Indiana Attorney General Todd Rokita appears to be threatening legal action after just three medical providers responded to a request for details on care for transgender minors he made earlier this year.
The move comes as Indiana’s ban on transition-related care for children is set to go into partial effect Saturday.
“We wrote to gender clinics and the state’s top hospitals asking about invasive transgender surgeries and hormonal treatments on minors as part of a good faith effort to get simple answers to serious questions about medical treatment of our youth — answers that Hoosiers want,” an office spokesperson said in a written statement. “Only three health care facilities responded, without actually answering any of the questions, which reveals a dire lack of transparency.”
Examining transition-related care
Rokita addressed his March 6 letter to at least 17 entities: a medical practice, a university, four hospitals and Planned Parenthood’s 11 Indiana locations. He laid out more than a dozen questions in the two-page document, including requests for data on hormone treatments, surgeries and consent.
“It is incumbent upon health care providers to ensure that minors and their parents, as consumers, are adequately advised of the short-term and long-term risks associated with these types of treatment,” Rokita wrote in the letter. “As the Attorney General of Indiana, it is my duty to gather information regarding the nature of your practice in this area to protect our Hoosier consumers.”
Transition-related genital surgeries are considered a permanent method of sterilization, but hormone blockers — used for decades to delay puberty — are generally considered to be reversible. Hormone replacement therapies are somewhat reversible, depending on the length of time someone has used them.
Rokita asked for responses by March 27. He got three.
Planned Parenthood’s Janell Duey, who directs regulatory compliance for the region including Indiana, responded with a one-sentence letter: “Indiana health centers do not provide minors gender affirming hormone care.”
Indiana University School of Medicine Dean Jay Hess simply referred Rokita’s office to health care system Indiana University Health. He said the university’s mission was focused on teaching and research, as opposed to the “uniquely clinical” information the office sought.
But Eskenazi Health CEO Lisa Harris defended the health care system’s “gender health” practices in a two-page letter.
"Eskenazi Health's mission is to serve the underserve populations of Marion County, and the transgender community is one of the most vulnerable populations in need of services, Harris wrote.
But she assured Rokita’s office that Eskenazi’s gender health clinic doesn’t advertise to minors, and doesn’t provide surgical services to minors. The clinic only treats a small number of minors more generally — and only those over 15 — she wrote.
It doesn’t prescribe puberty hormone blockers or provide gender-affirming garments to patients, regardless of age, according to Harris.
She also detailed the process the clinic uses to assess patients and design care plans, noting that minors’ parents are present at intake appointments and require consent from both children and their parents “at every step.”\
Possible legal action
Rokita’s office appeared unsatisfied with the results of its request, with a spokesperson writing the responses didn’t answer the questions posed.
“Now, their legal costs will undoubtedly increase as we implement more formal mechanisms to extract the information they are apparently hiding,” the spokesperson said. “Our office will continue defending Hoosier children.”
The office didn’t immediately respond to questions on what form those mechanisms might take, or what legal basis.
The threat comes as Indiana’s ban on a range of transition-related procedures for minors partially takes effect, on Saturday.
A federal judge issued a preliminary injunction earlier this month preventing the state from enforcing bans on puberty hormone blockers or hormone replacement therapies. U.S. District Court Judge James Patrick Hanlon upheld the ban on surgical procedures, although previous Statehouse testimony and court filings indicated weren’t occurring for Hoosier minors.