Maine Lawmakers Approve Puberty Blockers, Cross-Sex Hormones for 16- and 17-Year-Olds — Without Parental Consent

Mainers must be 21-years-old to buy tobacco products and at least 18-years-old to use a tanning salon.

But if Gov. Janet Mills allows a bill approved this week by Maine lawmakers to become law, then minors as young as 16 will be allowed to get puberty blockers and cross-sex hormones — even in cases where their parents object to the medical intervention.

The 73-60 roll call vote in the House fell nearly along party lines. Rep. Sawin Millett (R-Waterford) joined the Democrats in support of the bill, and Rep. Kevin O’Connell (D-Brewer) and Rep. Traci Gere (D-Kennebunkport) joined the Republicans in opposition.

The Senate also approved the bill in a largely-partisan roll call vote of 20-14. Sen. Joseph M. Baldacci (D-Penobscot) and Sen. David P. LaFountain (D-Kennebec) joined the Republicans in opposition to the legislation.

The bill, LD 535, defines “gender-affirming hormone therapy” as “nonsurgical, medically necessary health care that respects the gender identity of the patient, as experienced and defined by the patient.”

Under LD 535, 16- and 17-year-olds “diagnosed with gender dysphoria by a health care professional” may be provided “gender-affirming hormone therapy” without the consent of a parent if they inform their health care provider that they “discussed” their gender dysphoria with “a parent or guardian” who subsequently “refused to support treatment.”

During the floor debate, several representatives spoke both in support of and opposition to the measure.

Rep. Katrina Smith (R-Palermo) spoke in opposition to the bill, stating that “LD 535 is one of the most dangerous bills to come before our legislative body this year. This bill will have consequences for generations.”

“Gender dysphoria is a mental health epidemic,” Rep. Smith said. “Hormone replacement therapy is preying on children. A child should never be told they are not good enough in the body they are born with.”

“Our children are in crisis and now we, the adults, write legislation to coddle and codify their trauma, parental abuse, and poor mental health. We encourage behaviors we know to be unhealthy, untrue and catastrophic to their lives. We must stop this and stop it now,” Smith said.

Rep. Nina Milliken (D-Blue Hill) offered comment in favor of the bill.

“I rise in support of my numerous loved ones and friends who are trans and have been that way since before their 16th birthdays. I rise as teacher who knows and trusts teenagers to make decisions about their own bodies. And I rise as a mother who hopes that my children will access medically necessary care, with or without my knowledge, if they feel they cannot come to me safely to discuss that care,” Rep. Milliken said.

Rep. Lucas Lanigan (R-Sanford) spoke in opposition to the bill.

“I have a little problem with a 16 year old being able to make this dramatic of a change to their body, however they can’t buy a ticket to a rated R movie without their parents permission. I just feel this is another bill that we’re just going too far on where we’re taking the rights of parents away,” Rep. Lanigan said,

At the close of his remarks, Lanigan further clarified his position on the bill. “Its nothing against the trans community. I’m 100% supportive of what people want to do,” he said. “I’m a big believer of choice.”

Rep. Erin R. Sheehan (D-Biddeford), the sponsor of the bill, also spoke in favor of it.

“Puberty can be a confusing and uncomfortable time for many kids, but for trans kids diagnosed with dysphoria it can be unbearable,” Rep. Sheehan said. “For these kids, gender-affirming hormone therapy is a proven treatment to alleviate these symptoms.”

“Like many effective therapies,” she continued, “hormone therapies are not without risk, but for those diagnosed, their benefits are proven and they outweigh the risks.”

Sheehan also spoke to the issue of parental involvement.

“Parental engagement is the gold standard, as parents know their children best and love them unconditionally. Unfortunately, because these treatments and transgender existence itself is so widely stigmatized in the press, on social media, and even by community leaders in the halls of government, some parents are understandably afraid, unable, or unwilling to entertain the possibility that their child needs these treatments to thrive,” she said.

Rep. Sheila A. Lyman (R-Livermore Falls), commenting in opposition to the bill, also spoke to the issue of parental participation.

“This really comes down to being about parental rights,” Rep. Lyman said. “Our parental rights must be honored, respected, and upheld, period.”

“It is not the governments job to address and make laws about gender dysphoria,” Lyman argued.

Debate over LD 535 also took place on the floor of the Senate.

Sen. Lisa Keim (R-Oxford), speaking in opposition to the bill, argued that “changing pronouns may appease the cries of a teen in crisis, but medical alteration is a pursuit of an impossible-to-meet goal.”

“As we blur the lines of human identity,” Sen. Keim said, “it serves us all to remember the importance of loving each other for who we are.”

Keim also pointed out that state law prohibits minors under the age of 18 from using tanning bed and those under 16 from marrying. She also stated that minors are not allowed to get tattoos in Maine and are required to get parental consent for piercings.

Sen. Tim Nangle (D-Cumberland) spoke in support of the bill.

“Suddenly, we don’t trust doctors to make decisions that are in the best interest of their patients, with or without parental consent,” Sen. Nangle said. “This is not gender reassignment. This is the administration of naturally occurring hormones to slow or block puberty. This is not an irreversible surgical procedure. When you stop taking the blockers, puberty resumes.”

“This gives these kids time to work through the psychological problems that they may face. This is just like giving an antidepressant,” Nangle said.

Sen. Eric Brakey (R-Androscoggin) responded to these comments.

“I don’t think this is a question about trusting doctors, I think its a question about trusting parents, and whether medical decisions like these should take place with minors who are legally under the custody of their parents outside the context of discussion and consent by those parents,” Sen. Brakey said.

Brakey also spoke to his stance on LD 535 more generally.

“I don’t want this to be construed as a decision about whether your care about transgender people or don’t care about transgender people,” Brakey said. “I’m not rising today to deny that in certain circumstances [gender-affirming hormone therapy] is helpful, what I am rising to say is that when were talking about minors, its a bridge too far to cut parents out of this decision making process.”

As of June 2023, 20 states have laws on the books restricting minors’ access to gender-affirming care, including both hormone therapies and surgical interventions.

According to the “current standards of care” established by the World Professional Association for Transgender Health, “both parental consent and a medical diagnosis of gender dysphoria” are recommended “before a minor can receive puberty blockers or HRT [hormone replacement therapy].”