CBHC Testimony on SB 331

SB 331, a bill which would hurt New Hampshire's transgender youth, is up for a vote in the full Senate this Thursday, March 15th. An identical bill, HB 1560, was voted down in the NH House last week because it is wrong for New Hampshire's young people. Please call your Senator today and ask him or her to vote no on SB 331. Click here to find your Senator's contact information!

Below, you will find exerpts from the CBHC's testimony on SB 331. Please feel free to use it to help inform your calls. 

CBHC Testimony in opposition to SB 331

Re: CBHC’s opposition to Senate Bill 331, prohibiting Medicaid from paying for sex reassignment drug or hormone therapy or surgery

The CBHC opposes SB 331 because it removes medically necessary treatment options for children, youth and families and eliminates the ability of families and medical professionals to use flexible, culturally competent, and gender-affirming approaches and treatments. 

Every child is unique and treatment decisions should be between a parent, their child and the child’s medical and mental health providers. The American Academy of Pediatrics (AAP) strongly endorses the use of gender-affirming care when treating children.  In support of this policy, the AAP emphasizes that “discouraging or shaming a child’s gender identity or expression can harm a child’s social-emotional health and well being, and may have lifelong consequences.  

Failing to support medically necessary treatment for transgender youth and families could lead to more costs to the State in the long run. Rejecting a child’s gender identify and denying them gender-affirming care leaves them at an increased risk for depression, self-harm, isolation, posttraumatic stress, incarceration, homelessness, and suicidality.  Suicidality is one of the most serious elevated health risks facing transgender people. 

In 2013, the Diagnostic and Statistical Manual of Mental Disorders-5 (“DSM-5”) was revised and gender identity disorder was changed to gender dysphoria, a diagnostic criteria reflecting the psychological distress that occurs due to gender and sex discord.  The condition of gender dysphoria is associated with clinically significant distress or impairment in social, school, or other areas of functioning.  Puberty can be particularly difficult for gender non-conforming adolescents and children with gender dysphoria. Early intervention and treatment using gender-affirming approaches may alleviate psychological harm associated with gender dysphoria and lead to better physical and psychosocial outcomes. On the other hand, untreated gender dysphoria can drive depression, anxiety, social problems, school failure, self-harm and even suicide. 

This far-reaching bill would prohibit Medicaid from covering both gender-confirming surgeries and hormone therapy. Gender affirming hormone therapy is the primary medical intervention sought by transgender individuals.  We should be supporting our youth to achieve physical and mental well-being instead of creating barriers and restricting access to treatment for a particularly vulnerable population. 

Lastly, the CBHC opposes SB 331 because the passage and implementation of the bill could put New Hampshire out of compliance with federal law, thus jeopardizing the federal match for New Hampshire’s Medicaid program, which is generally 50% of the entire cost of the program. New Hampshire’s Medicaid program must comply with federal nondiscrimination laws, including regulations promulgated under the federal Medicaid statute prohibiting arbitrary restrictions on Medicaid coverage on the basis of diagnosis or health condition;  Section 1557, the nondiscrimination provision of the Affordable Care Act; and regulations governing the activities of Medicaid managed care organizations (“MCOs”) which expressly prohibit discrimination based on gender identity  and require state Medicaid programs and MCOs to develop methods of ensuring that all beneficiaries are able to receive health care services in a culturally competent manner, regardless of factors such as gender, sexual orientation, or gender identity. 

For the reasons presented above, the CBHC strongly urges the committee to vote SB 331 inexpedient to legislate.