Proposal could lead to sanctions against Alaska medical professionals for gender-affirming care

ANCHORAGE, Alaska (AP) — Alaska medical professionals who provide gender-affirming care for children could risk disciplinary action under a proposal set for review by the state medical board on Friday.

The proposal would deem any professional who uses hormonal and surgical treatments for minors “as being grossly negligent” and subject to sanctions by the board, according to the board’s minutes from a June meeting.

The type and extent of disciplinary actions were not spelled out, and board member Matt Heilala, an Anchorage podiatrist who was helping write the proposed regulations, declined to discuss the details Thursday with The Associated Press ahead of the meeting.

The move comes after the board in March sent a letter to state lawmakers expressing opposition to hormonal or surgical gender-affirming care for minors and urging legislators to enact limits on treatments. The Legislature — controlled by bipartisan majorities in both the House and Senate — didn’t take up the issue before adjourning in May.

Critics worry the board is overstepping its authority in pursuing regulations that could leave medical providers open to possible disciplinary actions. Instead of allowing the legislative process to play out, “they are now becoming the legislators themselves, which is inappropriate,” said state Sen. Löki Tobin, a Democrat who has been outspoken in support of the LGBTQ+ community.

The medical board at a June meeting designated member Heilala to help draft a statement for consideration that would pertain to declaring those providing the care “as being grossly negligent and therefore subject to disciplinary sanctions,” according to the minutes of that meeting.

Heilala declined to discuss the specific language stemming from that directive that the board would consider Friday but told the AP that the proposed rules would go through a deliberate and transparent process for the public. Such processes can take months, he said.

Gender-affirming care includes a range of medical and mental health services to support a person’s gender identity, including when it’s different from the sex they were assigned at birth. It encompasses counseling, medications that block puberty and hormone therapy to produce physical changes as well as surgeries to transform chests and genitals, though those are rare for minors.

Most major medical groups say access to the treatment is important for those with gender dysphoria and see gender as existing along a spectrum. While there’s wide, if not universal, medical consensus, the political situation is contentious.

In Texas, Republican Gov. Greg Abbott had issued an order allowing the state to investigate parents of transgender youth for child abuse. But a Texas judge in 2022 blocked the state from investigating families of transgender youths who have received such care and members of the LGBTQ advocacy group PFLAG Inc. over such medical care.

Tom Pittman, executive director of Identity Inc., an Anchorage-based advocacy and health care organization for the LGBTQ+ community, said about 500 Alaska medical professionals have signed an open letter opposing the changes being considered by the board.

The letter campaign organized by Pittman’s group said gender-affirming care for adolescents, when provided in partnership with families, is evidence-based medicine.

“Labeling it ‘negligence’ is not a medical conclusion. It is a political act with devastating consequences: punishing clinicians, undermining parents, and denying young people lifesaving treatment,” the letter states.

Fewer than 100 youth are receiving such gender-affirming care, Pittman said.

Pittman called Heilala’s actions politically motivated, saying he “has co-opted Alaska’s medical board and institution to launch a bid for governorship, and he’s using scapegoating and discrimination against what is a very small vulnerable population of Alaskans to create a bully pulpit for himself.”

Heilala is one of at least eight Republicans to announce plans to run for governor next year. But he said this is an issue the board has been working on for some time and “has nothing to do with my running at all.”

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Bohrer reported from Juneau, Alaska.