SCOTT DETROW, HOST:
Today, we want to introduce you to Kat. Kat is 14 and loves the show "Sherlock Holmes" - the one starring Benedict Cumberbatch, to be clear - and has always called Utah home. Earlier this year, the state passed a ban on gender-affirming care for people under 18. It went into effect immediately in late January. And Kat, who's transgender, and Kat's family had to face one of the most difficult decisions of their lives - whether or not to leave Utah. Here's Kat's mom, Jen.
JEN: I've always said, like, living here in Utah, I feel like a salmon trying to swim upstream, and I'm really tired. My fins are very worn.
DETROW: And we aren't using Jen or Kat's last name because they have concerns for their safety, but this is a story that we know is playing out all around the country. A lot of families are like Kat's. They're trying to make a big decision, and that decision isn't just about whether or not to leave. It's also about where to go. Often, that's states like Minnesota, where elected officials have protected trans health care for both patients and providers. So we're going to talk more about this. We're going to go to Utah and Minnesota to do so. And I'm now joined by KUER's Saige Miller in Salt Lake City. Hey, Saige.
SAIGE MILLER, BYLINE: Hi.
DETROW: And Minnesota Public Radio's Dana Ferguson in St. Paul. Hi, Dana.
DANA FERGUSON, BYLINE: Hey.
DETROW: So we started hearing about a family in Utah there, but, Dana, fill us in on what's going on in Minnesota.
FERGUSON: Yeah. So lawmakers here - because Democrats have the majority in the Senate, the House and the governor's office - were able to pass gender-affirming care protections this year, so that means that patients who come to Minnesota seeking gender-affirming care are legally protected against laws that might be in place in the states that they're coming from. And providers will be able to have those protections if they practice here as well. And I should mention that about 12 other states have similar protections they've put in place, though they vary a little bit depending on where you are - what those protections do.
DETROW: So that's a group of states going in one direction. And, Saige, Utah is one of the states going in a very different direction. We heard a little bit about Kat and Kat's family. Tell us more broadly what's been happening in the state House in Utah.
S MILLER: We've definitely seen a shift in politics in the state Legislature when it comes to transgender issues. About two years ago, Utah's Republican governor, Spencer Cox, vetoed a ban on transgender youth participating in school sports, but the Republican supermajority overrode that veto. And ultimately, the courts blocked the law, at least for now. But Kat's family have been on guard since that legislative move alone. Then Utah was the first state this year to ban gender-affirming care for transgender youth, and there's about 20 states that have done so as well, and about five have holds on such bans by the courts.
DETROW: So you're seeing Utah kind of go more and more in that direction. Broadly speaking, why are lawmakers pushing for these bans? What do they say they're worried about here?
S MILLER: So the lawmakers that I have spoke to and heard give their testimony on the floor was that they're worried about the lack of evidence surrounding the impact of this medical treatment on transgender youth, even though around 30 medical associations say that gender-affirming care is safe and effective for trans youth. State leaders do expect this law to be challenged in the courts. However, nothing has come to fruition as of yet, but the ban on trans care becoming law was really just the straw that broke the camel's back for Kat's family.
And, Scott, it's really the little things that hit the hardest for the family, like leaving behind their garden. Every year, over Mother's Day weekend, they buy seeds and plants for their backyard garden in their home in Utah.
JEN: Well, this year, I was buying moving boxes at Lowes to pack up our stuff. And when I saw the plants, I just sat in the parking lot and cried because it was the perfect illustration of how our lives have been turned upside down by someone who can flippantly say, well, just let the courts decide.
S MILLER: Sitting in a nearly empty two-story house, Jen somberly recounts the events that forced her family to leave the state they love. Kat is her youngest child. The 14-year-old says they've faced immense backlash since coming out as trans, including people using their dead name - that's the name given at birth.
KAT: I mean, especially my school - I've been constantly harassed and actually bullied out of the school for about a month. I had to stay home. And I get shivers of even thinking of going to school. I've been misgendered, teased with my dead name...
S MILLER: Earlier this year, the Utah Legislature voted to restrict access to gender-affirming care for transgender youth. State Senator Mike Kennedy, the bill's sponsor, said the bill was necessary because of the lack of evidence on the impacts of gender-affirming care on minors, but dozens of medical associations agree that such care is safe and effective. Kennedy himself has questioned whether the bill meets legal muster.
(SOUNDBITE OF ARCHIVED RECORDING)
MIKE KENNEDY: But I've tried, along with others, to do my best in this area. And I would bet every dollar that I have in my bank account right now that this will be litigated.
S MILLER: Kat was scrolling Twitter - down a "Sherlock Holmes" rabbit hole - when the news popped up on their timeline. Now that the governor had signed the ban, Kat wouldn't be able to get the medical care they've been considering.
KAT: People were freaking out. And I just remembered I just felt like I blacked out, and then I woke up hours later with just a tear-soaked pillow.
S MILLER: Jen says the whole family couldn't sleep for days afterward. She noticed her physical health was declining. Kat went from honor roll to 20-plus absences in school. All of this, Jen says, left them with no option except to leave Utah.
JEN: Utah and specifically Senator Kennedy and everybody else who's participated, they have forced this choice on me. How can I possibly stay and let my child be treated like this?
S MILLER: So Kat's dad began looking for a new job. He landed one in Washington state. They put the house on the market and started throwing their lives into boxes. It was a quick decision, and no one took the move easily, but it hit Kat the hardest.
KAT: It's just - the only place I ever knew was where all my friends are, and knowing that I'm going to have to go to 10th grade, probably one of the craziest grades to move states from 'cause everyone already has their little cliques. It's just going to be vile.
DETROW: That's reporting from Saige Miller at KUER in Salt Lake City.
Saige, I will say, I moved to another state in 10th grade, so that last point really resonates with me, hearing that. How is the family doing?
S MILLER: The family is settling into their new home in Washington, but as you would know, Scott, it's definitely tough to be uprooted. And Kat still really misses Utah, their friends and the memories that they made there. And they really value control, and they feel like that control has kind of been ripped out from underneath them. However, on the flip side, Jen says Washington feels amazing, and she's cried many tears of happy relief to just feel less stress and to be able to exist in her own home.
DETROW: Yeah. How'd they end up in Washington state? What specifically led them there?
S MILLER: I do know that Kat's dad was able to snag a job there first, but more importantly, they were looking ahead. They had considered Minnesota, but the family had concerns about how long those gender-affirming care for transgender youth protections would last because of the politics in the state. It's traditionally a purple state, and Democrats control the state for now, but they were worried that state leaders would reverse those protections if Republicans gained control again. And they really didn't want to have to pack up their stuff again and leave. And it's the fear that could become a reality for them.
DETROW: That is a really specific and powerful example of how the politics of a place and the current political environment affects people's lives in a very real way. So Dana Ferguson, let's go back to you. You're in St. Paul. Is there something to that concern that the protections in place right now could go away one or two elections down the line, depending on what happens?
FERGUSON: Yeah, as we've talked about a little bit, Democrats have control over three levers of power in St. Paul right now, but there is a sense that in future elections that could change. The state House here is going to be up for election next year, and then down the road in 2026, the Senate and the governor's office will also be on the ballot, so there's a sense among Democrats here, as well as LGBTQ groups, that there might be additional need to put these gender-affirming care protections in the Constitution. And that's something that Democratic leaders have talked about. They're weighing a constitutional amendment for next year that would provide some equal rights protections under the Constitution, and they're hopeful that, even if a future legislature came in and wanted to wipe out these protections, that they would be solidified in the state's constitution.
DETROW: So those are some choices or some things that might happen down the line. What else do we need to know about the protections that are in place right now in Minnesota?
FERGUSON: Yeah. I want to get to that, Scott, but I also want to give listeners just a quick heads-up that we're getting to a part in the story where we're talking about suicide and youth mental health. But to answer your question, for Minnesota doctors who provide gender-affirming care, this year has been a whirlwind. Calls from patients out of state have surged in the last year with more and more bans.
KELSEY LEONARDSMITH: It's 2023, and we're making refugees within the United States of America.
FERGUSON: That's Dr. Kelsey Leonardsmith. She practices gender-affirming care in the Twin Cities. Leonardsmith says the clinic used to get a few calls from out-of-state patients each year, but now they're getting that many each week. In the clinic's lobby, guests are welcomed by floor-to-ceiling floral murals, and they can pick up colorful buttons that express their pronouns. Staff members press a variety of button options.
UNIDENTIFIED PERSON: That one is she/her. I'm going to do a he/they next.
FERGUSON: More patients are coming here to start or continue hormone treatments that have been outlawed in their states, and some are making a permanent move. Clinics like this one and hospitals have had to train more providers to offer services, and they're still having trouble keeping up, says Leonardsmith.
LEONARDSMITH: You run a real risk of, like, doing wrong by trying to do right. Trying too hard to take care of everybody so that you're not doing a good enough job, and finding the right balance is really tough.
KATY MILLER: We are hearing from people all over the country.
FERGUSON: Dr. Katy Miller works at Children's Minnesota in the hospital's gender health program.
K MILLER: We've had families call from Florida, from Texas, Iowa - a lot from Iowa - North Dakota.
FERGUSON: Miller says patient requests have surged 40% at Children's Minnesota since other states began enacting bans. The hospital is working with other clinics, but it still has a one-year waitlist. Miller says patients traveling here have a lot on their minds.
K MILLER: I think another challenge is that people feel very afraid of what might happen next. People feel victimized by the government. It's led to just a degree of fear and anxiety about accessing medical care that I haven't seen before.
FERGUSON: Both Miller and Leonardsmith say their out-of-state patients feel like they're becoming political refugees, but even here, they're still on edge. Here's Leonardsmith.
LEONARDSMITH: People are updating their passports, and I know folks who have bought a new car because they wanted to make sure that if they needed to drive to Canada, their car wouldn't break down.
FERGUSON: Miller says she feels like she's working under a microscope. If she gets something wrong, it could become a political talking point. But her more pressing concern is keeping her patients alive.
K MILLER: My biggest fear is that one of my patients will commit suicide, and that's really pervasive. It's gotten worse. We know that these laws and these bans impact the mental health of gender-diverse youth. We know that trans and gender-diverse youth are at much higher risk of suicide.
FERGUSON: Both doctors say they worry about the ongoing trauma, but they plan to stay the course in Minnesota to be there for their patients no matter where they come from.
DETROW: And that's Dana Ferguson with Minnesota Public Radio, who is talking to me, along with Saige Miller of KUER in Salt Lake City, about what's going on in two different states here.
And just a reminder, if you or someone you know is in crisis, you can call or text the 988 Suicide and Crisis Lifeline - just those three digits - 988.
Dana, one of the doctors in the story talked about how people are just afraid of what might happen next and the uncertainty there. How are the people that you spoke to dealing with that?
FERGUSON: Yeah, that's right. Democrats and LGBTQ groups say they hope to market Minnesota as a refuge state for transgender people and their families and serve as a national model. Here's OutFront Minnesota executive director Kat Rohn. And OutFront is an advocacy group.
KAT ROHN: Sometimes we're too humble about our wins here. And I think, you know, this is one that we should all celebrate - about creating a state that's more inclusive at a time when our communities are under attack.
FERGUSON: But I do want to add that no Republicans in the state House supported the law.
DETROW: So let's go back to Utah one more time with Saige Miller. Saige, you mentioned the possibility of a court challenge to the care ban that we started this conversation with. What might that look like?
S MILLER: So we haven't seen a challenge to the state law just yet but the ACLU of Utah says it's working on one. And from there, you know, it'll go through the traditional methods, work its way up the courts, and they will decide in Utah whether the law should stand. But for now, the ban on gender-affirming care for transgender youth in Utah is here to stay.
DETROW: That's Saige Miller, a political reporter with KUER in Salt Lake City, and Dana Ferguson, who also covers politics for Minnesota Public Radio. Thanks to both of you.
S MILLER: Thank you.
FERGUSON: Thank you. Transcript provided by NPR, Copyright NPR.
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