Alaska medical board seeks to restrict abortion, transgender medical care

A proposed regulation could result in punishments for medical providers who give gender-affirming care to young Alaskans

The offices of the Alaska Department of Health and Social Services are seen in Juneau on Friday, July 1, 2022. (Lisa Phu/Alaska Beacon)

By James Brooks

Alaska Beacon

The politically appointed board that regulates health care in Alaska voted unanimously Friday to recommend that the state restrict medical care for transgender youth in the state and approved a letter asking Alaska lawmakers to end access to abortion in the late stages of pregnancy.

On transgender care, the board approved a draft regulation that — if made final — would declare that providing gender transition care for someone younger than 18 amounts to “unprofessional conduct” equivalent to drunkenly practicing medicine. 

Someone violating that regulation could be subject to disciplinary action. In the most extreme cases, the board has revoked medical licenses after a discipline investigation.

The draft regulation is subject to a public comment period before becoming final or being amended.

In a separate action, the board approved a statement declaring that it does not believe that abortions late in pregnancy are “ethical medical practice” and advised Alaskans to lobby the Legislature to change state law.

Currently, access to abortion in Alaska is protected by a precedent set by the Alaska Supreme Court, which has declared that medical care is covered by the personal privacy clause of the Alaska Constitution.

Both actions come amid a push by Republicans nationally to restrict abortion and gender-affirming care for children. Twenty-seven states, almost all of which are controlled by Republican politicians, have enacted laws or policies restricting gender-affirming care for children.

Abortion restrictions are more common, with only Alaska, eight other states, and the District of Columbia, having no restrictions on abortion care.

Board member Dave Wilson, a commercial pilot who sits in a public seat on the board, said before the vote that the transgender care regulation came about because of public requests.

“This was brought to us as a concern by members of the public, and we acted on that. This is not politically driven. This is not politically motivated,” he said.

Next to Wilson’s image in the board’s Zoom meeting was Dr. Matt Heilala, a podiatrist who is a member of the board and a Republican candidate for governor.

All six of the board’s current members were appointed by Republican Gov. Mike Dunleavy. The board has eight seats, but two are vacant. All six sitting members are male; four are from the Matanuska-Susitna Borough and two are from Anchorage.

Under the draft regulation, medical providers would be acting unprofessionally if they provide “medical or surgical intervention to treat gender dysphoria or facilitate gender transition by altering sex characteristics inconsistent with the biological sex at birth, including but not limited to puberty blockers, cross-sex hormones, mastectomy, phalloplasty, or genital modification to a minor under the age of 18 years old.”

The term “biological sex at birth” has frequently been used by Christian conservatives who believe gender is immutable and cannot be changed once assigned by birth.

That contradicts recommendations from most medical associations in the United States, which have defined gender dysphoria as a disorder that can affect children. The American Academy of Pediatrics, for example, has continuously supported access to chemical and surgical procedures to treat dysphoria and allow someone to potentially seek gender-affirming surgery.

Other countries, including the United Kingdom, have taken a different approach and have restricted gender-affirming care for children.

Since the start of President Donald Trump’s second term in office, the U.S. Department of Health and Human Services has also changed its policy to be against gender-affirming care for youths.

“Earlier in the year, we’ve seen a lot more study that is alarming,” Heilala said during Friday’s board meeting, “policy shifts across the world, and we have strong support of the governor on this. More than half of the states have either outright banned or curtailed this care. And I think it does need to be pointed out, a regulation is an opportunity and a tool to be used at the discretion of the board.”

He said that if the regulation is enacted, disciplinary sanction isn’t “an obligation … but it is an option.”

Public testimony on Friday was uniformly against the draft regulation.

Tom Pittman is executive director of Identity Inc., which offers gender-affirming care to minors in Alaska.

Speaking to the board, he said the proposed regulation “strips parents of their ability to work with trusted doctors to make the best decisions for their child. It shrinks the already fragile provider network and endangers children’s lives.”

Dr. Lindsey Banning, a licensed psychologist and the parent of a transgender child, said that the benefits of gender-affirming care are well-established.

“It’s quite simply the standard of care for trans folks that’s accepted by all major medical organizations in this country,” she said. “Blocking access to this care has devastating consequences on the health and well being of trans kids, dramatically raising (their) rates of depression, anxiety and suicide, and yet somehow we’re here watching this politically appointed medical board brazenly ask us to ignore the research and opt to politicize the healthcare choices of Alaskans.”

The draft regulation is expected to be vetted by the Alaska Department of Law, then would be published for a 30-day public comment period.

• James Brooks is a longtime Alaska reporter, having previously worked at the Anchorage Daily News, Juneau Empire, Kodiak Mirror and Fairbanks Daily News-Miner. Alaska Beacon is part of States Newsroom, the nation’s largest state-focused nonprofit news organization.