolution would not agree to take more time. This memo and
packet addendum is the alternative we were left with to explain our concerns and provide
information and reference materials that illustrate why we would be reluctant at this point to
vote yes or no on this resolution. Quite simply, more time is required to get a better
understanding of the controversies, associated policy changes, and the most current scientific
information regarding minors and certain types of gender-affirming care.
The resolution draft was reviewed by City Legal and their approved version was made available
to Council members just three days before it appeared in the packet. This fast-tracking has
placed us in the nearly impossible position of adequately processing conflicting and
contradictory evidence about gender-affirming care (also known as gender transitioning), which
involves puberty blockers (in the case of children and adolescents), cross-sex hormones, and
surgeries.
This is a very sensitive topic, that should be discussed with care, dignity and respect for those
who choose to transition, and empathy for what are significant difficulties that may be
encountered in the process. We also unequivocally condemn discrimination directed to trans
individuals and note our long support of the LGBTQ community.
Sadly, politicization of the topic of gender-affirming care is rampant, especially in the U.S., with
each side of the spectrum wishing to score points. This has created an environment where
asking questions and examining data is denounced and the questioner maligned. This is a
terrible situation for medical science to operate in. Debate and discussion are essential for
understanding any topic of inquiry, especially one that is so consequential and where experts
clearly disagree.
We fully support the bodily autonomy of adults and their right to undergo hormonal treatment
and surgeries – with informed consent – the foundation of medical ethics. But children are a
different matter for several reasons. First, minors cannot legally provide informed consent; their
parents or legal guardians must grant consent. Furthermore, with respect to gender-affirming
care, children generally lack the cognitive development to understand the implications of
2
sterility, inability to experience orgasm, and other potential but serious complications of gender
transitioning. Third, because children have not gone through puberty, gender-affirming care
involves even more life altering and irreversible changes to their person than is the case for
adults who undertake such care.
Parents or legal guardians of children are responsible for their children’s well-being, and for
protecting them from abuse or hazard. In the case of medical interventions, parents must be
properly and fully informed of the risks and hazards and so must children, to the extent that
children can understand them. However, we find there is substantial debate on the risks and
hazards of the chemical, hormonal, and surgical treatments involved in gender transitioning for
children and whether children are provided opportunity to assent to such procedures.
This debate has focused on data – particularly its quality and the absence of long-term studies.
It has also focused on ethics, both for reasons already mentioned and in light of recent leaks of
internal discussions of a leading gender transitioning advocacy group – WPATH (World
Professional Association for Transgender Health). As investigations reporter Jennifer Block
explains in her British Journal of Medicine article of February 23, 2023 titled “Gender dysphoria
in young people is rising—and so is professional disagreement”:1 “Three organizations (sic) have
had a major role in shaping the US’s approach to gender dysphoria care: WPATH, the AAP, and
the Endocrine Society.” These organizations inform other professional medical organizations on
the topic and all three of them are referred to in Resolution 2024-14.
Block goes on to describe the data deficiencies coming from each of these organizations as
reviewed by medical experts, and the need for greater stringency in research methods.
In England, whistleblowers at Tavistock (England’s National Health Services (NHS) only gender
clinic for children) called attention to what they asserted were unsafe conditions, and to what
the staff whistleblowers called an “unquestioning affirmative approach.”2 In response, an
independent review was conducted, resulting in the “Cass Report”3 that resulted in the clinic’s
closure. The Cass Report reveals that children were coached by Tavistock staff about what to say
to receive puberty blockers.4 Subsequently, the NHS has restricted gender transitioning for
individuals under the age of 16.5 Similar restrictions have now been implemented in other
European countries, such as Norway, Sweden and Finland.6
Resolution 2024-14 states that gender transitioning for children and adolescents is associated
with better mental health outcomes and lower rates of suicide. Studies have called these claims
into question with closer analysis of the quality of the data. Small sample size, biased sampling,
and failure to follow up on patients render this research of poor quality.7
Last year, the Endocrine Society’s new president Stephen Hammes asserted a linkage between
gender transitioning and alleviating suicide. The organization and Dr. Hammes have since been
taken to task in a July 23, 2023 editorial in the Wall Street Journal titled: “The Endocrine
3
Society’s Dangerous Transgender Politicization,”8 which was signed by 21 experts in the field of
pediatric gender medicine from 8 countries.
The letter states that health authorities abroad depend on systematic reviews of evidence to
determine the efficacy of hormone treatment and have found the claimed benefits reflected in
U.S. medical associations to be without dependable evidence. As journalist Leo Sapir reports
“among the international experts is Dr. Riita Kaltiala, chief psychiatrist at Tampere University
gender clinic, author of numerous peer-reviewed articles on trans medicine, and Finland’s top
authority on pediatric gender care.”9
Sapir summarizes:
“Dr. Hammes’ claim that “gender-affirming care” is a suicide prevention measure, the intl’
experts say in their WSJ letter, “is contradicted by every systematic review.”
Dr. Kaltiala had previously called the affirm-or-suicide narrative “purposeful disinformation” and
its promotion (given the contagious nature of suicide) “irresponsible.””
Sapir goes on to explain that the differences in the conclusions of U.S. medical associations
versus international experts stems from the former’s use of poor grade evidence rather than
systematic reviews of evidence – the highest level of evidence-based medicine (EBM, see figure
below). Sapir notes that systematic reviews of evidence “furnish the highest quality evidence.
They follow a rigorously developed, reproducible methodology. They do not cherry-pick studies
with convenient results, but instead consider all the available research.”10
Because Resolution 2024-14 includes the position of the American Academy of Pediatrics, it is
informative to note that, according to Sapir:
“The American Academy of Pediatrics’ main statement on gender medicine, authored by a single
doctor while still in his residency, is not a systematic review. The author himself has conceded as
much. A later published peer-reviewed fact check found the AAP statement to be a textbook
example of cherry-picking and mischaracterization of evidence.”11
Beyond the quality of evidence debate, astounding revelations of medical ethics transgressions
emerged in March of 2024 in the form of the WPATH Files.12 WPATH is the World Professional
Association of Transgendered Health and is featured in Resolution 2024-14 as an organization
supporting that “gender-affirming healthcare has been proven to be evidence-based, medically
necessary, and lifesaving.” WPATH is also cited by many other health organizations as they are
perceived to be experts in the field of transgender health.
The WPATH files were leaked by whistleblower(s) and consist of internal conversations, in both
written form and on video.
According to the press release of the group Environmental Progress, who received the tranche:
4
“Newly leaked files from within the leading global transgender healthcare body have revealed
that the clinicians who shape how “gender medicine” is regulated and practiced around the
world consistently violate medical ethics and informed consent.”
Within the files (included in this Packet Addendum), doctors and clinicians at WPATH:
 Acknowledge to each other privately that children under their care cannot fathom the
implications of their decisions (in violation of WPATH’s own Standards of Care 8 (SOC8)).
 Describe that parents may also not understand these implications.
 Make clear during a WPATH panel discussion (video is provided), that children are
confused about outcomes of hormone therapy.
 Admit that children do not have the cognitive maturity to grasp the implications of
sterility.
 Refer to follow ups that indicate 27% of those who transitioned (in a study with only
49% participation in the follow up) regret sacrificing their fertility.
 Discuss that a 9-year-old doesn’t have “the brain space” to understand lifelong sterility,
but advocate for transitioning despite being “stumped” by incongruity of the practice
and the child’s understanding.
 Admit that consent forms are not always read or understood, in contradiction to the
SOC8 statement that careful evaluation is provided for each patient.
 Discuss patients with severe mental health disorders (multiple personality, schizophrenia
and bi-polar) being allowed to transition, despite concerns about their ability to follow
post-surgical instructions and procedures.
 Speculate about serious side effects of the treatments, including liver tumors.
There are many more examples that call into question a variety of medical/ethical practices, and
which should clearly be investigated.
We include the WPATH Files with a report by Mia Hughes, a reporter with Environmental
Progress who offers a description and review of the contents of the leaked documents. Ms.
Hughes’ report is informative and provides context within the field of gender transitioning.
Regardless of whether one agrees with Hughes’ report, one can view the WPATH files
themselves to verify the above bullet points.
A further concern for us is the developing body of research that indicates that many children
that exhibit gender dysphoria may simply develop to be same-sex attracted adults. The Cass
Report Commissioned by the NHS indicates that this may be true for 89% of girls and 81% of
boys. There is concern that guiding such children into transitioning may consist of a kind of gay
conversion therapy13 –in effect heterosexualizing gay children.
To conclude, while we fully support transgender people and acknowledge that they can lead
happy and fulfilling lives, there is evidence that for minors, gender-affirming care involving
5
puberty blockers, hormone therapy, and surgery may be doing more harm than good. We, as
council members, are not in a position to determine this at this time, but what we have
described above gives us great trepidation about supporting gender transitioning in minors as is
the aim of Resolution 2024-14.
We believe that investigations of WPATH and their practices should be conducted. And it
should be determined to what extent WPATH has influenced other medical organizations.
Furthermore, we hope that subsequent research, discussion, and debate happens in an open
and transparent setting, and with the highest standards of scientific rigor including highly
controlled, double-blind studies, peer review and systematic reviews.
We will be abstaining on support for Resolution 2024-14 until more clarity is achieved on
gender-affirming care for minors. One of our council colleagues has described the resolution as
“symbolic” as it beyond our home rule authority and we agree with his assessment. It is a
serious matter, however, to support a policy that may be harming, not helping children.
1https://www.bmj.com/content/380/bmj.p382
2https://www.bbc.com/news/health-51806962
3https://cass.independent-review.uk/home/publications/final-report/
4https://www.dailymail.co.uk/health/article-13293513/Children-coached-NHS-doctors-puberty-blockers.html
5https://www.usnews.com/news/health-news/articles/2024-03-20/england-is-limiting-gender-transitions-for-
youths-us-legislators-are-watching
6https://www.forbes.com/sites/joshuacohen/2023/06/06/increasing-number-of-european-nations-adopt-a-more-
cautious-approach-to-gender-affirming-care-among-minors/
7https://www.transgendertrend.com/the-suicide-myth/
8https://www.wsj.com/articles/the-endocrine-societys-dangerous-politicization-endocrinologists-gender-affirming-
care-arkansas-dac768bd?mod=article_inline
9https://threadreaderapp.com/thread/1679603669010989057.html
10https://thehill.com/opinion/healthcare/4070174-why-europe-and-america-are-going-in-opposite-directions-on-
youth-transgender-medicine/
11https://thehill.com/opinion/healthcare/4070174-why-europe-and-america-are-going-in-opposite-directions-on-
youth-transgender-medicine/
12https://static1.squarespace.com/static/56a45d683b0be33df885def6/t/6602fa875978a01601858171/171147126
2073/WPATH+Report+and+Files111.pdf
13https://www.wsj.com/articles/most-transgender-kids-turn-out-to-be-gay-gender-affirming-care-conversion-
therapy-58111b2e

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