‘It’s going to kill people’: Local transgender man on impact of trans youth legislation
Nicole Girten, Great Falls Tribune
Jacob Doah couldn’t sleep the night before his top surgery.
“I was so excited to finally have this big colossal weight off of me, both physically and metaphorically,” Doah said. “One of the happiest days of my life.”
Doah, whose name has been changed for this story for fear of backlash, had breast tissue removed from his chest in mid-January, which he described as a “huge step for a trans individual that’s going transmasculine.”
Less than two weeks later, legislators in the Montana House Judiciary Committee passed two bills, HB-112 and HB-113, that were introduced by Rep. John Fuller of Kalispell. These bills aimed to require transgender women in sports to play with the team of their gender assigned at birth and barred transgender youth from acquiring gender-affirming treatment like hormones or surgery, respectively.
Fuller did not respond for comment.
Doah said the passage of these bills made it hard for him to enjoy his moment when he knew other people like him could potentially suffer.
“That filled me with so much sorrow,” Doah said. “When I first saw information about it, it was like I could feel my heart breaking.”
HB-113 failed to pass in the Montana House by a narrow margin, but was later reworded and passed as HB-427, which would bar minors from receiving gender-affirming surgery to treat gender dysphoria, including what Doah received. A healthcare provider would also be barred from referring patients who are seeking this treatment to other medical providers.
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During the House Judiciary Committee meeting on Feb. 22, chief medical officer of psychiatry at Shodair Children’s Hospital in Helena, Heather Zaluski, cited a Center of Medicaid Studies summary that describes gender-affirming surgeries as “safe, effective and necessary in treating gender dysphoria.”
Dr. Erin Grantham, a Pediatric Urologist at Billings Clinic, said in the same meeting that it is rare for doctors in Montana to perform gender-affirming surgeries to treat gender dysphoria in minors, but she says they are used to treat other medical issues.Get the Eight Nations newsletter in your inbox.
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“I’m asking you to allow trained physicians and other medical providers to continue to make good medical decisions, with family members,” said Grantham. “Passage of HB 427 unequivocally will prevent us from doing our jobs well and will do direct harm to vulnerable Montana children and their families.”
“It’s gonna kill people,” Doah said. “Point blank.”
The American Academy of Pediatrics released a study in Oct. 2020 that found young people between the ages of 15 and 17 in pursuit of gender-affirming medical care had higher rates of depression and self-harm, as well as suicidal ideation and suicide attempts. The study concluded that these results suggested this group may be particularly vulnerable and in need of appropriate care.
“I cannot tell you how many times I’ve heard individuals, LGBT and trans individuals specifically, they’re saying, ‘It feels so hopeless. Why am I trying so hard to focus on living if I know that I’m not going to get to be myself?’” Doah said. “That bill passing and just being able to get hormones, not being able to take the steps to formally get surgery, I’d be really scared to see the statistics.”
Fuller, who introduced the bills, said during the Montana House Judiciary Committee meeting on Feb. 22 that children live under the guardianship of adults because they “lack the maturity, prudence and experience to make safe, responsible decisions for themselves.” He said when gender dysphoria is in the mix, that these decisions can have lifelong consequences.
“A child experiencing body dissatisfaction needs care, counseling, compassion and guidance, addressing the real cause of the distress,” Fuller said. “Protecting children from surgical procedures that are purely cosmetic and irreversible is necessary and proper.”
Doah disagreed with Fuller’s claims that he was protecting children from making a permanent physical change.
“You know what else is a permanent decision for someone so young? Killing themselves,” Doah said. “And that’s far more likely to happen if you don’t have any of that affirming care, you don’t have that support system.”
Earlier this year: Montana bill limiting transgender youth health care advances
President of the Great Falls LGBTQ+ Center Board, Jasmine Taylor, said those that are impacted directly will be severely affected by lack of access to life-saving medical care.
“The people introducing these bills are bigots,” Taylor said. “Our adult leaders in the state are pushing so hard to discriminate from a population that’s, percentage-wise, incredibly small,” Taylor said. “I think it just shows how queer people are viewed in Montana. And I think kids are paying attention. I know the kids in our group are paying attention, and they don’t feel welcomed here.”
Taylor also said the board was concerned that requiring young trans women to play on the team of their gender assigned at birth may violate the Health Insurance Portability and Accountability Act (HIPPA) in disclosing private medical information. She said it would violate the privacy of persons currently living as the gender they identify with and that this outing may lead to bullying and safety concerns.
Doah described the time in his youth before he knew what transgender meant or could put words to his feelings as on the borderline between life and death. He described feeling as if his “very skin was wrong.”
“I have two suicide attempts underneath my belt that were just before I could even start figuring out what was up with me,” Doah said. “When I turned 15 I started learning the technicalities, while trying to fight for myself to go and get the medical attention I need, getting the hormones and being able to see a therapist.”
Doah’s Transition
Doah described the lengthy process involved in getting gender-affirming care in Great Falls. He was required by his insurance to receive a year of gender therapy, talk therapy for people questioning their gender or experiencing gender dysphoria. It was just happenstance that the therapist he was already seeing had started out as a gender therapist.
“It was really just luck,” Doah said.
The therapist then helped Doah understand the path that lay ahead of the then 16-year-old. Doah would have to see the only endocrinologist in Great Falls multiple times to begin receiving doses of testosterone and face being misgendered by the doctor’s staff, along with questions surrounding his ability to have kids.
“When people around you seem very much against every little thing you do, even when they’re medical professionals, it makes things a lot harder,” Doah said.
The only health provider who could perform his top surgery required patients to wait until they were 18 to get it done. Doah had to get a letter from his primary doctor, his current therapist, his previous therapist in order to confirm that this has been an ongoing issue for him, a letter from a psychologist, four letters of recommendation and a diagnosis of gender dysphoria on his charts for at least a year.
More: Transgender youth targeted by two proposed Montana bills
He was denied at least three times and needed to reach out to have the letters re-dated to be current. Otherwise, he would be denied again. With all his paperwork submitted, he was able to get his top surgery in mid-January.
Doah said the process would be even tougher for minors.
“You have to go through all that and likely more have to have your parents’ permission, and that’s assuming that your parental units or whoever is your guardian is accepting enough to even consider it, and second of all, is willing to vouch for you and they can really be an advocate for you as well, which is kind of a lot to ask for,” he said.
Taylor said permanent decisions, if and when they are made, are made with the full informed consent of parents and with a team of medical professionals.
“It is not simply a child, choosing to do something life-altering in isolation,” Taylor said.
LGBTQ living in Great Falls
Doah said he doesn’t leave his apartment out of fear from some of the threats he’s received from people in his neighborhood.
“They don’t think I should be alive,” Doah said.
“I’ve had individuals come to my door really late at night, and just start speaking Bible verses. I’ve had people leave paperwork outside of my door that says ‘God hates fags,’ one of my favorites,” he said. “I turned it into paper mache, because f*** that.”
Taylor said the LGBTQ+ Center tried to reach out for a police liaison to address hate crimes but they were continually denied.
“They’ve told us ‘no’ so many times that they put it in writing for me last time,” Taylor said.
Taylor described having to walk kids to their parents’ cars after meetings to ensure their safety, as well as running active shooter drills before big events like their Teen Prom.
City Commissioners voted down a non-discrimination ordinance last year that would have put in local protections for housing, public accommodations and employment. Commissioner Tracy Houck was the only official in favor. Taylor said the other commissioners cited the federal protections from the Supreme Court’s ruling last summer that extended the language of the Civil Rights Act to protect LGBTQ+ workers. She said it was devastating.
“The city is always asking, why do young people leave? Why don’t young people want to live here?” Taylor said. “You made it clear. You don’t want us to exist.”
Taylor said all five of the high school seniors in their youth group are leaving Great Falls, with the majority of them are leaving the state entirely.
“I think it’s better for them, safer for them to move,” Taylor said. “I think it’s safer for them to not be here, not because I don’t want them to stay in my community, but because their life is continually at risk when they live in these communities.”
Doah will also be moving. He will be joining his mother in Fort Lauderdale and is looking forward to a new life there, excited by the fact that non-discrimination laws in place there would protect him in his search for work and an apartment.
“I can go there and I can succeed,” he said.
HB-113 and HB-427 passed in the Montana House before the transmittal date and have been referred to the Senate Judiciary Committee.
The Trans Lifeline can be reached at 877-565-8860. The National Suicide Prevention Lifeline is 1-800-273-8255.
Nicole Girten is a Government Watchdog Reporter at the Great Falls Tribune. You can email her at ngirten@greatfallstribune.com. To support coverage of Great Falls and Cascade County subscribe to the Tribune by finding the “Subscribe” link at the top of the page.
Categories: Montana Legislature
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