OKLAHOMA CITY — Several Republican lawmakers are seeking to limit gender-affirming care for transgender Oklahomans through a slate of bills LGBTQ advocates say are extreme.

Ahead of the legislative session that starts Feb. 6, GOP lawmakers have pre-filed at least four bills that would ban gender-affirming care for many transgender Oklahomans.

The number and severity of anti-transgender bills proposed this year is alarming, said Nicole McAfee, executive director of Freedom Oklahoma, which advocates on behalf of LGBTQ Oklahomans. Pointing to a bill that would dictate what pronouns school employees could use when referring to students, McAfee said the anti-transgender legislation extends beyond health care issues.

“Part of it is that there’s this machine nationwide of anti-trans legislation that is moving, and people are feeding into this rhetoric that’s based in fear of trans people,” McAfee said.

A bill that would prevent health care professionals from providing gender-affirming care to anyone younger than 26 elicited criticism because it would block treatment for transgender adults and could implement one of the strictest bans in the country.

Under Senate Bill 129, doctors could be stripped of their medical licenses if they perform gender-reassignment surgeries or prescribe puberty blockers or cross-sex hormone therapies to someone age 25 or younger. The bill’s author, Sen. David Bullard, said he chose that age because 26 is when brain development is complete.

But Bullard, R-Durant, said he’s concerned that the bill could get challenged in court if passed in its current form and that he’s considering changing the prohibition to age 18 or 21.

Legislation Bullard authored last year that requires students to use the school restroom that corresponds with the sex listed on their birth certificate spurred a lawsuit from the ACLU.

“I am fully open to changing that age, and knew when I filed (the bill) that I probably would not be able to go forward at 26,” he said. “I think it is a necessity that we ban this at some stage in the state of Oklahoma.”

His bill would also bar the state’s Medicaid program from covering the costs of gender-affirming care.

Rep. Jim Olsen, R-Roland, and Sen. Nathan Dahm, R-Broken Arrow, filed similar legislation.

Olsen aims to block gender-affirming care up until age 21. Health care professionals who provide such treatment to younger patients could be charged with a felony under Olsen’s bill. Dahm aims to ban gender-affirming care up until age 18.

The bills largely include exceptions for medically diagnosed genetic anomalies, mutations or sexual development disorders.

Last year, the GOP-led Legislature passed a bill to bar University of Oklahoma medical facilities from providing gender-transition services to children. When Gov. Kevin Stitt signed the measure, he urged lawmakers to pass a statewide ban on gender-transition treatments for minors.

The American Medical Association has expressed opposition to bans on gender-affirming care, saying the treatment is “medically necessary, evidence-based care that improves the physical and mental health of transgender and gender-diverse people.”

Although puberty blockers and cross-sex hormones have not been approved by the U.S. Food and Drug Administration for gender-affirming care for children, the American Academy of Pediatrics said such treatments can reduce gender dysphoria and improve the mental health of transgender youth. Gender dysphoria occurs when someone feels discomfort because their gender identity differs from their birth sex.

“People have this really specific idea that gender-affirming care must be one or two procedures,” McAfee said. “In my mind, it is as broad a category as say, pediatric care. Gender-affirming providers work with trans patients to use best practices and find the care plan that they need, … and it often includes mental health care.”

Several lawmakers have proposed blocking taxpayer dollars from going toward gender-affirming care. Dahm’s Senate Bill 250 would prevent medical providers who offer such services from receiving Medicaid funding.

“My intent is to make sure no public funds are used for (gender-transition services) and to stop it from happening to minors,” Dahm said. “If an adult wants to pay out of their pocket to do those things, I’ll disagree with their decision, but, ultimately, it’s their decision.”

When Amelia Johnson of Oklahoma City has emailed lawmakers about some of these bills, she includes studies showing that transgender people have some of the highest suicide rates. Johnson, who is transgender and has been taking hormone replacement therapy since September, is the Oklahoma lead for United Rural Democrats.

Gender-affirming care is key to addressing gender dysphoria issues that can cause mental health problems and suicidal ideations, she said.

Researchers at The Trevor Project, which provides crisis support services for LGBTQ youth, found that gender-affirming hormone treatments can reduce depression and suicidal thoughts, according to a study of thousands of transgender and nonbinary people ages 13 to 24.

Nationally, Republicans are making transgender people out to be a boogeyman as they increasingly campaign on social issues, Johnson said.

“What it all comes down to on these bills is that you’re talking about a lot of people that don’t have experience in these fields,” she said. “You’re talking about people that are getting their political positions on these issues from highly sensationalized things that are meant to rabble-rouse rather than inform policy.”

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