Citizen Green: State cites ‘anti-LGBT hate group’ in HB 2 case


A legal brief filed after a hearing is kind of like a job applicant sending a follow-up email after an interview.

Eloquently constructed, it can complement and enhance a strong performance, or discretely address a rough patch. However, a rambling and disjointed message bogged down with unwieldy attachments is likely to only reinforce a bad initial impression.

Considering lawyer Butch Bowers’ risible claim in federal court on Aug. 1 that a transgender female entering a women’s restroom creates “a risk of public exposure,” the 518-page brief filed on Aug. 17 by lawyers for Gov. Pat McCrory, Senate President Pro Tem Phil Berger and House Speaker Tim Moore doesn’t exactly strengthen their case. As with much of the state’s ham-handed response to the legal, economic and social backlash against HB 2, the defendants bit down hard on their claim instead of trying to finesse the argument.

In opposing the US Justice Department’s position that HB 2 violates the civil rights of transgender people and amounts to sex discrimination, lawyers for the state of North Carolina make a bizarre argument that transgenderism isn’t supported by standard medical science.

“For children and adolescents diagnosed with gender dysphoria” — the condition of discomfort and distress because of a mismatch between one’s biological sex and gender identity — the state’s lawyers counsel that “strong evidence shows that the vast majority of cases (80-95 percent) will resolve by the end of puberty. Thus, the most effective course of treatment is individual psychological therapy, family therapy and treatment of psychological co-morbidities, along with allowing nature to do its work in puberty.”

The source of the state’s questionable science is revealed in an approving quote from an outfit called the American College of Pediatricians. Designated as an “anti-LGBT hate group” by the Southern Poverty Law Center, the American College of Pediatricians’ mission statement characterizes post-operative transgender life as “chemical and surgical impersonation of the opposite sex.”

Dr. Quentin L. Van Meter, the American College of Pediatrics’ vice president and an expert witness for the state, acknowledges that psychological evaluation, counseling, hormonal therapy during puberty and, in some cases, surgical intervention at the age of consent are standard practices in endocrine medicine. Citing ongoing studies of outcomes from transitional therapies, he goes on to complain: “What is missing is sound science to show that gender identity discordance is not a delusional state.”

Akin to climate change denial, the notion that being transgender might be “a delusional state” lies far beyond the consensus of modern psychology.

A task force of the American Psychological Association, boasting more than 117,500 members, issued a report in 2009 finding that for individuals suffering distress from a mismatch of gender identity and biological sex, hormone therapy and sex reassignment surgery “may be medically necessary to alleviate significant impairment in interpersonal and/or vocational functioning.”

While Van Meter and his associates counsel that children experiencing gender dysphoria should just wait it out and trust that they’ll reconcile themselves to a gender identity consistent with their biological sex, the American Psychological Association reports that “regrets and reversal to the original gender role” post transition “were rare,” reaching 1.5 percent at a maximum.

Another expert witness hired by the state, Dr. Paul Hruz, marshals an array of fearful outcomes about the supposed adverse health consequences of transition through hormone therapy. In addition to sterility, he cites “lower bone density which may lead to increased fracture risk later in life,” along with “disfiguring acne, high blood pressure, weight gain, abnormal glucose tolerance, breast cancer, liver disease, thrombosis, and cardiovascular disease.”

Although the comparison is not completely apt, it’s worth noting that the American Psychological Association reports that sex reassignment — which requires hormone therapy as a precursor — “resulted in improved mental health, socioeconomic status, relationships and sexual satisfaction.”

Hruz pooh-poohs the notion that the ability to use a bathroom that accords with one’s gender identity might be “a medically necessary or effective treatment for gender dysphoria.” And for good measure he adds that “such social affirmation measures” might prevent individuals from being cured of their transgenderism, or — as he puts it — “would interfere with known rates of gender resolution.”

Finally, to counter the US Justice Department’s position that the continued enforcement of HB 2 will impose an “irreparable injury” to transgender people, the state essentially makes the argument that they’re going to suffer from other “co-morbidities” like depression and anxiety anyway, so what’s the harm in piling on?

“Anyone attempting to ‘transition’ to a gender different from their chromosomes and original anatomy will likely face substantial psychological problems no matter what policies North Carolina adopts,” the brief argues. “Indeed, the evidence before the court establishes that gender dysphoria often overlaps with other disorders. At best, it is a complex and difficult task to disentangle harms occasioned by a state policy from underlying psychological issues.”