Trans activist urges Legislature to defeat bill that defines gender-confirming therapies

By Pedro Correa Henry

Twitter: @pete_r_correa

Special to The Star

True Self Foundation Executive Director Joanna Cifredo on Wednesday urged the Puerto Rico Legislature not to pass House Bill (HB) 768, saying the legislation would infringe on the rights of transgender youth who have support from their families in confirming their gender identity “with the assurance of a physician or a team of health care professionals.”

On the third day of public hearings before the House Committee on Social Welfare, People with Disabilities and the Elderly chaired by the Dignity Project Rep. Lisie J. Burgos, Cifredo said allowing this legislation to become law would lead trans minors “to seek transitional treatments clandestinely.”

As the STAR reported May 21, HB 768, penned by Burgos, seeks to amend the Minors Safety, Welfare, and Protection Act to define as an act of abuse when parents allow their children under 18 to undergo gender-confirming hormone therapies or surgeries.

Parents who make the difficult decision to accompany their children in this process are brave,” Cifredo said. “They have to deal with the ignorance and prejudices of people who do not understand our experiences and are not interested in learning about them.”

The bill also seeks to amend the Medical Licensing and Discipline Board Act to establish as “unprofessional conduct” the provision of hormone therapies or gender-confirming surgeries to a person under the age of 18, imposing a fine of $30,000 on the professional who fails to comply with the provision.

“In these hearings, lies about these young people have been perpetuated,” Cifredo said.

“Allow me to clarify some points to the committee: it is not true that 80% of people with gender dysphoria detransition back to the sex assigned at birth.”

According to the True Self Foundation director, gender dysphoria is “a diagnosis proven when a person becomes insistent, consistent and persistent in recognizing that an incongruence exists between their physique and gender identity for an extended time.”

Furthermore, she told legislators on the committee, what is true is that the majority of young queer people who present fluidity in their gender expression eventually identify with their assigned sex.

“It’s not the same thing as gender dysphoria,” Cifredo said, noting that the World Health Organization does not recognize gender dysphoria “as a mental disorder, but [rather as] a medical condition that can be treated with either pharmaceutical or surgical procedures.”

“This is very different from young people who present different behaviors that do not correspond to the stereotypes attached to their assigned sex,” the activist pointed out.

Likewise, unlike other deponents who claimed that local health professionals are casually prescribing hormone therapies to minors, Cifredo stated that such prescriptions are “made with great consideration in consultation with the youth, their parents, and a medical team after much education and therapy.”

According to the Mayo Clinic, both feminizing and masculinizing hormone therapies, also known as gender-affirming hormone therapies, are prescribed to induce physical changes in the person’s body caused by hormones during puberty to promote the matching of their gender identity and body.

The nonprofit academic medical center established in 1889 states that such therapies can “make gender dysphoria less severe, reduce psychological and emotional distress, improve psychological and social functioning, improve sexual satisfaction and improve quality of life.”

Cifredo also stated that the hearings portrayed a “fantastic and sensationalist vision” of gender-confirming surgeries on the part of people who have never met anyone who underwent such a procedure.

“The idea of a gender-confirming surgery being done hastily is completely false and cannot be more divorced from reality,” she said, noting that the procedure is expensive, requires authorization from different healthcare professionals and can take between one and three years to complete.

According to, the name of the surgeries mentioned above has changed through time because “as many trans folks have noted, surgery doesn’t change one’s gender — it changes the body in which one experiences that gender.”

When Burgos asked about gender-confirming surgeries, Cifredo told the legislator “there are no surgeons in Puerto Rico who specialize in this.”

“In the United States, there are around 15 doctors who have a long waiting list as more states are allowing health care plans to cover treatments for trans people,” she said. “Let me be very clear, there is no case in which a young person has been forced by their parents to take hormones and transition; that just does not happen.”

“According to what you’re saying, these parents are told by their children that they want to undergo these procedures?” the Dignity Project legislator asked.

Cifredo told Burgos that such proaction is common in trans youth who are aware of their gender identity. However, when they do not get the appropriate help, they face symptoms such as depression and anxiety, and are vulnerable to suicide.

Meanwhile, Burgos said HB 768 “is not transphobic,” adding that she has consulted people “who have this lifestyle.”

“I respect it,” Burgos said. “We don’t pretend to interfere with anyone’s intimacy, but we believe that we must protect minors.”

“This bill does not prohibit them from getting psychological treatment in order to find their orientation,” she added. “What it seeks to do is prevent minors from making momentous body choices that could be irreversible for those who identify with their biological sex. … We are preventing them from undergoing permanent mutilations.”

Cifredo responded that “being trans is an identity, not a lifestyle.”

“I don’t think you’re in the position of determining what’s transphobic to the trans community; we make that decision,” she said. “This piece of legislation is an anti-trans bill.”

Burgos, nonetheless, insisted that HB 768 is not a measure that seeks to harm trans lives in Puerto Rico as “it seeks to prevent children from having permanent mutilation of their biological genitals.”

“The fact that you describe a procedure that saved my life as a mutilation reflects a transphobic idea,” Cifredo replied. “This sort of vocabulary is truly offensive and does not promote a respectful discourse.”

In another deposition, Dr. Iván Lladó, a cardiologist with 40 years of experience, said he is in favor of the legislation due to “the cardiovascular consequences that minors may face during their adult life.”

“I believe that these children and their families should be welcomed and cared for in the medical community, with charity and compassion, and with the proper professional care that the dignity of the patient requires,” he said. “Therefore, we must not enter into experimental and invasive treatments that threaten their physical integrity and healthy development.”

However, when Popular Democratic Party Rep. Jesús Manuel Ortiz asked Lladó if he, or any of his colleagues, had ever treated a minor patient with secondary effects due to gender-confirming hormone therapy, Lladó answered that neither he nor other health professionals on the island have received such a case in their practice.

Other deponents, such as former Dignity Project gubernatorial candidate Dr. César Vázquez Muñiz, recommended increasing the age prohibition in the bill up to 21 years.

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