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Bill restricting gender-confirmation care sparks concern in Senate committee
Sen. Tom Takubo, R-Kanawha, speaks during a Senate Health and Human Resources Committee meeting. Takubo, a doctor, tried to amend a bill that would restrict gender-confirming care for minors to allow access to puberty blockers and hormone treatment therapy but was unsuccessful.
CHARLESTON — A bill that could have wide implications for teenagers receiving or seeking gender-confirmation care in West Virginia advanced out of the Senate Health and Human Resources Committee on Thursday and now heads to the Judiciary Committee.
In a meeting that included a lengthy debate, the Health and Human Resources Committee heard testimony from Dr. Kacie Kidd, medical director of the West Virginia University Gender and Sexual Development Multidisciplinary Clinic, who discussed the negative impact House Bill 2007 would have on hundreds of youths in West Virginia who are receiving or seeking gender-confirmation care.
The bill, as introduced in the House of Delegates, would have banned gender-confirming surgery for anyone under 18, but was amended to include puberty blockers and hormone treatment therapy before it was approved in the House.
Sen. Eric Tarr, R-Putnam, was one of the most ardent supporters of the legislation during Thursday’s meeting, saying that, in his opinion, the types of treatments being described were abuse.
Tarr said he was “caught off guard” to learn that WVU had a Gender and Sexual Development Multidisciplinary Clinic and said he believes surgeries are a “next step.”
“I can’t imagine, if I look back in my childhood or my kids’ childhood, to go back and make that decision for another human to change their sex, and what’s a little bit more disturbing about it is it’s the first step,” Tarr said. “And I don’t think we should give them a toe in the tent, let alone a next step, for this kind of treatment.”
Kidd said gender-confirming surgery is not performed on minors in West Virginia and there are no plans to offer it in the future. She added it is not common practice anywhere.
The committee voted down an amendment by Sen. Tom Takubo, R-Kanawha, who also is a doctor, that would have restored patient access to puberty blockers and hormone treatment therapy. Takubo said that while he agrees with a prohibition on surgery, he believes the other treatments are beneficial to patients, who have been shown to have a better quality of life as a result of the care they receive.
“We, as a legislative body I feel, are taking a dramatic overreach when we’re stepping into a field of medicine, where it is proven, whether you agree with it or disagree with it, that a patient does matter, their mental health, their ability to function. Their suffering is made less by therapy,” Takubo said. “I cannot, in good conscience, leave this section of the bill, when we know the facts are that this therapy does improve the functionality of a child. It decreases suicide rates. It helps with their mental health.”
The bill would have a devastating impact on hundreds of patients in West Virginia who are being treated for gender dysphoria, which is described in the Diagnostics and Statics Manual IV, Kidd said. Removing access to gender-confirmation care places patients at serious risk of depression, social isolation, self-hatred, self-harm and suicide, she said.
Treatment for gender dysphoria includes hours of extensive counseling and therapy before medical professionals determine whether puberty blockers or hormone treatment therapy are appropriate, Kidd said.
It would take six to 12 months to take someone off these treatments voluntarily, but that rarely happens, Kidd said.
“That’s not something that we have extensive experience with, because so many young people do so well on these medications and their families see the positive benefits and continue,” Kidd said. “If someone is forcibly removed from treatment, I can’t say, because I expect that would cause profound harm.”
The committee also voted down attempts by Takubo to amend the bill to allow those receiving care to continue treatment, a measure that was supported by Committee Chairman Michael Maroney, R-Marshall, who is also a doctor. Maroney said the decision should not be up to a committee of “mostly medically uneducated” lawmakers.
“This is equivalent to passing a law saying you cannot treat someone for schizophrenia. It’s the equivalent to saying you can’t give someone drugs for chemotherapy. Those are all peer-reviewed and proven. This is, too, but it’s just something we don’t understand or don’t get,” Maroney said. “To deny them continued treatment — that’s not only uneducated, that’s cruel, in my opinion.”
Speaking in support of Takubo’s amendment, Sen. Ryan Weld, R-Brooke, also expressed concern that the Legislature is out of its depth, medically speaking.
“I don’t truly understand any of this to the degree our doctor does, who has been here, but I’m a little surprised that we would, as legislators, so drastically try to micromanage health care. That we would step in and say you need to stop what you’re doing, or how you’re being treated right now,” Weld said. “That’s some big-government stuff right there, Mr. Chairman. I just don’t feel comfortable, as a legislator, telling somebody who is currently receiving treatment for their mental health disorder that they have to stop taking their medication by a certain date.”
Roger Adkins covers politics for HD Media. He can be reached at 304-348-4814 or email radkins@hdmediallc.com. Follow him on Twitter @RadkinsWV.
BOTH PHOTOS: The Marshall University Symphony Orchestra’s 62nd Young People’s Concert, presented by Marshall University and the Cabell County Board of Education in cooperation with The Woman’s Club of Huntington, takes place on Thursday at the Keith-Albee Performing Arts Center in downtown Huntington.
The Marshall University Symphony Orchestra’s 62nd Young People’s Concert, presented by Marshall University and the Cabell County Board of Education in cooperation with The Woman’s Club of Huntington, takes place on Thursday, March 2, 2023, at the Keith Albee Performing Arts Center in downtown Huntington.
The Marshall University Symphony Orchestra’s 62nd Young People’s Concert, presented by Marshall University and the Cabell County Board of Education in cooperation with The Woman’s Club of Huntington, takes place on Thursday, March 2, 2023, at the Keith Albee Performing Arts Center in downtown Huntington.
The Marshall University Symphony Orchestra’s 62nd Young People’s Concert, presented by Marshall University and the Cabell County Board of Education in cooperation with The Woman’s Club of Huntington, takes place on Thursday, March 2, 2023, at the Keith Albee Performing Arts Center in downtown Huntington.
HUNTINGTON — The Keith-Albee Performing Arts Center welcomed fifth graders from throughout Cabell County to see the 62nd Young People’s Concert on Thursday.
The concert is a partnership between the Marshall University Symphony Orchestra, the Woman’s Club of Huntington and Cabell County Schools. Fifth graders from Cabell’s public, private and homeschools were invited to attend.
The program was conducted by Marshall University’s Symphonic Orchestra conductor Elizabeth Reed Smith.
It also featured a performance from Isaiah Biehle, a sophomore student of Soli Deo Gloria Homeschool and winner of the YPC Auditions held in January. Biehle performed “Zigeunerweisen” composed by Pable de Sarasate.
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The Marshall University Symphony Orchestra's 62nd Young People's Concert, presented by Marshall University and the Cabell County Board of Educ…
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‘Forever chemicals’ about to get their first US limits
The Environmental Protection Agency is expected to propose restrictions on harmful “forever chemicals” in drinking water after finding they are dangerous in amounts so small as to be undetectable
Betty Rivas prepares breakfast for her family Thursday, Feb. 23, 2023, in Commerce City, Colo. Rivas was startled by a letter telling her that the drinking fountains her 8-year-old used at school weren't safe. PFAS stories had been in the local news and the school district told families to use bottled water.
Eric Kleiner, center, sorts samples for experimentation as part of drinking water and PFAS research at the U.S. Environmental Protection Agency Center For Environmental Solutions and Emergency Response, Thursday, Feb. 16, 2023, in Cincinnati. The Environmental Protection Agency is expected to propose restrictions on harmful "forever chemicals" in drinking water after finding they are dangerous in amounts so small as to be undetectable, but experts say removing them will cost billions.
Eva Stebel, water researcher, pours a water sample into a smaller glass container for experimentation as part of drinking water and PFAS research at the U.S. Environmental Protection Agency Center For Environmental Solutions and Emergency Response, Thursday, Feb. 16, 2023, in Cincinnati. The Environmental Protection Agency is expected to propose restrictions on harmful "forever chemicals" in drinking water after finding they are dangerous in amounts so small as to be undetectable, but experts say removing them will cost billions.
Betty Rivas buys water from a refill station on Thursday in Commerce City, Colo. Rivas was startled by a letter telling her that the drinking fountains her 8-year-old used at school weren’t safe. Her family is one of many in the community who do not drink the tap water and instead buy water from potable refill stations around town.
Betty Rivas cleans dishes using tap water Thursday, Feb. 23, 2023, in Commerce City, Colo. Rivas was startled by a letter telling her that the drinking fountains her 8-year-old used at school weren't safe. Her family is one of many in the community who do not drink the tap water and instead buy water from potable refill stations around town.
Betty Rivas fills a mug from a potable water dispenser in her home Thursday, Feb. 23, 2023, in Commerce City, Colo. Rivas was startled by a letter telling her that the drinking fountains her 8-year-old used at school weren't safe. Her family is one of many in the community who do not drink the tap water and instead buy water from potable refill stations around town.
The Denver Fire Academy is visible through a fence from the road Thursday, Feb. 23, 2023, in Commerce City, Colo. Firefighting foam used here up until 2018 is suspected to be linked to the discovery of PFAS, or “forever chemicals” found in city’s groundwater.
Jonathan Pressman, engineer and EPA water researcher, poses for a portrait, Tuesday, Feb. 14, 2023, in Cincinnati. The agency offers technical assistance to states and communities and it recently made $2 billion available to states for contaminates like PFAS.
A sample of granular activated carbon, used to remove PFAS from water, sits on display during a tour of the U.S. Environmental Protection Agency Center For Environmental Solutions and Emergency Response, Tuesday, Feb. 14, 2023, in Cincinnati. The Environmental Protection Agency is expected to propose restrictions on harmful "forever chemicals" in drinking water after finding they are dangerous in amounts so small as to be undetectable, but experts say removing them will cost billions.
Esther Hughes, top, removes bottles of water samples from a rotator inside a controlled temperature room at the U.S. Environmental Protection Agency Center For Environmental Solutions and Emergency Response, Thursday, Feb. 16, 2023, in Cincinnati. The Environmental Protection Agency is expected to propose restrictions on harmful "forever chemicals" in drinking water after finding they are dangerous in amounts so small as to be undetectable, but experts say removing them will cost billions.
A water researcher tests a sample of water for PFAS, Tuesday, Feb. 14, 2023, at the U.S. Environmental Protection Agency Center For Environmental Solutions and Emergency Response in Cincinnati. The Environmental Protection Agency is expected to propose restrictions on harmful "forever chemicals" in drinking water after finding they are dangerous in amounts so small as to be undetectable, but experts say removing them will cost billions.
Susan Pinney, director of the Center for Environmental Genetics at the University of Cincinnati, poses for a portrait, Tuesday, Feb. 14, 2023, in Cincinnati. PFOA and PFOS are part of a larger family of compounds called PFAS that are widespread, don't degrade in the environment and have been around for decades. "We as a community of scientists and policymakers and regulators really missed the boat early on," said Pinney.
Homes that flank an industrial zone are seen from the air Thursday, Feb. 23, 2023, in Commerce City, Colo. The Environmental Protection Agency is expected to propose restrictions on harmful "forever chemicals" in drinking water after finding they are dangerous in amounts so small as to be undetectable. Although the district built a facility to treat the contamination in Commerce City, it sparked long-simmering distrust in the predominantly Latino neighborhood, and questions over how long they had been exposed.
The Environmental Protection Agency is expected to propose restrictions on harmful “forever chemicals” in drinking water after finding they are dangerous in amounts so small as to be undetectable. But experts say removing them will cost billions, a burden that will fall hardest on small communities with few resources.
Concerned about the chemicals’ ability to weaken children’s immune systems, the EPA said last year that PFAS could cause harm at levels “much lower than previously understood.”
“We as a community of scientists and policymakers and regulators really missed the boat early on,” said Susan Pinney, director of the Center for Environmental Genetics at the University of Cincinnati.
There is also evidence the compounds are linked to low birthweight, kidney cancer and a slew of other health issues. It’s unclear what the EPA will now propose and how well it will protect people from these recently-understood harms.
The compounds PFOA and PFOS are part of a larger family of chemicals called PFAS, for per- and polyfluoroalkyl substances, that are widespread, don’t degrade in the environment and have been around for decades. They’ve been used in nonstick pans, food packaging and firefighting foam. Their use is now mostly phased out in the U.S., but some still remain.
Water providers are preparing for tough standards and testing that will undoubtedly reveal PFOA and PFOS in communities that don’t yet know the chemicals are in their water. The deadline for the proposal is Friday, but first it must be reviewed by the White House Office of Management and Budget. As of Thursday, that review wasn’t finished.
“This rule would help ensure that communities are not being poisoned,” said Jonathan Kalmuss-Katz, senior attorney, toxic exposure and health at Earthjustice.
Over the last decade, an increasing number of cities and towns, often abutting manufacturing plants or Air Force bases, suddenly realized they had a problem. In 2016, for example, Sarah McKinney was on maternity leave when she got word there was too much PFOA and PFOS in the tap water in her Colorado Springs suburb. She picked up her weeks-old daughter and hustled out to buy enough bottled water for her family of five.
“If I’m just spitting it out, can I brush my teeth?” she remembers wondering.
In response to concerns from people who had been drinking the water for years, McKinney’s water utility switched to a different source, provided water bottle filling stations and installed a $2.5 million treatment system that was the first of its kind in the country, according to Lucas Hale, the water district manager. The chemicals had gottem into the water from nearby Peterson Air Force base, which then builta treatment facility.
For communities with the pollutants, it’s not a cheap problem to solve.
Nationally, it could cost roughly $38 billion to remove enough of the chemicals to meet a strict EPA rule limiting them to where they can’t be detected, according to an estimate prepared by engineering consultant Black & Veatch for the American Water Works Association, an industry group. There also will be ongoing costs for filter material and testing.
The consultant looked at federal and state test results and estimated that 4% to 12% of water providers nationally will need to treat for PFAS due to the EPA rule.
Smaller, poorer communities will have a harder time affording the new systems and training staff on how to use them, experts said. And in general, smaller water providers with fewer resources already violate water quality rules more often than utilities that serve large cities.
“Small systems often need technologies that are more simple to operate,” said Jonathan Pressman, engineer and EPA water researcher. The agency offers technical assistance to states and communities and it recently made $2 billion available to states for contaminants like PFAS.
Inside the EPA’s research facility in Cincinnati, a row of vertical, forearm-sized glass tubes were partially filled with a resin material that can remove PFAS. The work ensures the agency knows how long it will last and how much PFAS it removes. That’s important for designing treatment systems. Last year the agency lowered its conservative, voluntary health thresholds to levels that tests can’t even detect — a fraction of a part per trillion. In 2016, it was 70 ppt. Before that, it was even higher. As the EPA recognizes the increased danger of these compounds, it will mean people who were once told their water was safe to drink will find out it actually requires treatment.
When people feel misled about the safety of their tap water, they are less likely to drink it. Instead, they tend to reach for expensive bottled water and consume sugary drinks more often, choices associated with health problems like diabetes.
“We do have challenges in this community with trust,” said Abel Moreno, the district manager of the South Adams County Water & Sewer District that serves Commerce City, an industrial stretch of Denver. Contaminants leaked from a nearby chemical manufacturing plant decades ago. Although the district built a facility to treat the contamination, it sparked long-simmering distrust in the predominantly Latino neighborhood, and questions about how long people had been exposed.
Last year, Betty Rivas was startled by a letter telling her that the drinking fountains her 8-year-old used at school weren’t safe. PFAS stories had been in the local news and the school district told families to use bottled water. It reinforced Rivas’s fears.
“With this recent PFAS issue, it’s one more reason to be certain that you shouldn’t drink the water in Commerce City,” she said.
Moreno responded that the district tested for PFAS long before the news reports, in 2018. It discovered extremely high levels in certain wells, but once the water went through the treatment plant, it didn’t surpass the EPA health advisory threshold in place at the time. Moreno’s agency closed the wells. He said the letter Rivas received was frustrating because PFAS hadn’t spiked — it had just made the news. Now, the district purchases and mixes in water from Denver to keep PFAS at undetectable levels and plans to build a treatment plant for a permanent fix.
Across the U.S., so far only local utilities and state regulators have imposed changes, not the federal government. Michigan set a drinking water limit and paid for testing. Those tests helped quickly find and fix some places with contamination and Michigan officials have said since then its limits haven’t proved too expensive.
New standards, however, will force tradeoffs, according to Chad Seidel, president of a water consultant company.
“Resources going towards addressing this are in some ways coming at a cost” of other needs, like removing dangerous lead pipes and replacing aged water mains, he said.
Kalmuss-Katz of Earthjustice said too many people are drinking contaminated water. Cost can’t be a barrier.
“The solution is to do whatever you have to do to ensure that people are not getting sick,” he said.
News
House approves bill to provide law enforcement with training on autism, Alzheimer's, dementia
Senate Bill 526 will increase education among health care professionals and members of the public regarding the importance of early detection and diagnosis of Alzheimer's disease and other dementia.
CHARLESTON — A bill headed to Gov. Jim Justice for consideration would provide law enforcement officers with training to appropriately respond to people with autism spectrum disorders, Alzheimer’s and related dementias.
Senate Bill 208 on Thursday cleared the House of Delegates, where it was approved 95-1, with four delegates absent, after already having cleared the Senate.
The bill would require the Law-Enforcement Professional Standards Subcommittee to establish a basic-training curriculum course for law enforcement and corrections officers in appropriate interactions with individuals with autism spectrum disorders, Alzheimer’s and related dementias.
The subcommittee also would be required to develop guidelines for law enforcement response to individuals with these diagnoses who are victims or witnesses to a crime, or suspected or convicted of a crime.
Delegate Dave Foggin, R-Wood, was the sole voice of dissent on the House floor Thursday, arguing it would be difficult for officers to identify traits of those diagnoses in emergency situations. The legislation also could make it difficult to recruit officers at a time when the number of applicants is already dwindling, he said.
“It’s very difficult to identify someone with autism, let alone when you’re in any emergency situation where their behavior may be a lot different,” Foggin said. “In 1990, in a town I’m familiar with, there were 286 people tested to become a police officer. Last night, there were four in the same town.”
The training course relating to Alzheimer’s and dementia would consist of two hours and should be based on evidence-informed research into the identification of persons with those afflictions, according to the bill. It would cover risks such as wandering or elder abuse, and the best practices for law enforcement officers interacting with such persons, according to the bill.
The course would be delivered by any qualified entity, organization or person approved by the Law-Enforcement Professional Standards Subcommittee, according to the bill.
The course of instruction and the guidelines relating to autism spectrum disorders would be developed and delivered by the West Virginia Autism Training Center at Marshall University, according to the bill.
The bill establishes guidelines for the course to cover topics such as positive responses to individuals with autism and the de-escalation of potentially dangerous situations, as well as provide an understanding of the way individuals with autism process sensory stimuli and language. It could also cover social communication, language difficulties likely to affect interaction, and appropriate methods of interrogation, according to the bill.
The legislation would also require instructors to include in the course adults with autism spectrum disorders and their caregivers.
Delegate Danielle Walker, D-Monongalia, said that as a mother of a child with an autism diagnosis, the bill would provide another “layer of trust” for the law enforcement community.
“This is lifesaving for my child and for other children who may be traveling through the borders of West Virginia. In this body and throughout West Virginia, we support and we protect people with different abilities,” she said.
Many people with an autism diagnosis are high-functioning but still have triggers, Walker said. This legislation would train law enforcement officials on how to respond to that.
“I was in a hit-and-run accident on Mother’s Day with him and my mother. He knew that first responders were coming to help, because I have him in the community with me all the time. But it’s just something about the lights when he sees them and hearing the sirens, it sends him over,” she said. “I don’t see this as a disrespect to our first responders. I think it adds another layer of trust.”
Roger Adkins covers politics for HD Media. He can be reached at 304-348-4814 or email radkins@hdmediallc.com. Follow him on Twitter @RadkinsWV.
