Who decides what medical or mental health care is best for your child? Would it surprise you to know that in the mental health arena the ‘age of consent’ is only 13 years of age in Washington?  Like laws surrounding abortion, parents of adolescents are potentially cut out of the decision making and mental health care of their teenage children.

When it comes to mental health treatment for issues of sexual orientation or gender identity, it could be even worse.

Conversion therapy, the use of talk therapy to help children suffering from questions of Sexual Orientation or Gender Dysphoria, was banned in Seattle as of August 2016.

The legislation sponsored by Councilmember M. Lorena González made the practice of conversion therapy on minors by licensed medical or mental-health professionals punishable by fines of up to $1,000. It also prohibits the advertising of conversion therapy.

In 2017, the Washington state senate introduced SB5722, which would extend the ban to minors statewide. When the legislature returns early in 2018, the debate is set to continue.  If such a ban were to pass, parents would not be able to seek mental health treatment for their children who may be struggling with gender identity or sexual orientation issues.

The American Psychological Association (APA) calls transgender, an “umbrella term for persons whose gender identity, gender expression or behavior does not conform to that typically associated with the sex to which they were assigned at birth.” The diagnosis often assigned these individuals by the clinical community is Gender Dysphoria. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains separate criteria for diagnosing it in adults and adolescents versus children.

While it is typically recognized that adult citizens of the United States have full jurisdiction over their own medical choices, those under 18 are considered under the authority of their parents. A debate, on these terms, surrounding the appropriate treatment for children and adolescents who may be transgender is taking shape all around the world.

The Daily Mail recently profiled parents who felt the state-sponsored, National Health Service (NHS) in England was pressuring their kids to go through with medical procedures to change their sex. The article reports that one mother was shocked to find her child being referred to a specialist transgender clinic, after only a 40-minute evaluation. Some of the parents made claims that their children only began hating the biological sex they were born after cases of extreme bullying by other students and that NHS employees refused to listen to their claims.

The rush to label children transgender comes on the heels of the NHS signing a “memorandum of understanding,” which is nearly identical to implementing a ban on conversion therapy. The memorandum makes it illegal for staff to challenge the person’s gender confusion.

It is pertinent to note that the science on this matter has not been settled yet either. There is much debate in the medical community as to whether transgender is a clinical disorder and furthermore if those who don’t adhere to the gender binary deserve protections similar to that which is guaranteed based upon immutable characteristics like race.

Dr. Quentin Vanmeter, a pediatric endocrinologist from the American College of Pediatricians does not view transgenderism as a civil rights issue. He says that transgenderism is a mental health issue, and there is no scientific evidence that it’s a physiological phenomenon. He believes that treating it as if it’s a natural phenomenon and speaking about it as a civil rights issue is doing a disservice to the children struggling with this type of mental illness.

He’s not alone either, former Chief of Psychiatry at Johns Hopkins University, Dr. Paul McHugh, also believes that being transgender is a psychological problem, not a biological phenomenon. He thinks that transgender individuals should be referred to mental health counseling, not surgery.  A statewide ban such as Seattle’s on talk-therapy for minors dealing with gender dysphoria would make this impossible.

With a degree of doubt cast on the advocacy of LGBT groups painting transgender as a biological phenomenon and not a psychological problem, parents need to be skeptical of hormone therapies and sex reassignment surgery, which hold the potential to alter a child or adolescent’s  life indefinitely.

Parents should have the right to explore all of the options available for their children and adolescents and make the decision that seems most appropriate to them, not the state.

Genevieve Malandra is a contributing writer to Family Policy Institute of Washington.