Repeal North Carolina Law Limiting LGBT Rights, AAP Says

Marcia Frellick

April 19, 2016

The American Academy of Pediatrics (AAP) is adding its voice to those calling for repeal of North Carolina's House Bill 2, also called HB2 or "the bathroom bill." The law, which was passed March 23, blocks cities and local governments from enacting measures that could protect gay and transgender people.

The national organization, representing 64,000 pediatricians, and its North Carolina chapter, representing 2000 pediatric care professionals in the state, issued a joint statement yesterday calling for the repeal.

Board Vote Was Unanimous

AAP felt it had to step in because of the potential harm to children who would not be protected under the law, Deborah Ainsworth, MD, FAAP, president of the North Carolina chapter, told Medscape Medical News.

"Many of these kids get caught up in prostitution rings. Many of these kids commit suicide because they're not being accepted. Many don't have an adult they can trust. It's a small group, but a small group of very vulnerable children," she said.

The state chapter's board acted unanimously, she said. Moreover, the communication received by their offices since the announcement has been overwhelmingly positive, though Dr Ainsworth acknowledges that some pediatricians won't agree with the stance.

In the statement released April 18, Dr Ainsworth said: "As pediatricians, we know first-hand how increasing burdens and barriers for youth who are lesbian, gay, bisexual or transgender (LGBT) can increase their risk of depression, substance abuse, dropping out of school, or suicide.

"The law can also have unintentional consequences for children born with gender-related genetic disorders, children with disabilities who may need a different sex parent to help them in the restroom, and children who find themselves homeless due to lack of support for their gender identities."

She added: "We all have a fundamental responsibility to support and nurture children and adolescents to ensure that they can grow and develop into healthy adults. Laws like HB2 send a distressing message to transgender youth and can worsen the challenges many already face. We must do better for North Carolina's young people. They're counting on us."

AAP Saw a Trend

This issue warranted a national statement, Dr Ainsworth said, because leaders saw a trend of discriminatory legislation being proposed elsewhere. She pointed to Georgia, where legislators passed the Free Exercise Protection Act on March 16, which would have limited protections for LGBT people. It was vetoed 2 weeks later by Gov. Nathan Deal, a move that has caused backlash from conservative Republicans.

As bills are being proposed across the country, state legislators are deciding which groups should get protections related to housing, employment, and access to public bathrooms, she noted.

"We wanted to make a statement to other states that this might harm children and to please think about what you're doing," Dr Ainsworth said.

Previous Support for LGBT

It's not the first such political action supporting LGBT people by the AAP. In February, the academy joined several other leading health and welfare organizations, including the National Association of School Psychologists and the American Counseling Association, in a letter urging governors to oppose discriminatory legislation against transgender people.

It also came out with a statement in 2013 supporting civil marriage for same-gender couples — as well as full adoption and foster care rights for all parents, regardless of sexual orientation.

How the Law Passed in North Carolina

The controversy in North Carolina started February 22, when the city of Charlotte passed an ordinance expanding the state's antidiscrimination laws so that LGBT people would also be protected in places of "public accommodation," which, among other things, meant transgender people could select bathrooms according to the gender with which they identify. It was to be enacted April 1.

But on March 23, at a one-day special session, North Carolina's General Assembly not only repealed the Charlotte ordinance, but passed measures further limiting LGBT protections in North Carolina — and Gov. Pat McCrory signed it into law.

The new law gave existing state law the final say in what is covered under antidiscrimination — which applies to race, religion, national origin, color, age, biological sex, and handicaps. So local governments now can't expand "employment" or "public accommodations" protections to others not already specified.

That's why the AAP said it had to send a different message, officials said.

Karen Remley, MD, put it this way in the joint statement: "The message some public leaders have chosen is not the message we should be telling transgender children and teens. The message of the American Academy of Pediatrics to transgender youth is this: we support you, and we will speak up for you. And so today, we do. We urge the governor of North Carolina and all other states considering similar measures to reconsider and repeal these harmful policies, and in so doing, stand up for transgender children."

Drs Ainsworth and Remley declared no relevant financial relationships.