Having failed to ban all gender-affirming medical care for transgender minors, some Republicans in New Hampshire are trying to pass a bill to ban only genital surgeries for this population.

Such surgeries are exceedingly rare for minors, but they are sometimes deemed medically necessary, and in any case, the bill would interfere with the doctor-patient relationship and parents’ rights to direct their children’s health care, opponents say.

The original bill, House Bill 619, would have banned puberty blockers, hormones, and top surgery as well as genital surgery for people under 18. It never got out of committee. An amended version, on which the New Hampshire House Health, Human Services, and Elderly Affairs Committee held a public hearing Tuesday, would ban only genital surgery and referrals for it.

“We do not seek to invalidate your experience,” Republican Rep. Erica Layon, the bill’s chief sponsor, said in the hearing, The Boston Globe reports. “This effort is to prioritize your lifelong health and well-being by pumping the brakes on the rapid adoption of this medical care for your age group.”

Several groups representing doctors, social service providers, and LGBTQ+ activists testified against the bill. A representative of Dartmouth Health, a major medical center in the state, said its policy is usually to avoid genital surgery for minors, but there are some cases in which it’s needed.

“It’s really dangerous to legislate medicine in this way,” said Courtney Tanner, senior director of government relations for Dartmouth Health.

GLBTQ Legal Advocates and Defenders attorney Chris Erchull mentioned how rare such surgeries are. His group cited a study estimating that “405 transition-related genital surgeries were performed between 2016 and 2020 on patients between the ages of 12 and 18,” the Globe reports, and Erchull said most of the patients were 18 and very few were from New Hampshire.

“We are talking about a very, very small number of surgeries, and the only place I know anywhere near here is Boston Children’s Hospital where a surgery like that has ever taken place, and it is very rare even there,” Erchull said.

The amended bill would also change the state’s ban on conversion therapy for minors to clarify that counselors can discuss gender identity with young people, but some commenters said this is unnecessary. “I’m concerned that a lot of the points in the conversion therapy amendments reflect a fundamental misunderstanding of gender identity,” Erchull said.

James Bomersbach, representing the New Hampshire Psychological Association, expressed concern that the new language confuses legitimate therapy for trans youth with conversion therapy. “There is no legitimate purpose for conversion therapy. There is no scientific evidence that it could work,” he said. “That is not the case for gender-affirming care or any of the things that may be falling under that umbrella.”

A fellow legislator challenged Layon on how advocates for parents’ rights could seek to limit those rights when it comes to gender-affirming care, but Layon said those rights are not absolute. “A parent can’t authorize their child to go use heroin,” she said.

Eleanor McDonough, a trans woman who recently moved from Florida to New Hampshire, said that comparison doesn’t make sense. “When legislating against personal medical rights, any infringement is not only dangerous, it’s a slippery slope,” she said. “It is not the role of government to decide if care which is widely acknowledged as the best treatment for gender dysphoria is medically necessary.”

It’s now up to the Health, Human Services, and Elderly Affairs Committee to decide whether to put the amended language before the full House. Both the New Hampshire House and Senate have Republican majorities, and the governor, Chris Sununu, is a Republican, but the state’s GOPers are generally more liberal on LGBTQ+ issues than those in other parts of the country. Sununu has, for instance, signed bills into law banning anti-trans job discrimination and use of the “LGBTQ+ panic” defense in homicide cases.

He did, however, join most of the nation’s other Republican governors in opposing the Biden administration’s proposed rule establishing student athletes’ right to compete under their gender identity, with some exceptions. New Hampshire has not restricted trans participation in school sports, but Sununu said each state should decide on its own policy.

Pictured: New Hampshire Rep. Erica Layon; parent and child