Health center supporters respond to Gardiner parents’ concerns about gender-affirming care

GARDINER — Some parents expressed at a public forum Tuesday that they are concerned about a potential lack of parental involvement in gender-affirming care offered at a newly proposed school-based health center.

The centerorganizers say would help combat chronic absenteeism, substance use, mental health issues and other health issues at Gardiner Area High School by providing primary care services on-site and regardless of insurance status or ability to pay.

However, Michelle Tucker kicked off the forum’s question-and-answer period with her concerns about the care of transgender students: “Does this health center have a policy of keeping transgender treatment confidential from parents?” Tucker made up his mind Run for MSAD 11 school board this fall partly because it hopes to prevent transgender students from using the school bathroom of the gender they identify with.

Joanne Joy, senior program manager at Healthy Communities of the Capital Area, the center’s sponsor, said each health center complies with state laws regarding confidentiality and gender-sensitive care. Joy helped moderate the forum, which was held at the Johnson Hall Opera House and approximately 40 people attended.

Under Maine lawMinors who are 16 years of age or older can legally consent to gender-affirming hormone therapy without the involvement of a parent only if:

• The minor was officially diagnosed with gender dysphoria by a doctor;

• The doctor determines that the minor will or will experience harm if he or she does not receive gender-affirming hormone therapy;

• Minors tell a physician that they have discussed their gender identity with their parents or guardians and the parents or guardians have refused to support the treatment of the minor’s gender dysphoria;

• A minor gives written consent after a doctor determines that he or she is mentally and physically capable of giving consent.

These provisions apply to all health care providers in the state, including Maine’s remaining 27 school-based health care centers, such as Cony High School in Augusta and Maranacook Community High School in Readfield.

Under state law, students even younger than 16 can receive confidential care in other areas after a doctor determines they are competent to consent.

According to a 2024 survey by the Trevor Project, a nonprofit dedicated to preventing LGBTQ+ youth suicide, only 13% of transgender youth in the U.S. had access to gender-affirming hormonal health care, and 61% of these youth were concerned about losing access to this care . Nearly half of young transgender and non-binary people said they had considered suicide in the past year, and three-fifths said they had recently experienced symptoms of depression.

2022 test published by a journal affiliated with the American Medical Association and by the National Institutes of Health found that young transgender people who had access to gender-affirming care had a 60% lower risk of moderate to severe depression and a 73% lower risk of suicide within a year.

Additional research cited by the U.S. Department of Health and Human Services’ Office of Population Affairs found that family and peer support are critical to facilitating and organizing this gender-affirming care. The office stated in 2022 that there was no support report“can result in rejection, depression and suicide, homelessness, and other negative outcomes.”

Diandra Staples, deputy chief operating officer at HealthReach, said only seven of the 181 students attending Lawrence High School’s school-based health center in Fairfield received confidential services – that is, services provided without the consent or knowledge of a parent or guardian. On Tuesday, Staples answered many questions from concerned community members.

“And let me tell you, these seven kids don’t have that support system, typically they don’t have parents,” Staples said. “They usually live on someone’s couch. They don’t have that knowledge, and sharing that information with others is quite a dangerous situation.”

Katie Gillihan, a registered nurse who works at the Lawrence High School health center, said doctors try to involve parents at every step, almost always calling and asking if they can see their child before the visit.

Gillihan, however, said care providers sometimes need to build trust with a student to engage parents about more sensitive issues such as mental health, sexual activity or gender identity.

“Many of these children, after a few visits, once they had built trust in me and the medical system – nine times out of 10, these children allowed me to involve their parents or guardians,” she said. “But I wouldn’t have been able to convince that child to engage with other supports, I wouldn’t have been able to prevent the pregnancy or access services if I hadn’t had the opportunity to even talk to them and let them know how to access them.”

Tucker responded that she agrees that more people should be involved in students’ care, but that parents, not doctors, should be the primary point of decision-making. In fact, she said, she often refused when doctors asked her to leave the exam room to talk to her child alone about her concerns.

The presenters pointed out that using the health center is voluntary, and parents should discuss the use of the center and its services with their children in advance.

Tucker also expressed concerns about teachers and administration being involved in medical decisions. However, in response, Joy said that the health center would simply be located in the school building and would be completely separate from the school administration. Decisions will be made solely by health care providers, parents and students, not school staff, she added.

The MSAD 11 board has not yet scheduled a vote on whether to approve the facility.

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