Policy Issues / Healthy Communities

The SAFE ACT Q&A

Summary: Arkansas Governor Asa Hutchinson (R) vetoed the SAFE Act (HB 1570) on April 5, 2021. The bill prohibits doctors in Arkansas from performing gender transition surgery on minors and prohibits the use of state, county, or local funds for use in such procedures–including a legislative ban on gender transition surgeries through the Arkansas Medicaid program.

What is the SAFE Act?
The SAFE (Save Adolescents from Experimentation) Act is a bill introduced by Arkansas State Rep. Robin Lundstrum (R-Springdale) to prohibit doctors from performing gender transition surgeries–including irreversible procedures–on minors. It also prohibits the use of public tax dollars for such procedures.

Does the bill discriminate against individuals who claim to be ‘trans’?
No. The legislation in no way codifies or even lays the groundwork for discrimination against individuals who identify as a different gender from their biology. While activists and the media have falsely labeled the bill as “anti-trans,” such deception is solely in the context of the legislation prohibiting irreversible gender transition procedures on minors. In fact, the bill protects all children and minors, especially those who identify as a different gender than their biological sex or suffer from gender dysphoria.

Does the bill outright prevent gender transition surgeries from occurring in Arkansas?
No. The legislation only prohibits such procedures from being carried out on minors. Individuals who are 18 and older are not prohibited from seeking out these procedures. Additionally, doctors in Arkansas are not prohibited from carrying out such procedures on adults.

Does the bill include a ban on puberty blockers and cross-hormone therapy for minors?
Yes. The legislation includes non-genital transition procedures such as puberty blockers and cross-hormone therapy, often referred to as ‘chemical castration,’ as prohibited services for minors. 

What is the rationale for including cross-hormone therapy as part of ‘gender transition’ procedures?
Studies show that cross-hormone therapy can cause extreme and detrimental damage to those who undergo it. For biological females, this includes, but is not limited to organ damage, increased risk of breast and uterine cancer, irreversible infertility, and coronary artery disease. For biological males, this includes, but is not limited to organ damage, increased risk of blood clots, irreversible infertility, and increased risk of heart attacks.

What is the rationale for including puberty blockers as part of ‘gender transition’ procedures?
The use of puberty blockers on children with gender dysphoria is a relatively new procedure. In one trial, all the children using puberty blockers went on to cross-hormone therapy, revealing that these drugs do not constitute merely “a pause.” As of now, there are no longitudinal studies on the physical and psychological ramifications of giving children puberty blockers, but what limited data is available suggests that such treatment leads children to begin physically transitioning. Lawmakers in Arkansas believe such procedures on minors–who are not in a position to legally or developmentally make such decisions for themselves–is little more than experimentation and exploitation. 

Is the SAFE Act an “anti-trans health” bill?
No. The bill emphasizes the reality that some individuals truly suffer from gender dysphoria and does not prohibit such individuals from receiving therapy, counseling, and the supportive care they need. Additionally, it makes exceptions for physicians treating those born with ambiguous genitalia, that is, the bill accommodates physicians and adults when it comes to the very small number of people born with both male and female anatomical parts.

Is gender transition surgery ‘healthcare’?
No. The first rule of medicine is “do no harm.” The implementation of irreversible nongenital and genital reassignment surgery–particularly on children and developing teenagers–is indisputably harmful. Additionally, a 2019 study showed that such procedures have shown no advantage in “relation to subsequent mood or anxiety disorder-related health care.”

What are the suicide rates for those who receive ‘gender transition’ surgery?
Very high. Some studies have shown that the attempted suicide rate for individuals struggling with gender dysphoria is already a stunning 41 percent. That is 10 times higher than the general population. Data for those who have actually had gender transition surgery shows that they are 19 times more likely to die by suicide.

Why was this bill introduced?
The SAFE Act is aimed at protecting children from the decisions of adults that would result in irreversible physiological and psychological damage. A recent tragic case in Texas saw a 7-year-old boy caught between his mother and father with the mother seeking to transition her son into a girl. From 2016 to 2017, gender transition surgeries increased by 155 percent and were the fastest-growing procedure for plastic surgeons. This is an issue that will not be going away anytime soon, increasing the impetus to protect vulnerable children from permanent physical and psychological damage. 

Did the bill pass?
Yes. The bill passed 70-22 in the State House and passed 28-7 in the State Senate, both on a bipartisan basis.

Is the General Assembly going to override the governor’s veto?
The Arkansas State House and State Senate successfully voted to override Governor Hutchinson’s veto on April 6, 2021.