Transgender teen shares experience with gender-affirming care in trial against Arkansas law

Dylan Brandt finally feels proud of his yearbook pictures after more than two years of testosterone treatments, he said Wednesday in federal court.

Brandt, 17, is one of the four transgender minors challenging Act 626, Arkansas’ ban on gender-affirming medical care for people under 18. He was the final witness for the plaintiffs, represented by the American Civil Liberties Union, at the end of the third day of the trial.

“My outside finally matches the way I feel on the inside,” he said. “I have my days, but for the most part, this has changed my life for the better. I can look in the mirror and be okay with the way I look, and it feels pretty great.”

Act 626 would prevent him from continuing to receive testosterone in Arkansas.

The law, known as the Save Adolescents From Experimentation (SAFE) Act, prohibits physicians from providing “gender transition” treatments like hormones, puberty blockers and surgeries to minors. The act became law in May 2021 after the Arkansas Legislature overrode Gov. Asa Hutchinson’s veto.

U.S. District Judge James Moody, who is hearing the case against Act 626, placed an injunction on the law in July 2021 that was upheld in August by a three-judge panel of the 8th U.S. Circuit Court of Appeals.

If the law goes into effect, the four transgender plaintiffs and their families would have to either travel or move out of state in order to get the healthcare they need, according to the parents of all four minors, as well as Dylan Brandt, the only minor to testify.

All four families have relatives and support networks in Arkansas that would be difficult to leave behind, they said.

Joanna Brandt, Dylan’s mother, said the family does not have concrete plans to move away from Greenwood but sees it as more plausible than regularly traveling for medical care. Both would be a financial and emotional burden, she said.

“I don’t like [the idea], especially not that we could potentially be forced out,” she said. “We’re not ready to go anywhere.”

Medical groups, including the American Medical Association and American Psychiatric Association, have lobbied against Act 626, saying the banned treatments are safe and that medical decisions should remain in the hands of doctors and their patients.

Dr. Michele Hutchison, the former director of the Gender Spectrum Clinic at Arkansas Children’s Hospital in Little Rock, testified against the bill when it was moving through the Legislature last year.

Three of the minor plaintiffs have been treated at the Gender Spectrum Clinic. Hutchison was also a plaintiff until she moved to New Mexico in July for a new job, and she testified for the plaintiffs’ case Wednesday.

Dr. Kathryn Stambough became the clinic’s director after Hutchison left. She is also a plaintiff who testified Wednesday.

Both Hutchinson and Stambough said they fully inform transgender minors and their parents about gender-affirming medical treatments before receiving consent and administering them.

Joanna Brandt said she felt comfortable consenting to Dylan’s testosterone after discussing it at length with physicians, psychotherapists and Dylan himself. He started receiving the treatment in August 2020.

When asked by attorneys if the clinic encourages or pressures children to be transgender, Hutchison said no.

The defense attorneys with Attorney General Leslie Rutledge’s office have asked witnesses throughout the trial if young people later regret going through a gender transition. Hutchison and Stambough said they have not seen this in their patients at the Gender Spectrum Clinic.

Dylan Brandt said medically transitioning has been “one of the best feelings” and he does not regret it.

Joanna Brandt confirmed her son’s testimony.

“I compare it to a feeling that he had been holding his breath for years and he was finally able to exhale and relax,” she said.

Most transgender youth come out after puberty has started, according to the doctors that testified this week, so physicians prescribe gender-affirming hormones much more frequently than puberty blockers — hormones that pause or delay puberty in adolescents.

However, some children realize they are transgender before puberty, such as Brooke Dennis of Bentonville, one of the plaintiffs. She told her parents, Amanda and Shayne Dennis, that she was a girl at the end of second grade, Amanda testified Wednesday.

Brooke is now 10 and in fifth grade. She is showing early signs of puberty and experiencing anxiety about the prospect of her body changing, such as developing an Adam’s apple, her mother said.

The family has discussed puberty blockers with providers at the Gender Spectrum Clinic, she said.

Amanda Dennis said it is “distressing and upsetting” to think about any of her three children not being able to receive healthcare in Arkansas.

“It fills me with such sorrow that that would happen here where I live,” she said. 

The fathers of the other two plaintiffs testified Tuesday. Donnie Saxton of Vilonia said his son Parker is “a new person” as a result of testosterone, and Aaron Jennen of Fayetteville said his daughter Sabrina’s confidence flourished after receiving testosterone blockers and estrogen. Both said they are concerned about the potential negative impacts of Act 626 on their children’s mental health.

The Gender Spectrum Clinic does not recommend or provide surgeries to transgender youth, Hutchison and Stambough said.

Dr. Deanna Adkins, a pediatric endocrinologist from Durham, N.C., testified Monday that she has never referred minors for genital surgeries but has for gender-affirming mastectomies in transgender minors assigned female at birth.

Dylan Brandt said he hopes to eventually get a gender-affirming mastectomy because his chest “still causes discomfort” for him.

All the witnesses said they have seen vast improvements in transgender teenagers’ mental health after receiving gender-affirming hormone therapy.

Arkansas Children’s administration decided to stop initiating hormone therapy for transgender youth in February of this year. Patients already receiving hormones have been able to continue, Stambough said, but the Gender Spectrum Clinic has referred 44 patients elsewhere, and not all of them have been able to receive hormones.

“I think a lot of them are holding out hope, but they have expressed ongoing concerns and anxiety and distress surrounding their ability to get care that we have evaluated them for,” Stambough said.

Hutchison said it would be “kind of cruel” to legally force all transgender minors in Arkansas to wait until they are 18 to receive this care. She and Stambough both said minors with gender dysphoria might hurt themselves if their transitioning options are restricted.

“I am not hyperbolic when I say I have concerns that not every patient would be able to make it to 18, in terms of patients’ self-harm and suicidality,” Stambough said.

The trial was originally scheduled to last two weeks, but Moody said Monday that he could hear the case until Friday. The plaintiffs’ attorneys said they closed their case earlier than they had originally planned.

The trial will not convene Thursday. The defense will call its three currently available witnesses to testify Friday, and the trial will continue at the end of November.