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A proposed ban on gender-affirming care for minors would affect Oklahoma adults too

Protestors at the Oklahoma State Capitol. They were protesting House Bill 2177, a bill that bans gender affirming care for minors and limits it for adults.
Beth Wallis
StateImpact Oklahoma
Protestors at the Oklahoma State Capitol. They were protesting House Bill 2177, a bill that bans gender affirming care for minors and limits it for adults.

House Bill 2177 bans care for minors, but it also bans insurance coverage and public funds for trans Oklahomans of all ages.

House Bill 2177 is making its way through the statehouse. It purports to ban gender-affirming care for children and teens in Oklahoma. Supporters say children and teens aren’t equipped to make life-altering health decisions for themselves.

But critics take issue with the idea that gender dysphoria is something a person simply grows out of, as well as parts of the bill that get less attention.

“There, I think, are just an increasing number of trans people worried about, even though they are not minors, could they still afford care here?” said Nicole McAfee, the executive director of 2SLGBTQ+ advocacy organization Freedom Oklahoma. Could they afford to move, if not.”

One provision says no health facility receiving state funds can administer gender-affirming care to anyone of any age. Another provision would ban insurance companies from covering gender-affirming care, again, for all Oklahomans, no matter how old they are.

A protestor at the Oklahoma State Capitol.
Beth Wallis
StateImpact Oklahoma
A protestor at the Oklahoma State Capitol.

“Would that mean that facilities that … did blood work for people who needed hormone levels checked relative to hormones that they are prescribed?” they said. “Like, would that be something that would no longer be covered?”

Without insurance, gender affirmation surgeries can run anywhere from $20,000 to more than $100,000. But long before someone considers surgery, it’s common to undergo significantly less invasive care — medications like hormones or hormone blockers.

StateImpact talked with trans Oklahomans about the risks people could face if the bills pass and these new barriers to access make care too difficult to find. We aren’t using their names because of discrimination concerns.

One of the people we talked with raised concerns about sourcing medications.

“A lot of trans people, if they don’t have access to doctors and things like that, will get meds through online sources that are not as reputable,” she said.

When a patient starts hormones, the medical provider conducts blood tests to see where their current levels are and tests them multiple times over the first six months.

“And without insurance, that is very costly,” she said. “When I was doing that, it ended up being like $200 per appointment.”

And even with well sourced medication, taking it without medical supervision can be harmful. Some medications can have side effects that are life-threatening. One testosterone blocker can cause patients to retain too much potassium. Having a potassium level spike can cause heart palpitations, vomiting, chest pain and death.

“I actually had that happen to me, and I can’t take that medication for that reason,” she said. “But I wouldn’t have known that if I couldn’t get blood tests.”

Another Oklahoman we talked with said she moved to Oklahoma years ago for work, noting that the Legislature often talks about attracting workers.

“They did attract me here,” she said. “I actually love this city; I’m in Oklahoma City.”

But with bills like this one, a Senate Bill criminalizing gender-affirming care for minors, and others that aim to winnow down 2SLGBTQ+ rights, she and her spouse found jobs out of state.

“The underlying content of these bills, I think, is just, ‘They don’t want me here,’” she said. “‘They don’t want people like me here.’ I guess it’s working. Because I’m leaving. And I hate that.”

Each of the bills mentioned in this story made it out of their chamber of origin — so the House and Senate — and will start the committee process in the opposite chamber in the coming weeks.

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Catherine Sweeney was StateImpact Oklahoma's health reporter from 2020 to 2023.
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