Law & Principles

Ray Carter | January 10, 2023

Oklahoma lawmakers seek to end sex-change operations on youth

Ray Carter

Under newly filed legislation, it could soon be illegal in Oklahoma to surgically remove or alter an individual’s healthy body parts as part of treatment for transgender-identifying youth and young adults.

State Sen. David Bullard said that when he was first elected just four years ago, he “could not have imagined that it would be necessary to file a bill to protect children in our state from being legally sexually mutilated,” but he has since learned otherwise.

“Surgical and chemical genital mutilation has been occurring in our great state, and it must be stopped,” said Bullard, R-Durant. “We have a sacred duty to protect our children from those who wish to do them harm. Senate Bill 129 is designed to protect our children from those who want to benefit financially at their expense.”

Senate Bill 129, which creates the “Millstone Act of 2023,” makes it illegal for any physician or other healthcare professional to provide or refer patients for “gender transition procedures” if the patient is younger than age 26, including both surgical procedures and hormone treatment.

Physicians who violate the law would face felony charges and the loss of their medical license. The bill allows prosecution to occur up to 40 years following a violation or 40 years after a patient turns 18.

The bill also makes it illegal to provide taxpayer funding, either “directly or indirectly,” to “any entity, organization, or individual that provides gender-transition procedures” to an individual younger than 26.

The bill’s title refers to the Biblical admonition in Matthew 18:6 declaring it would be better that “a heavy millstone be hung around his neck, and that he be drowned in the depths of the sea” than for someone to cause a child to sin.

“Child abuse is a felony in our state and mutilating a young person’s genitalia should be viewed no differently,” Bullard said. “The Millstone Act will hold those who perform child mutilation accountable by making such activity a felony. Those guilty of such a heinous crime will be both legally and financially liable.”

The legislation includes exemptions for procedures relating to the treatment of a medically verifiable disorder of sex development, treatment of any infection or disorder that has been caused by or exacerbated by the performance of gender transition procedures, or to prevent imminent danger of death or impairment of major bodily function.

During a special legislative session last September, lawmakers voted to block certain funding to the Oklahoma Children’s Hospital at OU Health if the facility provided puberty blockers or performed transgender surgeries on youth.

Lawmakers reported that officials at OU Health admitted that the Roy G Biv facility had provided breast-removal surgery and hormone treatment to some patients who identified as the opposite sex and referred patients to other doctors for more significant surgeries.

Both transgender surgeries and hormone treatments have been criticized by some medical officials as medically unnecessary and even harmful to patients. One lawmaker publicly reported that OU Health officials acknowledged two in five minor patients who had undergone transgender surgeries at the facility had already expressed regret.

The ban on OU Health was imposed shortly after political commentator Matt Walsh released the findings of his staff’s investigation of a similar Vanderbilt clinic in Tennessee that provided transgender treatments and surgeries to youth.

One video obtained by Walsh showed that a Vanderbilt official said the clinic was performing transgender operations on youth because the surgeries are a “big money maker,” in part because the surgeries require a lot of “follow ups.”

Due to constitutional restrictions on special legislative sessions, the bill passed by lawmakers last September dealt only with OU Health, meaning other providers could still perform transgender surgeries on minors in Oklahoma. Lawmakers promised to pursue a true statewide ban during the 2023 regular session.

State Rep. Jim Olsen, R-Roland, has also filed legislation. House Bill 1011 prohibits health care professionals from providing, attempting to provide or providing a referral for puberty blockers, cross-sex hormones, and gender reassignment surgeries for healthy people under the age of 21.

“It’s irresponsible for anybody in health care to provide or recommend life-altering surgeries that may later be regretted,” Olsen said. “We know there are some people who undergo the gender transition process and later identify as their biological sex. Performing irreversible procedures on young people can do irreparable harm to them mentally and physically later in life.”

During last September’s debate on the OU Health bill, Olsen referenced medical literature that showed males who take estrogen have a roughly three-times greater risk of heart attack, along with increased risk of stroke, gall stones, and breast cancer. Females who take testosterone have increased risk of cardiovascular death, severe liver dysfunction, hypertension, breast cancer, uterine cancer, and ovarian cancer.

State Sen. Nathan Dahm, R-Broken Arrow, has also filed legislation on the issue.

Senate Bill 252 would prohibit anyone under the age of 18 from receiving gender reassignment surgery, and Senate Bill 250 would prohibit medical officials and entities from receiving reimbursement through Medicaid if they offer gender transition services.

“Our state should not condone genital mutilation, much less fund it,” Dahm said. “These are elective procedures at best, and we should certainly not be subsidizing them.”

Bullard’s legislation was condemned by Freedom Oklahoma, an organization that lobbies for transgender causes. Via Twitter, the group decried SB 129 as “another attack on best practice medical care for trans people.”

“These bills are cruel, political tactics meant to scare doctors into limiting best practice care, and push trans people out of Oklahoma,” Freedom Oklahoma stated.

The group also attacked Olsen’s bill, claiming the legislator had made it “clear he is willing to let trans young people die to advance his political agenda,” and stating that Olsen “is engaging in escalation of violence against transgender people through the power of his office.”

Some critics have questioned whether lawmakers can legally bar surgeries for individuals over age 18. Bullard said he chose the age of 26 due to scientific findings that show the brain does not fully develop and mature until the mid- to late 20s with the prefrontal cortex, the part responsible for critical skills like planning and controlling urges, developing last.

NOTE: This story has been updated since initial publication to include information on Senate Bills 250 and 252.

Ray Carter Director, Center for Independent Journalism

Ray Carter

Director, Center for Independent Journalism

Ray Carter is the director of OCPA’s Center for Independent Journalism. He has two decades of experience in journalism and communications. He previously served as senior Capitol reporter for The Journal Record, media director for the Oklahoma House of Representatives, and chief editorial writer at The Oklahoman. As a reporter for The Journal Record, Carter received 12 Carl Rogan Awards in four years—including awards for investigative reporting, general news reporting, feature writing, spot news reporting, business reporting, and sports reporting. While at The Oklahoman, he was the recipient of several awards, including first place in the editorial writing category of the Associated Press/Oklahoma News Executives Carl Rogan Memorial News Excellence Competition for an editorial on the history of racism in the Oklahoma legislature.

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