Wisconsin’s Assembly Bill 104, also known as the “Help Not Harm” Act, aims to prohibit healthcare providers from performing, assisting with, or recommending gender-transition procedures for individuals under 18. The bill, authored by Representative Scott Allen (R-Waukesha) and Senator Cory Tomczyk (R-Mosinee), reflects a growing legislative effort in several states to restrict access to gender-affirming care for minors.
What the Bill Does
AB 104 bans doctors from providing treatments intended to alter a minor’s physical characteristics to align with a gender different from their sex assigned at birth. Specifically, the bill would prevent medical professionals from prescribing puberty blockers, administering hormone therapy, or performing gender-affirming surgeries for minors.
However, the bill does outline certain exceptions:
- Medical Conditions Affecting Sex Development – If a child is born with a genetic condition affecting their sexual development, doctors can still provide treatment as long as the decision is made in good faith by a parent or guardian.
- Treatment for Complications from Previous Gender-Affirming Procedures – If a minor has already undergone medical treatments or surgery for gender transition, healthcare providers may offer care to address complications, even if those procedures were performed legally.
- Life-Saving Medical Care – The bill allows surgeries for minors if they are deemed medically necessary to prevent life-threatening conditions or serious harm.
A key argument from supporters of the bill is that minors lack the maturity to consent to irreversible medical decisions. Advocates believe that children and teenagers should not undergo medical procedures that could lead to permanent physical changes, especially when studies suggest that many cases of gender dysphoria resolve naturally after puberty.
The Argument in Favor of AB 104
Supporters of the bill argue that minors should not be allowed to make life-altering medical choices before adulthood. They point out that society restricts many significant decisions—such as joining the military, getting tattoos, or buying firearms—until individuals reach 18. They believe gender-transition procedures should be no different.
Additionally, proponents cite concerns over the long-term effects of puberty blockers and hormone therapy. A study referenced in the bill’s cosponsorship memo claims that puberty suppression may permanently alter neurodevelopment and that as many as 98% of children with gender dysphoria ultimately identify with their birth sex after puberty.
Supporters frame AB 104 as a measure to protect children from potential harm, arguing that parents who encourage medical transitions for their children may be engaging in a form of child abuse. They emphasize that the bill does not restrict gender-affirming care for adults but ensures that minors wait until they reach maturity to make such decisions.
The Argument Against AB 104
Opponents of AB 104, including the Wisconsin Legislative LGBTQ+ Caucus, argue that the bill blocks necessary and potentially life-saving medical care for transgender youth. They stress that gender-affirming care—including puberty blockers and hormone therapy—is supported by every major medical association in the U.S., including the American Medical Association and the American Academy of Pediatrics.
Medical experts say that gender-affirming care significantly reduces depression and suicidality among transgender minors. A 2022 study published in JAMA Network Open found that transgender youth who received gender-affirming medical care had a 60% lower risk of moderate or severe depression and a 73% lower risk of suicidal thoughts. Opponents argue that denying such care could put vulnerable youth at risk of severe mental health crises.
Critics also point out that AB 104 would punish doctors by permanently revoking their medical licenses if they refer minors for gender-affirming care outside Wisconsin. This level of government intervention, they argue, undermines doctor-patient relationships and prevents families from making medical decisions in consultation with their healthcare providers.
Moreover, opponents warn that the bill could drive transgender families out of Wisconsin. A recent Trevor Project survey found that 40% of LGBTQ+ youth and 45% of transgender youth in Wisconsin considered moving to another state due to restrictive laws and policies.Gov. Tony Evers is certain to veto the bill, however, that is not stopping Legislative Republicans from acting on it. Evers vetoed the same legislation last year.