The House, Thursday, March 27, 2025

Deputy Speaker Steven SmithThe question is on the adoption of the amendment. Are you ready for the question? A division has been requested. Members take your seats. The question is on the adoption of amendment (1083h). Rep. Weber is recognized for a parliamentary inquiry.

Rep. Lucy Weber (D - Ches 5)Thank you, Mister Speaker. Mister Speaker, if I know this amendment makes an exceedingly harmful bill a teensy tiny bit less harmful because instead of terminating medical care that has been continued in some cases for years with the passage of a law that says you can no longer receive your treatment, the amendment allows up to the end of this year for physicians to taper off the treatment that they prescribed and parents agreed to for minors, would I now press green for the amendment?

Deputy Speaker Steven SmithThe question is on the adoption of amendment (1083h). This is a division vote. If you are in favor; press the green button. If you are opposed, press the red. Voting stations will be open for 30 seconds. Have all members present had the opportunity to vote? That was worth it. The House will attend to the state of the vote. 350 in favor, 4 against, the amendment is adopted. The bill is on second reading and open to further amendment. Rep. Weber moves floor amendment (1316h) found in your seat pockets. Rep. Lucas is recognized to speak to the amendment. Before everybody gets on their way out there to find snacks and coffee, this is one on one, and I'd be shocked if there wasn't a division or roll call. Seriously, we did a division on the last one, there probably going to all be something. So, let's not go too far. Lunch gets further and further away while we wait. Sorry, Rep. Lucas, go ahead.

Rep. Janet Lucas (D - Graf 7)Thank you, Mister Speaker. Mister Speaker, I rise in support of the amendment (1316h) so that patients younger than 18 years of age may continue to be treated through their minority, that is their 18th birthday. Consistent with those referenced under RSA 332-N:2, if such treatment was commenced before, and is still active on the effective date. Abruptly withdrawing treatment for gender dysphoria, particularly puberty blockers and hormone therapy, can lead to a range of physical and psychological consequences, including the return of dysphoria symptoms and potential health complications and increased mental health challenges. Stopping hormone therapy can lead to reversal of physical changes accomplished during treatment, cause withdrawal symptoms and cause a resurgence of distress and discomfort associated with gender dysphoria, thereby exacerbating existing mental health issues and potentially lead to new ones. Withdrawal can lead to difficulties in family, peer and friend relationships resulting in social rejection, consequent negative sense of wellbeing and poor self esteem increases the risk in self harm and suicide. This bill, HB 377 for which an amendment (1316h) is addressed, sends the message that not only does New Hampshire refuse to acknowledge the importance of treatment for the diagnosis of childhood gender dysphoria, it would deprive patients who have spent years on a journey of self knowledge and definition, social adaptation, individual and family therapy. From accessing medical therapy when it is time biologically and psychologically not according to the calendar. HB 377 would deny parents and their children the right to proceed with medical therapy if that is what they decide is best in consultation with their caregivers. HB 377 would prioritize New Hampshire government intervention over the patient/physician relationship. There is a small element of humanity that can be added to an otherwise cruel and restrictive bill. Vote for floor amendment (1316h) by pressing the green button to give families of transgender children an opportunity to continue care so that they remain fully treated in the Granite State. Vote for amendment (1316h) so that these loving and devoted families can take an iota of hope from today's proceedings. Thank you, Mister Speaker.

Deputy Speaker Steven SmithRep. Layon is recognized to speak against the amendment.

Rep. Erica Layon (R - Rock 13)Thank you, Mister Speaker. I rise in opposition to this amendment. While at first blush it may seem compassionate, it is not. Puberty blockers or chemical castration as it is referred to when used in adults and hormonal therapy have increased risks the longer you take them. These risks include weak bones, heart problems, blood clots, reproductive issues, neurological issues, cancer and more. I'll focus on bones. Brittle bones are life threatening. One out of every three adults over the age of 50 who break their hip will be dead within 12 months. I always thought that was the elderly, but that's over 50. Puberty is the time when we build our bones, and these medications interrupt that process. Studies show that 1/3 of kids on these drugs will suffer devastating bone density loss that puts them at the bottom 2% of bone density for their age group. As somebody who almost died after breaking my femur at age 29, I'm a little sensitive to that risk. But there is good news. Children who are treated with these drugs for precocious puberty, suffer serious bone loss during treatment. The same kind of bone loss. But stopping these drugs during the natural puberty window allows most kids to build normal bone strength lowering their lifetime risk of breaking a bone and dying from that. This amendment would undermine informed consent by creating a rush to start these risky drugs. These drugs are not perfectly safe. Anybody who says that is misleading parents, misleading kids and misleading all of us. The amendment adopted by the committee provides for a common sense weaning off period through the new year. This amendment is not needed so please vote red and I ask for a roll call vote.

Deputy Speaker Steven SmithThe question is on the adoption of amendment (1316h). Rep. Layon has requested a roll call vote. Is that sufficiently seconded? Yeah, this will be a roll call vote. Members take your seats. The question is on the adoption of amendment (1316h). Rep. Weber is recognized for a parliamentary inquiry.

Rep. Lucy Weber (D - Ches 5)Thank you, Mister Speaker. Mister Speaker, if I know that the overwhelming testimony of parents of trans minors and adults who are now trans who were once minors who were trans is that these treatments are life affirming and life saving. And if I have heard loud and clear from members of this body that we ought to trust parents to adequately research and determine the treatment and medical decisions for their children. And if I know that to deny one distinct class of children a treatment that they need is discriminatory and cruel, would I now press the red button? Green. Green button. My apologies.

Deputy Speaker Steven SmithRep. Mazur is recognized for a parliamentary inquiry.

Rep. Lisa Mazur (R - Hills 44)Thank you, Mister Speaker. If I know the definition of biological sex was altered in this amendment. And if I know these puberty blocker drugs, and cross sex hormones are not safe and not approved by the FDA for blocking healthy puberty. And if know this amendment keeps vulnerable children on these harmful gender transition medications. And finally, if I know the amendment we just passed previously allows for a weaning off period with a deadline, would I please press the red button so that we can proceed with the original bill as amended? Thank you.

Deputy Speaker Steven SmithThe question is on the adoption of floor amendment (1316h). This is a roll call vote. If you are in favor; press the green button. If you are opposed; press the red. Voting stations are open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 168 in the affirmative; 203 in the negative, the amendment fails.

Speaker PackardThe motion before us now is ought to pass as amended. For what reason does the member rise?

Rep. Brian Cole (R - Hills 26)Mister Speaker, I move the previous question.

Speaker PackardThe motion is to move the previous question. Rep. Weber has requested a roll call. Is that sufficiently seconded? It is sufficiently seconded. This will be a roll call vote. Representative Weber: Mister Speaker, I understand that the previous question has been moved. Would you explain to the body exactly what that means in terms of our procedures going forward, so we all understand it?

Speaker PackardIf the motion is adopted, we proceed immediately to the final question.

Rep. Lucy Weber (D - Ches 5)So, the effect is that the voices of those who have signed up to speak will be effectively stifled?

Rep. Lucy Weber (D - Ches 5)So, would I be correct in understanding that if one wanted to allow members their right to speak, they ought to be voting against this motion?

Speaker PackardThe motion is to move the previous question. This is a roll call vote. The Chair recognizes Rep. Berry for a parliamentary inquiry.

Rep. Ross Berry (R - Hills 44)Thank you, Mister Speaker. Mister Speaker, if I know that we just heard two awesome debates about this subject and I know there's 12 more coming, but I also know, Mister Speaker, that I would like to pass this legislation, but not have to sit through 12 debates. And, Mister Speaker, if I know the member just raising the question about previous question, used previous question last term, would I now vote green so we can act on the question?

Speaker PackardThe Chair recognizes Rep. Wade for a parliamentary inquiry.

Rep. Alice Wade (D - Straf 15)Thank you, Mister Speaker. Mister Speaker, if I know that this bill will cause significant harm to New Hampshire families and would remove a parent's right to have the final say in healthcare decisions for their child and that this care is recognized by every major medical association as the best care for trans children. And I know that my life was saved by the very care that this bill will seek to take away. And if I know that we should not vote to close debate and stifle speech on a bill with such deep impacts on New Hampshire families without hearing arguments from both sides, would I now press the red button?

Speaker PackardThe motion before us is to move the previous question. This is a roll call vote. If you are in favor; you'll press the green button. If you are opposed, you'll press the red button. Voting stations are open for 30 seconds. Has everybody present had the opportunity to vote? The House will attend to the state of the vote. 177 voting Yea; 194 voting Nay, the motion fails. Now before us is the motion of ought to pass as amended. The Chair recognizes Rep. LaMontagne.

Rep. Jessica LaMontagne (D - Straf 17)I rise in opposition to HB 377 because it discriminates by banning medical care for just trans kids and unfairly targets a very small number of minors from getting the care that they, their parents and their medical providers believe they need. Despite what some proponents of this bill are telling you, these drugs are used safely and effectively for other reasons and their effects are reversible. Under this legislation, these hormones would be allowed to treat a boy who is developing breasts, that is for a boy to gender affirm his boyness, but not for a trans boy who wants to delay breast development. He is denied this very same treatment. Because this bill is clearly discriminatory, the passage of this bill will certainly result in many lawsuits that the state will need to defend, a fact that was completely ignored in the fiscal note. This bill specifically denies parents of trans kids the ability to make informed decisions with their medical doctors and counselors about what is best for their children. This body just passed the parental bill of rights. That includes the right to make healthcare decisions. So, I call on all of you that voted for the parental bill of rights, do you believe that parents know best or do you not? We had many trans teenagers and their families, young and old, trans adults that come and testified that being allowed to transition changed their lives for the better. As far as parents, one man really stood out to me. He said, I didn't even know what trans was, but I know my kid and I believe her. We had one notable young man who came to support the bill from out of state, by the way. He described how he went through a trans phase and his father put a stop to it, in his words. That only reinforced to me that parents do know best, and the process works. It does not mean that all trans kids are just going through a phase. The vast majority of trans kids tell their parents almost from the time they can talk that I am a boy or vice versa. This is why therapy for these children starts early and takes years for parents to sort out before any hormone treatment is prescribed. But this bill would ban this process altogether, even banning counseling and referrals. I am not a trans activist. There is a member of my own caucus who will probably get up and tell you that we are all just lemmings following this agenda and that he's going to buck the trend. But this is not about trans or not trans. This is a matter of civil rights. I am doing what my party always does. We stand up for all of our civil rights. I used to feel uncomfortable with some parts of trans care, but my views have come around. I learned more about transgender care first through private conversations with my best friend who is an OB-GYN and had some trans kids for patients. She explained how important puberty blockers are to give kids experiencing this dysphoria more time to figure things out without going through the trauma. That's how it feels to these kids. The trauma of starting to develop breasts or facial hair. I've always come to see the cruelty in this bill of not allowing puberty blockers until children are 18 years of age. If denied this care, trans children will not be able to escape developing secondary sexual characteristics that they are hoping to avoid. If they go forward as adults, they will have to live with these characteristics for the rest of their lives. Puberty blockers are temporary and reversible, but puberty is not. This bill makes an exemption for minors who are born with a medically verifiable disorder of sex development, which includes physical manifestations such as ambiguous genitalia. I think we all accept that intersex people, or what we used to call hermaphrodites, do exist. They have been documented as far back as ancient Greece. In recent centuries for such conditions, parents were often advised by their doctors to alter the genitalia shortly after birth. The reason for this was to affirm sexual identity one way or another. But in recent years, it's been more common practice to delay treatment and let the child develop as they will and include counseling for parents and children all along the way and then provide treatment that makes the most sense for that individual. I think most of us would agree with that process, but what this legislation does is accept that rare conditions such as being intersexed. Rare conditions I meant to say, such as being intersex are real, but it tells trans children and their parents that what they experience is not real and that they do not exist. It denies the careful process of individualized counseling and progressive cautious treatment that we allow for others. But who are we to say that gender dysphoria is not real? Do you deny the existence of micro bacteria because you can't see it with the naked eye? So many parents tell us that they didn't believe true gender dysphoria was real either until this occurred in their own family. Like intersex conditions, true gender dysphoria has existed but has been denied and ignored leaving trans people invisible in their own misery. The way we treat small numbers of people who are different, people about whom we have uncomfortable feelings, has changed over time and other ways as well. In the middle ages, we used to put people with mental illness on boats and ship them off, the ship of fools. We used to lock up children with Down Syndrome and now we let them live with their parents. People used to be imprisoned for being gay and people born with unusual contradictory secondary sexual characteristics were offered livelihoods such as side shows in a circus. I say all this because we've come a long way in the way we treat other human beings who are different. Medical treatment for gender dysphoria is no different than that process. Legislation like this is truly regressive. This bill punishes a very small minority of children rather than admit that we just don't understand you. Proponents of this bill will tell you that it's meant to protect children, but they ignore the overwhelming testimony in opposition to this bill to focus on the 1% of the 1% who regret transition. None of us wants anyone to see regret in transition as an adult, but with all other medical care, we address these concerns within the medical community and with oversight boards, not by politicians banning an entire body of comprehensive medical care for certain people only. What do we call people who pick on the most vulnerable among us? In a speech last week, there was a reference to a nanny state. This legislation would make New Hampshire a bully state. Please don't roll back progress on becoming a more kind, thoughtful and humane society and how we treat other human beings. None of us are above the law and none of us are beneath it either. So, vote no on HB 377.

Rep. Alice Wade (D - Straf 15)Thank you, Mister Speaker. I rise today in opposition to HB 377, not as a Democrat, not as a talking point, but as someone whose life was saved by the very care this bill seeks to take away. I'm sure that for many of you, this bill is something abstract. Just one more in a long line of bills that we all have to get through today. You will vote on it and move on with your lives. We cannot. The families of New Hampshire cannot. I'm asking you to stop and think about the real consequences for families here in the Granite State. There are only two people in this entire body that can speak directly from personal experience on this issue. Myself and my colleague from Concord. I, myself, am the only person in this entire body who can speak to what it is like to start hormone therapy as a minor. I cannot even begin to tell you how much my life turned around when I was finally able to start hormone therapy. I wouldn't be standing here today without it. It took months of effort convincing my parents, but when I was finally able to start hormone therapy, my mental health improved drastically. I only wish I could have started it sooner. Last week, we all agreed that parents should have the final say when it comes to health care decisions, but here we are trying to prevent parents from helping their children when they are desperate, desperate to receive lifesaving care. Calling the lived experiences of thousands of Granite Staters and decades of medical research just anecdotes is not nuance, it's willful ignorance. When people in this body say that we need nuance discussions and compromises, I agree. The problem is that my position is I'd like to have access to heath care, equal treatment and to mind my own business. Trans people has existed for centuries and will continue to, but this bill is targeted and without nuance as it gets. Imagine receiving lifesaving care, then having someone with no understanding or experience try to rip that away from you because they think they know better. Do you know what the regret rate for hip replacement is, 4.8%? Do you want to know what the regret rate is for hormone therapy is, less than 1%? But we aren't trying to ban hip replacements, are we? I could use any number of surgeries that you could call irreversible that have much higher regret rates. The only reason these treatments in particular are being targeted is because the trans community has been unwillingly brought into the cross hairs of politics. I will not compromise the rights of Granite Staters on a manufactured issue. On that note, there are actually so few detransitioners here in New Hampshire that two of them had to be brought in from out of state to testify during the committee hearing. Throughout the public testimony on this bill, those people laughed while children were bravely testifying to defend their right to receive health care. As I got involved in politics this past year, I got to know the mother of a trans child. You will hear more about her story shortly. When her child came out to her as transgender, and she saw that their health care was under attack, she knew she had to step up and say something. Before I was a state rep, I held her hand as she cried during a public hearing last year while we listened to people say horrible things about trans people, including her own child. She lived in New Hampshire most of her life, but because of the passage of HB 619 last year, she had to uproot her family to move away from the state she loved in order to get the health care her child needed. We should not let New Hampshire be a state where people have to flee in order to receive lifesaving and live changing care. Her story is not hypothetical. It is the real and actual consequences of what happens if we continue to go down this path. I said it last week and I will say it again. The public does not support this bill. 106 signed up to support it, 1,659 opposed it. If we are not here to listen to the people of New Hampshire when they are begging us not to do this, what are we here for? I am proud that the Democratic Party believes people deserves equal rights and access to health care and that empathy, not the targeting of those different from us, is part of our core values. I'm here today asking Republicans to join us in that. Don't take away health care from people desperate to receive it. Before you vote, I urge you to seriously think about the harm that passing this bill will cause and join me in voting against HB 377 today. Thank you.

Speaker PackardThe Chair recognizes Rep. Alissandra Murray.

Rep. Alissandra Murray (D - Hills 20)Thank you, Mister Speaker. I rise today in opposition to HB 377, and I will be speaking here representing my dear friend, Michelle Foley. Two years ago this month, I sat in this room to testify for a mom from my town that I hadn't yet met face to face. I testified in opposition to HB 619 that day. At the time, I didn't know that six months later I would be back to testify in opposition to the amended bill for my own child. Being a parent of six is something I have never taken for granted. I have grown to appreciate and understand that I will not have all the answers, that I can never make judgments of another parent decision without being in their shoes and that I will never be fully prepared for what is coming next. That point was emphatically made over the past two years in our family's life. One thing I have always known is that I will always do whatever it takes to do what is best for my children, no matter what the obstacles are. Being a Granite Stater for 45 years, I never expected for the obstacle to be the state I was raising my family in. When my now 18-year-old daughter came to me when she was 16 and told me that one of her best friends had stopped her from taking her life that very afternoon, I didn't know exactly what was causing her to feel so distraught and depressed that she would end her own life. She had been in therapy for several months and we had taken measures to keep her safe, like having me stay home with her while she was home schooled due to chronic illness. In less than a month after that attempt, she came to me and asked if she was too old to start hormone replacement therapy. As a medical professional, I knew I needed to find medical care as soon as possible. After my first time telling my story at the State House, a representative approached me to explain the purpose and importance of these bills. She emphasized that they are there to provide safety for children that may have parents that are less informed and resourceful than myself yet consequently taking away the rights of every parent to make important and essential medical decisions for their children. While some of you may not agree that this is the reason for proposed bills such as HB 377, I've heard many of you speak to the importance of parental rights just last week. The importance of being able to find and obtain the medically necessary care for my own family is one of the most important aspects of being a mother. With the plans clearly laid out in last year's legislative session, I knew as a mom we could no longer live in the Granite State and continue to have my daughter live free from legislators making decisions about her health care and about what was best for her future. But unlike the presented points of providing safety for those who may not have support of parents, not all parents have the resources or the ability to uproot their whole family from their home to keep them safe from the harm that a bill that may or may not intend to cause. Plainly voting yes for HB 377 is taking away the right for a parent to care for their child that they may have brought into this world and cared for from the moment they were conceived. In contrast, a vote for the rights of parents to continue to make the decisions and support their children with love and the medical care they need to thrive is the right and responsible choice. This is the story of my friend, Michelle, who moved out of state just a couple of months ago in order to be able to continue to receive care for her child that was already receiving care in this state. She saw what was happening here last year and made the right decision for her family and like she said, not every family can make that decision. You will be either voting to force families out of their home state or to forcibly detransition kids who are on these hormones, which if they are so supposedly so dangerous and experimental then why is it okay to use for all these other conditions? Why is that okay, but in this one case, it's not? That's discrimination, quite literally.

Speaker PackardDoes the member yield to questions? The member does not yield. The Chair recognizes

Rep. James Roesener (D - Merr 22)Thank you, Mister Speaker. I rise today in opposition to HB 377. Deeply honored to share this story. Luke Boisvert, a 13-year-old trans boy from Nashua, New Hampshire opposes HB 377. Due to a medical condition called Turner syndrome, Luke may not appear his age to some. Turner syndrome is a condition where part of the DNA from his X chromosome is missing, meaning his body cannot go through puberty naturally. As a result, he needs hormone treatment to experience any puberty. Luke prefers to take testosterone as it aligns with his desire to look, sound and live his life as a boy as he is most happy. Luke has been out as transgender since 2021 though he has felt this way for much longer. Growing up he never enjoyed girly things and always dressed in masculine clothes, engaged in activities deemed masculine. He related to masculine characters and often dressed up as them. His sister jokingly said he was an old man trapped in a little girls body. While these behaviors absolutely do not define a person as transgender, looking back Luke realizes he was just a young boy who didn't know how to express that he was one. This ban cannot be put in place because it would result in families like Luke's having to choose between stopping his testosterone keeping him in a prepubescent body for the rest of his life with dangerous implications or it would force his family to completely reconstruct his health care treatment that is otherwise keeping him healthful and happy only due to the threat of criminal penalty that would place him in a body that doesn't reflect who he is or who he ever will be. Luke Boisvert is a brave 13-year-old transgender boy from Nashua, New Hampshire. It is a privilege to amplify his voice in this Chamber and to stand in solidarity with him and so many others in our state. His story is a powerful reminder of what truly is at stake with HB 377. This bill is not just about policy, it is about real people, real lives and the fundamental right to access care that allows us to live our lives as true and as fully as we can. Health care is highly individualized and nuanced. Rarely can we ever find the language in a law that will not obstruct real necessary care when we place bans. No one should be forced into a body that feels foreign to them, and no one should have to fight for the medical care that affirms their identity and wellbeing, especially not as children. I urge this body to listen to Luke, to us, to recognize the humanity in our stories and to reject HB 377 as a bill trying to solve an issue that does not exist. We have a responsibility to protect the dignity, health and the futures of the transgender youth in our state. Thank you.

Rep. Loren Selig (D - Straf 10)Thank you, Mister Speaker. Today I rise in opposition of HB 377 and to speak on behalf of a mother in our community. Jennifer, who is a mom from Nashua, much like I'm a mom from Durham. Jennifer testified on this bill as well. She said I'm a mother of three children. My youngest is trans male. I've created an environment in my home where my children can be open and honest with who they are. When my son was nine, he told me he was actually a boy. He had been born female, but he socially transitioned to male, and I saw his whole world open up. He always hated school, but he began to engage and find friends. When his haircut and wardrobe changed, he finally seemed comfortable in his own skin. We went to court to change his name to reflect his gender. The school thankfully supported his social transition and called him by his/he/him pronouns and new name. As a mother, I grieve for the loss of my daughter, but I also celebrated the newly gained son. My newly gained son. Over the next four years I have watched my son's journey of discovery. He's very confident and aware of who he is. My son has a unique situation as where his body does not produce any sex hormones. We did not have to pursue puberty blockers, but if he needed them, he would have had them. In May, he is scheduled to start testosterone. This was not an easy decision. He's had countless meetings with his primary care practitioner and endocrinologist. He's had months and months of counseling. He is a well rounded and happy kid. This bill seeks to destroy my family's values, my role as a mother to support my child and it inappropriately inserts the government into my child's health care. His body, his medications, his sense of self are not things to be regulated or banned. I know with 100% certainty that he is a boy and that having secondary male sex characteristics is the right choice for him. I know this because he has done his research and knows what feels right in his body. I know this because his health care team is supportive of his treatment. In 2025, I never thought I'd have to remind the legislature that my child's health care is not up to you. You don't get to decide. You don't get to legislate private decisions. This legislative body has no right to dictate the kind of schooling my child gets, the hobbies he participates in, the religion he practices and certainly and without a doubt you don't get to decide his private medical choices. New Hampshire is better than this. I am my son's mother, and I believe he deserves the autonomy to decide what medical treatment he receives with my guidance, of course. In speaking also as a mother in addition to sharing Jennifer's comments, I want to say at no time should anyone be dictating my children's medical decisions. It's up to me to know if my child needs that ankle surgery her orthopedist prescribed. It's up to me to know if my child should be put on hormones because she had really bad periods or because she had really bad acne. It is up to me to make medical decisions for my child and not the legislature.

Speaker PackardWill the member yield to question? The member does not yield. The Chair recognizes Rep. Mehegan. The Chair recognizes Rep. Beauchemin.

Rep. Paige Beauchemin (D - Hills 3)Thank you, Mister Speaker. I rise today in opposition to HB 377. I'd like to share a story about someone like me, a New Hampshire mother, who supports and protects her children unconditionally. This story is from Sara Tirrell from Plymouth. My name is Sara Tirrell, and I am a lifelong resident of New Hampshire. I am a proud mother of a 16-year-old transgender daughter. Like every parent, my top priority is keeping my child safe, healthy and thriving. But unlike many parents, I also have to spend countless hours fighting for my daughter's basic human rights. Last week, I sat in the gallery and listened as you discussed the importance of a parental bill of rights. While I disagree with the intentions behind that bill, I agree with the sentiment that parents have the right to make decisions about their children's medical care. So, I struggled to understand how just days later many of you are now advocating to take away that very right. Today, my daughter is a strong, healthy and happy 16-year-old. She has worked incredibly hard to get to this point, supported by family, friends, therapists, medical professionals and a community that loves her. She knows exactly who she is, and she is living her best life. How can any of you presume to know her better than I do? How can anyone presume to know her better than the trained professionals who have been helping her every step of the way? This is not just about politics, this is about our children's lives, their futures and their wellbeing. The suicide rates among transgendered youth are high for a reason. Your vote today will either save lives or jeopardize them. I ask you not to vote along party lines, but to listen to the real people, the people who are affected by your decisions. People like my daughter and family. Please choose compassion, empathy and the preservation of life. Thank you.

Rep. Lily Foss (D - Hills 41)Thank you, Mister Speaker. I rise today in opposition to HB 377 and I'm here to share a story from Rosie Emerick, a mom who is worried for her family. My name is Rosie Emerick, and I am the parent of an 8-year-old trans child. I want to say that I am tired and scared. I'm tired of having to come to the State House every week and sit in a room for hours and listen to people who have never really taken the time to get to know a trans child or adult, make accusations about what kind of parent I am, what type of person my child or another other trans person is and what is best for them. I am scared that the state I love and have grown up in will not be a safe place for my family anymore. I am scared that my child won't be able to easily get the medical care they need. I am scared to let my child use the bathroom in public. I am scared for my child and all of the amazing children and adults whose lives will be made unnecessarily hard. My child's journey is theirs and theirs alone. Contrary to the testimony I read online, I did not force my child into this. Why would I? Why would I subject them to this? They didn't choose this. I didn't choose this. Nobody else compelled or influenced them into this. What I did is listen and pay attention. I listened to what they started telling me from the time they first started speaking sentences and I continue to listen every day. If they said, mom I was wrong and I want to go back, I would be the first one to affirm that too. I love my children with everything in me and it is me and my child in collaboration with their trained medical providers with years of professional experience who should be making their medical decisions. I am here today because I am doing everything in my power to build my child a world where they know I will always fight for them. I will always listen and love them when they tell me who they are. Despite all of this hardship right now, my trans child has given our family a wonderful gift. We are all more comfortable in our skins, more confident in the ways in which we don't meet the impossible standards of femininity or masculinity. We are more understanding and compassionate. We are more willing to seek to understand. We are fiercer and more likely to stand with those being marginalized and mostly we have more love because we have created an amazing community and family for ourselves. If you were truly looking to understand the painstaking journey of parenting a trans child, I recommend One day I'll grow Up and Be a Beautiful Woman, a mother's story by Abi Maxwell. She tells the story of her trans child's early journey right here in New Hampshire. As myself, adding that the book is so popular that it has a 12-person waiting list for the e-book from the New Hampshire State Library. Thank you.

Rep. Heather Raymond (D - Hills 5)Thank you, Mister Speaker. I rise today in opposition to HB 377. I am here to share the story from Lauren Cole Johnson, an educator and a mother of a trans child here in New Hampshire. As an educator of high schoolers, as a parent and as a resident of New Hampshire for more than two decades, I am distraught and saddened to continue to encounter horrendous legislation emerging from this body in response to unfounded fear. HB 377 is based on inaccurate assumptions by folks who know little how gender affirming care works and the positive such care can have. I speak with compassion and love for my family members and for the LBGTQIA community. To quote an inspiring young person I heard testify in regard to hateful bills that would harm her sibling, "I am not going to answer questions because there should not be any questions about what I say here. This bill does nothing to help children. It does direct harm to children." The title of HB 377 is "vulnerable child compassion and protection act." Compassion is defined as a feeling of deep sympathy and sorrow for another who is stricken by misfortune accompanied by a strong desire to alleviate the suffering. The proposed act does not invoke deep sympathy for children, nor does it alleviate the suffering of said children. In fact, this act promotes the criminalization of trained medical professionals whose years of training is backed by decades of scientific research. In criminalizing professionals, this bill also does direct harm to their patients. The word protection means care and guardianship. Who are you trying to protect? This bill does nothing to protect children. I strongly urge you to vote against HB 377 and vote yes for compassion. Thank you.

Rep. Christal Lloyd (D - Hills 8)Thank you, Mister Speaker. As we know, HB 377 will affect individual lives of Granite Staters. I rise today in opposition to HB 377 and I'm here giving a voice to Stephanie Cawley, a transgender woman from Conway who wishes she had access to this gender affirming care that others have. This is Stephanie's' story. This bill will strip the rights of parents and their transgender children to access in the medical care they need. It also ignores recommendations from all major medical groups, including the American Academy of Pediatrics, The Endocrine Society, American Medical Association, American Psychological Association and supported by the scientific peer reviewed literature and the standards of care established by the Worldwide Professional Association for Transgender Health. According to a study in 2022 by Osen et al., trans kids are almost always right about being trans with 98% maintaining their identity as transgender over time. She further states, I knew I was transgender at 4 years old in 1959 when the option to transition didn't exist. As a result, I suffered mostly irreversible effects of endogenous male puberty and had to undergo expensive and painful transition therapy to include psychological counseling, laser hair removal, electrolysis, 3 surgeries and hormonal therapy. This legislation wants to take us back to a time where transgender kids and their parents no longer have access to scientifically supported health care. What is gender affirming health care? It starts with a conversation between a parent and a child. Typically, these conversations take place many times before the parents agree to talk with their pediatrician or therapist. After multiple sessions of therapy, a plan is developed by parents, doctors and therapists with the child to begin social transitioning. This involves changes in names, pronouns, clothing and social relations. It involves schools, churches and other groups and you should note that this stage does not involve medical surgeries. Once a child hits 10 or stage 2 puberty, then and only then are puberty blockers considered and initiated assuming social transition is going well and everyone, parents and the child, doctors and therapist are in agreement with the plan. These puberty blockers, which have been used for 40 years, and are still being used for premature puberty, called precocious puberty, have a very good safety record. HB 377 would outlaw these puberty blockers for transgender kids but allow them for cisgender kids. That is the very definition of discrimination. The usage of puberty blockers buys time for everyone to make sure the transition is right for the child. This transition takes several years depending on when it is initiated, which allows the child, parents, doctors and therapist to carefully and safely make sure that this is the right path for them. Surgery is almost never done before the age of 18 except in medically necessary situations. Multiple studies have shown that transgender kids who are denied gender affirming health care are at greater risk for adverse psychological affects, including anxiety, depression, suicidal ideation and substance abuse. All of which, myself, have suffered from as a transgender young person because I couldn't access gender affirming health care in my time. In the US transgender survey done in 2022, 98% of respondents report their lives were greatly improved following their transitions. The small percentage of people who are not happy with their transition are often due to the lack of support from friends and family or poor medical treatment and few may decide that gender transition is just not for them. I urge to reject this unnecessary discriminatory and invasive governmental overreach that restricts the rights of parents, their transgender children and health care professionals. It's backed up by decades of scientific research. Those were Stephanie's words. Thank you.

Rep. Lisa Mazur (R - Hills 44)Thank you, everyone. Thank you, Mister Speaker. I said it during the hearings, and I'll say it again, I know this is an emotional subject. I want to begin with an undeniable truth. Children cannot fully comprehend the lifelong consequences of altering their bodies with powerful medications. Yet, today, children as young as 8 or 9 are being prescribed puberty blockers, sometimes after just a few hours of consultation. Gender dysphoria is real and it's painful and those struggling deserve compassion, but rushing minors into irreversible medical interventions is not the answer. These treatments are often presented as safe and reversible, yet evidence-based studies from multiple countries, including the UK, Finland, Sweden and Canada show little to no long-term support for their effectiveness. In fact, the UK systematic review led to several countries putting a ban on gender transitioning medication for children. These studies also show that these medications do not prevent or lessen depression or suicide. This is not a question of parental rights. It is about protecting children from harm. The majority of kids with gender dysphoria do grow out of it by adulthood. Fact. Interestingly, this year some House Democrats filed legislation that prohibited the sale of over-the-counter weight loss and muscle building supplements to minors and imposed penalties on retail establishments that sold the supplements to minors. How are these supplements considered dangerous, but taking harmful gender transition medications that can cause genital atrophy and stop critical puberty related developments, affecting bone growth, brain development and fertility be considered? How is that okay? Puberty blockers like Lupron were developed for prostate cancer and endometriosis, not for children. Studies show that the vast majority of kids placed on puberty blockers go on to take cross-sex hormones making them lifelong medical patients. These drugs, as I said in my previous PI have not been approved by the FDA for blocking healthy puberty. We must ensure that young people receive the psychological care they need while safeguarding them from these harmful and forever life altering treatments taking away their health, their choices, their fertility and their futures is not progressive. It is harmful and regressive. Protecting children isn't regressive, it's responsible. Children deserve protection not experimental medical procedures pushed by ideology rather than sound science. Please press the green button to pass this very important bill. Thanks for hanging in there.

Speaker PackardRep. Granger has requested a roll call. Is that sufficiently seconded? It is sufficiently seconded. This will be a roll call vote. Members take your seats. The motion before us is the majority committee report of ought to pass as amended on HB 377. This is a roll call vote. The Chair recognizes Rep. Weber for a parliamentary inquiry.

Rep. Lucy Weber (D - Ches 5)Thank you, Mister Speaker. Mister Speaker, if I have heard over and over again that we should support the rights of parents and that parents should be trusted to make decisions in the best interests of their children. And if I know that denying one distinct class of minors their right to appropriate medical treatment and one distinct class of parents their right to make medical decisions in the best interests of their minor children is not only discriminatory, but unspeakably cruel, would I now press the red button to defeat the ought to pass? Thank you, my colleagues.

Speaker PackardThe Chair recognizes Rep. Layon for a parliamentary inquiry.

Rep. Erica Layon (R - Rock 13)Thank you, Mister Speaker. Mister Speaker, if I know that when the risk of thalidomide came to light, the medical community stopped that on their own because back then we still believed in science and evidence-based medicine. And if I know that parents can't give informed consent if they aren't told of the risks of drugs and if they are told that the only alternative to treatment is a dead child because that is coercion and not consent. And if I know that these side effects for these drugs are serious enough that sometimes the risk is too high to give these drugs to people with cancer, yet we are turning some of these children into lifelong medical patients, which enriches big pharma. And if I know that counseling offered to children in New Hampshire who are questioning their gender identity by law is required to affirm them. The law requires that they affirm that changed gender identity and it cannot accommodate any questions as to whether that child is not persisting with that gender identity making that counseling invalid. And if I know that we should be tearing down stereotypes, would I press the green button to tell kids they don't need drugs to fit a stereotype?

Speaker PackardThe motion before us is the majority committee report of ought to pass as amended. This is a roll call vote. If you are in favor; you'll press the green button. If you are opposed, you'll press the red button. Voting stations are open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 197 voting Yea; 167 voting Nay, the committee report is adopted. The House recessed at 12:35 p.m. RECESS The House reconvened at 1:35 p.m. (Speaker Packard in the Chair)

Speaker PackardThe motion before us now is ought to pass as amended. The Chair recognizes Rep. Lucas.

Rep. Janet Lucas (D - Graf 7)Thank you, Mister Speaker. Mister Speaker, I rise in opposition to HB 712 as amended. It is a bill that would eliminate access to breast surgery as a treatment for gender dysphoria before the age of 18. In so doing, it violates the rights of certain patients and their parents by arbitrary disqualification. A gender dysphoric individual younger than age 18 who has made the long journey with the support of family and caregivers having had prolonged and detailed counselling and medical therapy at age 17, perhaps may understandably wish to undergo breast surgery near home and post operative recovery at home before heading off to college or to a new job. This is a transitional time when preoperative appointments and preparations and surgery can be scheduled with minimal disruption of life plans. This bill as amended has the potential for unintended consequences. It attempts to define permissible breast surgeries in cisgendered minors and in a few lines, it proposes to delineate those surgeries to which surgical textbooks devote thou- sands of pages. There is no mention of which surgeries can or should be done by a general surgeon with five years of residency, training or by specialists who have had additional multi-year fellowships. Because this bill sets out a specific and limited list of exceptions, the bill would inevitably infringe upon care plans for patients whose diagnosis have nothing to do with gender dysphoria. In addition, this bill allows for government intrusion into the patient provider relationship and presents a punitive format to the provider who may be deciding whether to practice in the State of New Hampshire. What are these caregivers to make of this? Will they take one look at a New Hampshire practice opening and move on? Will New Hampshire's medical schools and residencies lose applicants to programs in more fair-minded states as the Granite State becomes known as the state of obstruction? The effect of this bill is denying one distinct class of minors their right to appropriate treatment or referral and one distinct class of parents their right to make medical decisions in the best for their children. No group in New Hampshire has the right to tell parents they don't know what is best for their children. It's time for legislators to stop dictating to health care professionals how to provide care, perform surgery and practice medicine. Everyone is free to refuse care for themselves and their children. No one has the right to refuse that care for anyone else. Focus on common sense. Press the red button to vote no on HB 712. Thank you, Mister Speaker, and I request a roll call vote.

Rep. James Roesener (D - Merr 22)Thank you, Mister Speaker. I decided to get a view from the other side of the room today. So, I'm here to stand in opposition to this bill and I have another story for you. I'm the only story this time so hold onto your seat. I rarely tell my personal story, but I think due to the hard work this office calls for, we need to approach each other with an open heart and honest dialogue. Some aspects of my story are difficult to hear and to share, but I hope that we can do this together. My experience with gender dysphoria began early though it took years to understand what I was feeling. As a child I knew I was different. I preferred race cars to Barbies. I hated dresses and the color pink. I really liked things like bugs and gross things and Teenage Mutant Ninja Turtles. I preferred to roughhouse with the boys and never really played house with the girls. My interest definitely set me apart, but I never felt isolated. I had many friends, mostly boys, and I felt comfortable in those connections. It never occurred to me that these friendships or my preferences might be linked to my gender identity. Despite being confident in my interests and identity, I struggled with a deep overwhelming self hatred. I knew being a girl didn't limit me, and I still had this quiet awareness that something wasn't quite right. I was taught that girls could like things boys could like and do anything boys could do, but it still didn't seem to quell the questions that I had about myself or rather how I felt about myself. But I never questioned it either because I was told that I was a girl. I imagined and often wished that I had been born a boy, imagining how much more comfortable my life would have been, but being a girl was an unchangeable fact. For years I was trapped in a reality where my feelings didn't make any sense. During puberty, my disconnect between my sense of self and my body deepened. I tried to communicate this discomfort to the adults around me, but I was told what I was feeling was simply a part of growing up. I was told that girls often experience discomfort with the changes in their body. Of course, girls can like or dislike any of these things, but I knew my feelings ran deeper or rather it was something very different. I couldn't find the right words to explain the profound unease that I felt. So, my depression and anxiety deepened. I was told I was just hormonal or genetically predisposed to mental illness which I guess wasn't wrong but wasn't the core of it. I was assured that though I hated myself, I was a beautiful young woman, but these reassurances did not comfort me but rather deepened my mental health crisis. Talking about self harm and suicidal ideation is difficult, but it is crucial to have these conversations. Research has shown that speaking openly about suicide or asking someone if they are struggling with ideation does not increase the likelihood of a tragic outcome. In fact, discussing these difficult topics can help save lives when it is done right. I began to self harm to cope with the overwhelming frustration and discomfort I felt with my body. I imagined taking drastic actions that would force medical intervention hoping to remove parts of myself I could no longer bear. That might have been my path if I had not learned about what top surgery was through the stories online of transgendered individuals sharing their ends gender. Although I didn't understand or accept my own identity, the concept of top surgery gave me a reason to hold back from harming myself in that way. I told myself that maybe that I could see that happen to myself one day and that harming myself would destroy my chance of pursuing that in the future. This did not resolve the disgust I felt every day. I still felt trapped. I didn't want to live anymore. I couldn't make sense of anything that was happening to me, and I didn't understand why my life was so disjointed or why I could not navigate the world as seamlessly as others seemed to. My misery seemed endless, and I couldn't fathom how others could imagine a future for themselves, let alone how they had the strength to face another day feeling so disgusting. I'm here today because I got lucky. My story is part of a larger reality. Young trans people, especially when it comes to gender affirming care, are often dismissed, disrespected and denied. The fear of rejection around access to care is overwhelming. Instead of support, we face laws that deny our self-affirming and lifesaving treatments. Voices that speak over us in a system that refuses to see us as who we are. I stand before you today in this esteemed body in this historic House advocating for my community. I stand here because I almost didn't, and it was thanks to the intervention of amazing doctors that I get to continue to speak to you today. Talking about how receiving gender affirming surgery transformed my life is challenging. It was something that is such an intrinsic part of me now that I rarely ever reflect on it anymore. The moment my recovery began, I simply melted into a new normal. There wasn't a period of adjustment. It was just as if life had begun. I lost the many burdens I was carrying, the constant back pain, the shortness of breath, the rashes and blisters to my skin as I concealed who I was. I can breathe now. I can look in the mirror and feel at peace, maybe a little self conscious sometimes like I should go to the gym, but I no longer am haunted by thoughts of self harm. My life didn't become perfect, and I was no longer trapped in a body that held me back. Denying this care ignores clear, peer reviewed evidence that it improves mental health, reduces suicide rates and helps trans youths live healthier, happier lives. When people ask me why not just wait, it cuts deep. I attempted my life at the pain of this waiting. Gender dysphoria isn't just something that can just be put on hold or delayed, it's a relentless and overwhelming force that grows more unbearable the longer it is ignored or dismissed. It is soul crushing. Some lawmakers have said to me, I've experienced depression myself so I can empathize, but the care you are describing seems too extreme. I genuinely appreciate their attempts to relate, however gender dysphoria is not the same as depression. It cannot be fully treated or resolved with antidepressants or therapy alone. Gender dysphoria requires specialized care that addresses the root of each individual, not just the emotional distress it can cause. Yet the very care that can help alleviate this gender dysphoria is the one that we are talking about criminalizing. I am the only person in this body of over 400 people who can speak from experience. I know this perspective may be new for many of you and so that's why I speak today. The public deserves decisions that are informed, thoughtful and rooted in understanding. What isn't new is how good government works. We live in a country founded on personal freedoms where we value to protect liberty and rights. When it comes to the choices of others, you don't have to like it, you don't have to agree with it, you don't have to understand it, but that doesn't mean you have to take it away from someone else because of your personal beliefs. We believe in live and let live. We believe in live free or die. I had to wait until I was an adult to pursue my top surgery, not because I wanted to but because I didn't have enough support or resources to have that option as a teenager. My life up to this point was not easy. It was not healthy, and it was not safe. No person should have to go through that. I stand in full throated opposition to this bill. If this bill passes, we are limiting the opportunities for young people to thrive. Instead of supporting them in navigating their identities with care and the resources they need, we will be forcing them onto a hard road, or worse, no road at all. I would never recommend the lengths that I had to go through to get where I am today. There is a better way. Medical intervention for the exceptional cases who absolutely need it is the better way. This should include absolutely the input of many professionals who know what they are talking about. Nobody is handing top surgery out like candy. I urge you to believe trans people know who they are better than a politician knows them. I urge you to trust that parents know their children better than a politician knows them. I urge you to acknowledge that doctors know their patients' needs better than a politician knows them and I urge you to vote no on this bill today. Thank you.

Rep. Alissandra Murray (D - Hills 20)Thank you, Mister Speaker. The bottom line for me is I do not believe the legislature should be making health care decisions for any individual and especially for children who are involving their doctors and parents in these decisions already. I want to start by sharing my own experiences with trying to access gender affirming care. I was raised in a conservative Christian household homeschooled from beginning to end. I had no non-religious friends, no access to the Internet and was cut off from the few gay family members I did have and yet I knew by the time I was 6 years old that I wasn't straight, and I knew by the time I was nine that I wasn't a girl. At the time I didn't even know the words transgender or bisexual or non-binary, I just knew I was different. Around 20 years old, I discovered the trans and non-binary community and felt like I finally had the language to understand myself. I also found out that top surgery wasn't just an option for trans men, but it was also an option that many non-binary people pursued. I instantly was excited by the prospect, but I decided to take my time to figure out if this was the right decision for me. I had been raised to dress a certain way and regularly made to feel like I was a sinful and promiscuous person just for wearing jeans and a t-shirt. I knew that this could be the reason for my discomfort in my own body and so I made the decision to wait. Long story short, I'm now 30 years old and I'm more than sure that I do want to pursue top surgery. At this point I've been considering top surgery for the past decade, but I have faced barrier after barrier in actually getting that care. Only two surgeons in the entire state are covered by my insurance policy and for different logistical reasons I'm not able to go to either of them, so my only option is to pursue out of network care. Considering these surgeries cost thousands of dollars and will likely put me out of work for weeks, I have been at a standstill for years where I'm literally unable to get the health care that I need that my doctor knows I need, and this is my experience as a 30-year-old. Now imagine how much harder it is to access these surgeries as a minor. All of this is to say that not only are these surgeries uncommon but they're actually inaccessible to many people with gender dysphoria, especially since trans individuals are more likely to experience poverty and less likely to have health insurance coverage. You must intentionally seek this care out and you must be able to afford it and those are two huge hurdles. Gender affirming surgeries are rare in minors, especially in New Hampshire. Approximately 2 to 300 top surgeries are performed on minors across the entire country and these surgeries are much less common than cosmetic breast procedures performed on teenagers who are not transgender. Around 3,200 girls ages 18 to 19 received cosmetic breast implants in 2020 according to the American Society of plastic surgeons and another 4,700 teenagers ages 13 to 19 had breast reductions. A Harvard study conducted just last year found that 97% of chest surgeries on minors are performed on cisgender boys, surgeries done to remove excess fat from their chests. This is called gynecomastia, otherwise known as gender affirming care. Data has demonstrably proven that gender affirming surgeries not only have a low rate of regret but also one of the lowest rates of regret amongst all surgeries. A total of 27 studies conducted by the American Society of plastic surgeons polling 7,928 transgender patients who underwent any type of gender affirming surgery concluded that the prevalence of regret after gender assignment surgery was less than 1%. In clearer terms, 99.7% of trans individuals were satisfied with the results of their surgery. Meanwhile up to 30% of individuals who undergo knee surgery experience regret. Up to 25% of people regret getting heart surgery, 30% report regret after prostatectomy and 19.5% express regret after bariatric surgery, yet all of these procedures are still legal, as they should be. The reality is that top surgery is already difficult to access for multiple reasons. Despite what some of my colleagues might say, gatekeeping and combative attitudes in health care are a very real barrier to gender affirming care. Often trans people have to spend years proving who they are in order to access that treatment. The financial, social and mental burdens as causes actually increases the chance of detransition. The number of people who do not continue with transition varies depending on where in the world they live and is subject to a number of factors, including societal acceptance of transgender people and access to health care. These are factors that are not addressed in this legislation. We cannot legislate health care based on varying circumstances, and we should not change our laws because .4% of 1% of the population regret decisions that they chose to make. No one is forcing anyone to get these treatments against their consent, but this legislation does force people to put off the treatment that they do want, treatment that has been deemed medically necessary and we as a legislative body have no right to stand in the way of that. I wanted to end by saying that this testimony is very similar to the one I gave at the public hearing on this bill. After that hearing, one of the committee members went on social media and called me a biological man after I gave a speech about wanting top surgery. Do you know what that tells me? That there's no genuine effort to listen and learn from the people who are actually impacted by these bills. I have been open and willing to talk to anyone who wants but we can't have an honest and nuanced conversation if you aren't willing to listen and we can't have an honest nuanced conversation if you avoid talking to me in the first place and we can't have an honest and nuance conversation if your first starting point is to take my rights away.

Rep. Alice Wade (D - Straf 15)Thank you, Mister Speaker. I'm here to share a bit about my own story of bottom surgery in the hope that you may understand why banning various top surgeries in New Hampshire is reckless and unnecessary. Even before starting hormone therapy, I knew that one day I would want to get bottom surgery. After being on hormone therapy for about a year, I started seriously looking into my options for surgeons. I researched for months to find one with a good rating, tried pricing out how much it would cost with my insurance plan and was looking forward to finally being comfortable in my own skin. I had recently started college and planned out the timing of how I would give myself enough time to recover, but the problem was I also had to plan out my career at the same time. For an engineer, internships are everything when it comes to job prospects, but summer would be the best time to pursue surgery, and I wasn't sure if winter break would be long enough for me to recover safely. One thing led to another, and I managed to land an internship I just couldn't pass up. The summer after that it was a research assistantship and another internship a year later. What I had originally hoped to get surgery at 19 ended up taking many many more years to actually complete. It was only after I graduated college that I could finally get the timing right between graduating and my full-time job. I only turned 18 after starting college and I saw it as an opportunity to reinvent myself transitioning medically, socially and legally. Many other trans people do the exact same thing. For someone who started hormone therapy earlier it would be much easier for them to be able to get surgery at 17 in the summer before college where they can rest and recover at home with their families. Only in the case where it has been deemed medically necessary by a doctor and approved by the parents. I don't know about you, but I'm not a doctor and we all know what happened to the only physician on Health and Human Services who stood up for medical science over party politics. There was another thing that stood out to me in my search for a surgeon. There were none even remotely close to me that met my needs. I ended up having to fly all the way to Washington DC to get bottom surgery. When your surgeon is that far away, post-operative care is incredibly difficult. Banning these surgeries will drive out anyone who actually knows what they're doing from the state. And the fact that arguments were made that we can't ban cat declawing because it's very rare and gets between the patient provider relationship, which in this case was an actual cat, tells me that it implies cats deserve more bodily autonomy than trans people. You cannot call these surgeries experimental or harmful while simultaneously allowing everyone else to get them except for trans people. This ban is discriminatory, unnecessary and I urge you to vote against HB 712 today. Thank you. Speaker Packard: The Chair recognizes Rep. Damon.

Rep. Hope Damon (D - Sull 8)Thank you, Mister Speaker. I rise today in opposition to HB 712 and I'm here representing Diana George, a mother from Hancock and speaking with her words. My husband Jason George and I are the parents of a 23-year-old assigned female at birth transgender son. Our son came out to my husband and I as being male at age 17 just before his sophomore year of high school. As you can imagine as a parent, hearing this from their child who you had been raising as a girl for 15 years, news like this is initially shocking, frightening and confusing. Rather than dismiss my child's feelings and courage, which I know now would have been a devastating mistake, my husband and I sought help for our child through the health care community. These health care professionals had determined through evidence-based guidelines evaluation and medication that my son was transgender and that the best course of treatment was to allow him to transition from female to male socially and medically via hormones and chest reconstruction surgery. As a registered nurse, I am also versed in reading and evaluating evidence-based scientific and medical research, which I have done extensively regarding gender dysphoria and gender identity since my son came out as being transgender. The World Professional Association for Transgender Health (WPATH) is an international and interdisciplinary health care association who sets the standards of care for transgender health care. The professional organizations who are in support of WPATH standards of care include the following, the American Medical Association, the Endocrine Society, the American Psychiatric Association, the American Psychological Association, the National Commission on Correctional Health Care, the National Association of Social Workers, the American College of Obstetrics and Gynecology, the American Society of Plastic Surgeons and the World Health Organization. In New Hampshire, for a child to begin any hormonal treatment for gender dysphoria, the child must be assessed by a licensed therapist who specializes in working with transgender youth. The therapist must evaluate the child to determine if the child is persistent, consistent and insistent about their gender dysphoria and gender identity. If after months of therapy and living socially as their preferred gender and the child remains persistent, consistent and insistent, the child may be allowed to begin hormone treatment under the care of a pediatric endocrinologist. Hormone blockers are completely reversible. Cross hormones such as testosterone and estrogen are not allowed to begin until the child has met the above-mentioned criteria under a licensed therapist care and in most cases has reached the age of at least 14 years. If a teenager has already begun puberty and gender dysphoria has set in, a transgender teenager may decide that to feel more comfortable in their body, they need to undergo gender affirming surgery. This may involve chest reconstruction. This was the case with my son. At age 16, after having been on testosterone for a year, my son asked my husband and I if he could have what the transgender community refers to as top surgery. There was a lot of careful thought put into this decision. Initially to assuage my son's gender dysphoria about his breasts I bought him chest binders. These are an undergarment similar to a sports bra for which trans males and some non-binary people choose to wear to hide their breasts. Chest binders are very tight and restrictive. They are also hot and can be uncomfortable to wear in the warm months. My son wore breast binders for a while but eventually found them to be too restrictive, difficult to don and take off and not really alleviating his gender dysphoria because as a trans male he did not feel he should have female breasts. At this stage in my son's transition, after consulting with his health care team, my husband and I made the deeply personal and difficult decision to allow our son to undergo top surgery. My son is now 23 years old and is an amazing happy and talented adult. He does not regret having undergone his surgery. He knew who he was then, and he knows who he is now. A child does not choose to be transgender. Being transgender opens the door for incessant ridicule, misunderstanding, rejection and bullying. Multiple studies have shown that when a transgender child is allowed to transition and accepted by their family, peers and society, they will go on to thrive and lead healthy and happy lives. When a child comes out, and as transgender parents, we must make the most heart-wrenching and difficult decisions about our child's health and future. There is an enormous amount of thought, consideration, fear and worry about making the most deeply personal and difficult decision to allow your child to transition. I can tell you today that it has been the best decision my husband and I have ever made regarding my son's health and well-being, and I vehemently oppose HB 712. I am honored to speak those words of Diana George, and I ask you all to find it in your heart to let the parents and the health care professionals be the people who make these decisions. Thank you.

Rep. Seth Miller (D - Straf 21)Thank you, Mister Speaker. I rise today in opposition to HB 712 and to further amplify the voices and the lived experience that we heard during our testimony of the residents and constituents of New Hampshire, to that end, I will share the story of Reverend Sam Holland. My name is Reverend Sam Holland, and I am the chairperson of the Justice and Witness Ministry of the New Hampshire Conference of the United Church of Christ. The United Church of Christ is a large Christian denomination in New Hampshire representing rural, suburban and urban settings, people of all income levels and people of all and no political affiliations. I was elected by this politically diverse church to serve in my role. I am non-binary. While I was assigned female at birth, I have never felt either male or female. To affirm my full personhood, I had top surgery in New Hampshire in early 2024 just after my 37th birthday. Having top surgery has been one of the best health decisions of my life. Some of the most scarring memories of my adolescence were dealing with my chest. I never wanted my chest to grow as a child, as a teen and into adulthood. I longed for a chest like boys and men around me throughout my life, but I knew I was in the middle, non-binary. As the world changed, and I started to meet non-binary people who had had top surgery I realized that with treatment my body could match my full personhood. This misalignment between my chest and my true self caused both mental and and physical pain including physical chest pain and issues related to nutrition. As a full adult it took over 18 months to get top surgery. I had a counselor and therapist specializing in gender for more than one year before even seeing a surgeon. The total cost of the surgery with insurance was between $3,000 and $7,000. Without insurance it would have been around $100,000. I do not know what the final amount I paid was because I saw every payment I made as necessary. Further, I had the love in support of friends, family and faith communities in New Hampshire and throughout the country. I felt physically better when I woke up from my surgery. To this day I am glad I made this health decision for myself and really for my family too. With regret rates being 1% or less it would be absurd for our state to legislate the banning of this important procedure. I have excellent health insurance and made this health decision with health professionals. I would not have wanted politicians creating barriers to what I needed and I certainly would not want that for any youth in New Hampshire. Trans youth and adults are both at risk at this moment, for each legislative action is not just about how people can or cannot access health care, it is about the message we send to people who are already bullied and excluded. Please oppose HB 712 and do not create a double standard around this health matter. Speaking for myself, I echo these words. Let us look to the lived experiences of our residents. The testimony that they overwhelmingly provided in committee and online. These are our constituents. These are the people we are here to protect, not the outsiders who have instigated this bill. Thank you.

Rep. Lisa Mazur (R - Hills 44)Thank you, Mister Speaker. This bill is grounded in a crucial question, do children change their minds? If the answer is yes and research and personal testimonies suggest it is, then we must act now to protect them from life-altering irreversible medical procedures. Young girls and teenagers lack the maturity to fully understand the permanence of removing their breasts. Their brains are still developing. Their emotions are in flux and their identities are still forming, yet some are being led to believe that major irreversible surgeries are the solution to their struggles without fully comprehending what they are giving up. The devastating consequences of allowing these breast surgeries on young women are already unfolding. Just last year an autistic woman in New Hampshire, who did change her mind, filed a lawsuit against her former endocrinologist and other medical providers saying she was misled into inappropriate gender affirming surgeries and treatments when she was younger that left her in pain and have ruined her life. Under a health provider's care, they performed a double mastectomy and removed all of her other reproductive organs. According to the lawsuit, "she cannot get back the life that was stolen from her. She will never be able to conceive and bear a child. Even if she could conceive a child, she will never be able to breastfeed her child." She lives in daily pain from the effects of removing her perfectly healthy breasts. The reality is hospitals across the country including in Boston are now limiting or ending minors access to these surgeries. Why? Because the evidence is clear. The Journal of Sexual Medicine recently studied over 100,000 patients and found that those who underwent these types of gender transition surgeries had significantly higher rates of depression, anxiety, suicidal ideation and substance abuse compared to those who did not. We must acknowledge the serious risks involved. Breast removal is not just a cosmetic change, it is a life-altering surgery that comes with physical and psychological consequences. There is no going back. The scars, both emotional and physical, can never ever be undone. If these surgeries don't improve mental health outcomes why, why are we rushing to push young girls, little girls, down this irreversible path? Why are we allowing doctors to perform these surgeries on little kids? This legislation ensures that minors are safeguarded from premature elective procedures, while still allowing, which this bill does, appropriate medical discretion for legitimate needs. I urge my colleagues on both sides of the aisle to support this measure because protecting children should never ever be a partisan issue. Thank you.

Speaker PackardThe motion before us is ought to pass as amended on HB 712. Rep. Granger has requested a roll call. Is that sufficiently seconded? It is sufficiently seconded. This will be a roll call vote. Members take your seats. The motion before us is the majority committee report of ought to pass as amended. This is a roll call vote. The Chair recognizes Rep. Weber for a parliamentary inquiry.

Rep. Lucy Weber (D - Ches 5)Thank you, Mister Speaker. Mister Speaker, if I know that limiting breast surgeries to a specific list of acceptable procedures for specific conditions only has dangerous and unintended consequences for everybody else who might need a surgery for a different condition. If I know that the example of this is that the amendment that you just passed was drafted after I asked if this bill, as originally submitted, would have prohibited somebody who needed it from getting the lumpectomy and the lymph node removal, that there was the routine care for me after my cancer diagnosis last fall. And if I know that I want to affirm the right of every Granite Stater to appropriate medical treatment and the rights of parents and medical providers to direct that treatment, would I now push the red button to defeat this poorly drafted and discriminatory legislation? Speaker Packard: The Chair recognizes Rep. Layon for a parliamentary inquiry.

Rep. Erica Layon (R - Rock 13)Thank you, Mister Speaker. Mister Speaker, if I know that this bill when drafted and included breast tissue always intended to include lumpectomy and I still believe it includes lumpectomy, but in order to accommodate our colleague from Walpole, we drafted this amendment to satisfy her concerns. And if I know that WPATH, the medical organization which has been cited as one of the standards, actually removed the section on ethics and replaced it with UNIX so I don't really trust their judgment so much anymore. And if I know that this bill has exceptions for abnormally large breasts in both boys and girls, cancer, infection and other tissue damage, which is quite broad reaching but limits the surgery to everyone under 18, including both teenage girls who want to look like the magazine models and get implants and for children who are concerned about this because they don't fit the stereotype that they think they should belong to. And if I know that we heard from a woman who worked at a leading pediatric gender clinic who started questioning the orthodoxy when she had a patient call her a month after she had surgery to remove her breasts crying and asking to get them back and the surgeon would not even take her call so her regret could not be included in statistics.

Speaker PackardThe House will be in order. The member will suspend. I've given pretty good latitude to both sides of the aisle today on PIs. Member may continue.

Rep. Erica Layon (R - Rock 13)Thank you, Mister Speaker. Thank you, Mister Speaker. And if I know that I've also helped a new mom struggling with an infant because her breast removal left her with her milk ducts trapped with no exit and the physical pain from holding her infant was almost as great as the psychological pain knowing that that breast removal had removed that opportunity to comfort her child, would I then press the green button to say that all kids need to wait until 18 to enlarge, reduce or remove their breasts? Thank you.

Speaker PackardThe motion before us is the majority committee report of ought to pass as amended on House Bill 712. This is a roll call vote. If you're in favor you'll press the green button, if you're opposed, you'll press the red button. Voting stations are open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 200 voting Yea; 165 voting Nay, the committee report is adopted. (Rep. Steven Smith in the Chair)