The two witnesses testifying for the state Tuesday in a trial over Arkansas’s ban on gender-affirming medical care for transgender youth acknowledged this isn’t their area of expertise.
But sociologist Mark Regnerus and former plastic surgeon Patrick Lappert testified that their professional experience led them to believe young people should not undergo medical interventions that change their bodies to better align with their gender identities.
Pretty much every medical association you can think of supports providing medical treatments including trans-sex hormones and sometimes puberty blockers to transgender youth. But Regnerus argued this widespread support is something of a fad, lacking in factual underpinnings and riding a wave of wokeness. Regnerus told the court he believes there’s not enough good science driving protocols for treating transgender minors, and that doctors and public health experts are being peer pressured into giving transgender patients and their families the treatments they want. He described a tyrannical cancel culture where anyone who questions trans-sex hormones and puberty blockers on demand faces retaliation and professional ruin.
Arkansas Deputy Solicitor General Dylan Jacobs had a hard to getting through his questions for Regnerus, who beamed into the courtroom at 8 a.m. from somewhere in Europe because of a previously planned trip. There were the usual technical glitches and delays, but the real holdups were the objections from plaintiffs’ attorneys, who argued repeatedly and often successfully that Regnerus didn’t have any relevant expertise to offer.
The author of an infamous and now debunked 2012 study that claimed children of same-sex parents fare worse than children with heterosexual parents, Regnerus offered an anecdote about Brown University researcher Lisa Littman, whose professional reputation suffered after she published a study looking at whether some gender dysphoria stems from social contagion. Littman eventually updated and corrected her paper, but controversy over her findings rage on.
Punctuated by repeated objections from ACLU attorney Daniel Richardson and questions from an apparently befuddled and increasingly frustrated judge, Jacobs moved Regnerus through nearly two hours of stop-and-start questioning focused largely on the concept of “ideological capture,” which Regnerus explained as authority figures and professional organizations being co-opted in order to serve the aims and ends of a subset of people and interests. He suggested this is what has happened to cause the likes of the American Academy of Pediatrics and the American Medical Association to be supportive of gender-affirming medical care for people under 18.
Regnerus classified the nearly universal acceptance of trans-sex hormones as treatment for transgender youth as a “Castro consensus,” something accepted as the truth based not on scientific evidence, but because everyone agrees it’s the truth.
U.S. District Judge James Moody denied motions filed this past summer to keep Regnerus and Lappert from testifying. Attorneys from the American Civil Liberties Union unsuccessfully argued that the men lack the expertise required to serve as expert witnesses.
But on Tuesday, Moody sustained many of the objections plaintiffs made based on Regnerus’s qualifications and standing as an expert on the subject. Moody asked repeatedly and fruitlessly for Regnerus to provide examples of doctors or organizations opposing what’s now standard treatment for transgender youth. “I’m just trying to find out what I’m suppose to take away from this witness,” Moody said at one point.
Near the end of his testimony, Regnerus downplayed concerns that denying gender-affirming care for transgender youth could drive them to suicide. They might threaten to do it, but not many of them really will, he said.
“There are fairly small numbers of completed suicides among gender clinic patients, and that’s just a very different impression than one gets when you read about suicidality,” Regnerus said. He speculated that playing up the risks of suicide is used as a motivation to move families toward medical gender-affirming treatment. This coldhearted bit of testimony elicited tears from one of the parents in the courtroom.
On cross examination, Richardson linked Regnerus to the rightwing extremist group Alliance Defending Freedom, whose mission statement is “Committed to protecting God’s design for marriage and family.” Richardson pointed to legal documents from a Michigan case challenging adoption by same-sex couples, in which the court threw out Regnerus’ testimony because the study he was citing had been paid for by the ultraconservative Witherspoon Institute.
“The court finds Regnerus’ testimony entirely unbelievable and not worthy of serious consideration. The evidence adduced at trial demonstrated that his 2012 study was hastily concocted at the behest of a third party funder. … The funder clearly wanted a certain result and Regnerus obliged.”
Lappert’s testimony was far more technical. He drilled down on the risks that come with surgeries transgender people might undergo to alter their bodies, and he suggested those risks are worthwhile only for cisgender people.
While Act 626 — dubbed the SAFE (Save Adolescents from Expermentation) Act by its sponsors — would outlaw medical gender-affirming treatment for minors in Arkansas, the question of plastic surgery is already settled. No doctors in Arkansas perform gender transition surgeries for people under 18, so the relevance of Lappert’s testimony in a trial focused only on treatment for minors was unclear.
Lappert is no longer a practicing plastic surgeon and now runs a clinic that offers laser hair removal and botox injections. He described surgeries he performed over his career in some detail, but could speak only to their effects on cisgender people since he never treated any transgender patients except one: a person who was born male, transitioned to live as a woman and then went to Lappert to have his breast implants removed. Lappert described surgeries he’s done to rebuild breasts, vaginas and penises lost or damaged to disease or mishap, but said he would not perform these procedures to facilitate a gender transition.
“You don’t sacrifice function for the sake of a cosmetic result,” he said. Lappert suggested gender dysphoria is a form of body dysmorphic disorder, which he described as someone “blaming their unhappiness on a certain attribute because they don’t want to look at the actual cause of their sorrow.” Surgery is not an appropriate treatment for people with body dysmorphic disorder, he said.
ACLU attorney Laura Oswell objected throughout Lappert’s testimony, pointing to his near complete lack of experience working with transgender patients.
Court adjourned for the day by 2 p.m.
There are only two days left in this trial, set to wrap up Thursday. Plaintiffs are challenging the constitutionality of Act 626 of 2021, which would bar transgender adolescents and teens in Arkansas from accessing puberty blockers or trans-sex hormones in the pursuit of aligning their physical bodies to their gender identities. Puberty blockers and trans-sex hormones would still be legal for other uses, but doctors who prescribe them to transgender youth, or who refer those patients elsewhere for this care, would be reported to the Arkansas Medical Board.
The ACLU is challenging the law on the basis that it discriminates based on sex, since other patients would still have access to these treatments. The law also infringes on parents’ rights to make medical decisions for their children and muffles doctors’ free speech by forbidding them to refer patients elsewhere, they said.
Act 626 survived a veto from Governor Hutchinson and was set to go into effect in the summer of 2021, but Moody issued an injunction until the trial. It’s a bench trial, meaning there is no jury and Moody will make the decision on the constitutionality of the law. Regardless of what he decides, his ruling will almost certainly be appealed to the Eighth Circuit.
A parade of medical experts including doctors, endocrinologists and a bioethicist, along with trans youth and their family members, testified in October to the benefits of medical gender-affirming care. Clinicians shared evidence supporting these treatments, and Arkansans shared stories of life-changing and possibly even lifesaving transformations that would be denied in the future if Act 626 takes effect. Dozens of mainstream medical associations signed on in opposition to Act 626, along with the Arkansas Chamber of Commerce, some Arkansas-based businesses and the Walton Family Foundation.
The conservative Family Research Council, along with Alabama and 19 other states, signed on in defense of the trans health care ban.
The team of attorneys from Arkansas Attorney General Leslie Rutledge’s office charged with defending the law have so far called a doctor and therapist for one of the plaintiffs, but those testimonies happened behind closed doors to protect her medical privacy. On Monday, the state called psychiatrist Stephen Levine, who testified that while he has serious concerns that transgender people don’t get enough psychological counseling and guidance first, he does sometimes support medical gender-affirming care for minors. Levine also said he does not support cutting off hormone treatments for people already getting them, something that would almost certainly happen if Act 626 goes into effect.
Tagged: ACLUAct 626Judge James MoodySAFE Acttransgender health care
