First-in-nation trial over whether a state can ban sex-change treatment for children starts in Arkansas: a landmark BATTLE pitting Republicans against transgender rights campaigners

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A trial over whether states can ban cross-sex hormones, puberty blockers, and sex-change surgery for children begins in Arkansas this week, in a landmark case pitting Republicans against trans campaigners.

US District Judge Jay Moody will hear testimony over the law he temporarily blocked last year blocking doctors from providing sex change treatments to anyone aged under 18. It also prevents doctors from referring patients elsewhere for such care.

Arkansas was the first state to enact such a ban on transition treatment for kids, with Republican politicians in 2021 overriding Gov. Asa Hutchinson's veto of the legislation, called the Save Adolescents From Experimentation Act.

Hutchinson said the prohibition went too far by cutting care to those currently receiving it.

Advocates of the law say it is within the state's authority to regulate medical practices. The trial is expected to last two weeks.

Dylan Brandt speaks at a news conference outside the federal courthouse in Little Rock, Arkansas. The teenager is among several trans youths and families who are challenging a state law banning their treatment

'This is about protecting children,' Republican Attorney General Leslie Rutledge said.

'Nothing about this law prohibits someone after the age of 18 from making this decision. What we're doing in Arkansas is protecting children from life-altering, permanent decisions.'

Arkansas Gov. Asa Hutchinson, a Republican, vetoed the Save Adolescents From Experimentation Act, saying it went too far 

For those experiencing gender dysphoria, transitioning with drugs and surgery can be life-saving. Still, some experts warn against providing irreversible treatments to adolescents, pointing to growing numbers who come to regret their procedures.

Whether to allow young people to take puberty-blockers, hormones or undergo surgery has become a hot-button issue in America's culture wars, and Republican officials in Arkansas and other states have sought to limit access to procedures.

Several medical groups, including the American Medical Association and the American Academy of Pediatrics, oppose the bans and experts say the treatments are safe if properly administered.

The families of four transgender youth and two doctors who provide gender-confirming care want Moody to strike down the law, saying it is unconstitutional because it discriminates against transgender minors.

They also say it intrudes on parents' rights to make medical decisions for their children and infringes on doctors' free speech rights.

'As a parent, I never imagined I'd have to fight for my daughter to be able to receive medically necessary health care her doctor says she needs, and we know she needs,' said Lacey Jennen, whose 17-year-old daughter has been receiving gender-confirming care.

A similar law to Arkansas' has been blocked by a federal judge in Alabama, and a Texas judge has blocked that state's efforts to investigate gender-confirming care for minors as child abuse.

Children's hospitals around the country have faced harassment and threats of violence for providing controversial treatments to minors.

'This latest wave of anti-trans fever that is now spreading to other states started in Arkansas, and it needs to end in Arkansas,' said Holly Dickson, executive director of the American Civil Liberties Union of Arkansas, which filed the lawsuit.

The American Civil Liberties Union of Arkansas filed the lawsuit on behalf of the families of four transgender youth and two doctors who provide treatment for transgender people

The above map shows the population of transgender adults and children across America in 2020, according to the Williams Institute at the University of California, Los Angeles. Its estimate for children aged 13 to 17 has doubled since 2017. It shows the highest population is in southern states, followed by those along the east coast

A three-judge panel of the 8th US Circuit Court of Appeals in August upheld Moody's preliminary injunction blocking the ban's enforcement. 

The state has asked the full 8th Circuit appeals court to review the case.

The trial in Arkansas comes as debates about gender transitioning surgeries and medical treatments rage across the country.

The number of children with gender dysphoria has exploded in recent years, giving rise to the use of powerful puberty-blocking drugs.

About 300,000 children aged between 13 and 17 (1.4 per cent) in the US identify as transgender, according to most recent estimates from 2020.

That is double the number estimated to be transgender in 2017 in a previous report by the same researchers, though they used different estimates.

Some say the rise is born out of increased awareness of gender dysphoria and growing acceptance in society. 

Others say the impressionable minds of children are easily swayed by 'fads' among peers, and that children are not ready to make irreversible decisions about their gender.

As the numbers rise, a growing number of people who received transition treatment as minors are voicing their regrets.

California teenager Chloe Cole spoke out against the rush to affirm youngsters with drugs and hormones.

She told a medical panel how she was encouraged as a 13-year-old to take puberty blockers and later have surgery that 'irreversibly and painfully' damaged her body as she transitioned to Leo, a boy.

In her testimony, she warned of the dangers of online LGBTQ+ activism, unreliable therapists and a medical process and its reversal that left her unlikely to be able to have children and unable to breastfeed.

Polls show Americans are divided, but hew to traditional gender norms.

A Pew Research Center poll in May found that most Americans — 60 percent — said sex was determined at birth, rather than by an individual's choice, while 46 percent favored laws against providing children with medical care to transition.

An NPR/Ipsos survey the following month found that 31 percent of respondents supported state laws preventing transgender youngsters from undergoing medical transitions, while 47 percent opposed them.

Three 'Detransitioners' who have voiced regret for their decisions

An increasing number of people who have undergone gender-transitional procedures are voicing regret for their choices, with many saying they feel they were influenced into making drastic choices without proper counseling.

Shape Shifter, pictured, says he even dreams about having a penis, while before his first transition he would dream about having a vagina

 A 32-year-old detransitioner from Massachusetts going by Shape Shifter says he was 'brain washed' into removing his penis by staff at Fenway Health and The Philadelphia Center for Transgender Surgery, who didn't warn him of the negative effects of surgery because it was 'bad for business.'

'I will never be able to get my penis back which is extremely traumatic for me,' he said in an August interview. 'I want it back and I can't. Sex is traumatic for me now because I've had botched surgeries.' 

A 26-year-old from the UK named Sam says she regrets the transition she undertook at 21.

Sam said she made the decision to transition after a mere two-hour counseling session. 

Sam (pictured after her mastectomy) is now warning others of the dangers of going through gender transition too quickly without proper therapeutic support

'I do believe that therapy should be involved at all stages of the transitioning process to help spot and explore red flags that may appear in someone's transitional journey.

'I also think more information should be given to individuals to make sure that their informed consent is truly informed.

Alia Ismail, a 27-year-old from Michigan, is detransitioning after becoming a male at just 18.

She legally changed her name to Issa in August 2015 and underwent a double mastectomy in February 2016. 

But after realizing she wanted to de-transition, the 27-year-old stopped taking male hormones in February 2021 and is going by the name Alia again.

Alia Ismail, 27, pictured as both a male and a female