Update 2/26/20: Following public testimony in which 50 people expressed concern about withholding medical care from trans kids, Rep. Greg Chaney, the Republican chair of the House Judiciary, Rules and Administration Committee, announced that he would not schedule a vote for House Bill 465.

David Taylor planned to take his own life if he wasn’t able to transition before he graduated.

Taylor, a 17-year-old high school student in Idaho, began socially transitioning during his sophomore year and decided to medically transition by undergoing hormone replacement therapy (HRT) a year later. Before he came out to his parents and started taking steps to be the boy he knew he always was, Taylor said he remembers life as “such a dark place to be.” He couldn’t look at himself in the mirror and would hide behind his hair at school, praying the thick wall of bangs would simply erase his existence.

“Nothing around you is OK,” Taylor said about his life at the time, “and you don't really know what it feels like to feel OK about yourself.”

His mother, Miranda, said her son has “blossomed” since he began the slow process of transitioning two years ago, which includes regular injections of testosterone to help Taylor’s body align with his male gender identity; she’s watched a withdrawn, lonely kid become “a wonderful young man.”

Having the option to transition was “literally life-saving,” Taylor added. “I'm just a couple months away from graduation,” he said. “I wouldn’t be on this phone talking to you now.”

The choice to transition may soon be denied to young people across the state of Idaho. According to the LGBTQ+ advocacy group Freedom for all Americans, the Gem State is one of at least 14 that have introduced legislation which would make it illegal for trans youth to receive affirming treatment for their gender identity; this includes medications like hormone therapy and puberty blockers, the latter of which are designed to delay the onset of puberty, or surgery. Similar bills have been put forward in states like Colorado, Illinois, Kentucky, Ohio, Tennessee, South Dakota, and West Virginia.

But critics say Idaho’s legislation is the most extreme anti-trans medical care bill introduced at the state level this year. Referring to gender-affirming care for trans youth as “genital mutilation,” House Bill 465 would subject any physician caught offering hormone therapy or confirmation surgery with a felony charge. According to the American Civil Liberties Union, which opposes the legislation, convictions under HB 465 would be “punishable up to life in prison.”

“Parents of transgender children, like most parents, simply want what is best for their children, which includes working with physicians to ensure that their children are provided with the most medically appropriate treatments,” ACLU of Idaho Policy Director Kathy Griesmeyer said in a statement. “It is not the government’s role to be involved in this process.”

The bill’s sponsor, Idaho state Rep. Christy Zito, did not respond to request for comment about why she supports HB 465. However, lawmakers in other states say these measures are necessary to prevent young people from making decisions about their bodies before they are old enough to understand the consequences. State Rep. Fred Deutsch, author of a South Dakota bill voted down earlier this month, claimed the solution to “children’s identification with the opposite sex isn’t to poison their bodies with megadoses of the wrong hormones, to chemically or surgically castrate and sterilize them, or to remove healthy breasts and reproductive organs.”

“I’m the son of a Holocaust survivor,” he said during a radio interview with the anti-LGBTQ advocacy group Family Research Council. “I’ve had family killed in Auschwitz, and I’ve seen the pictures of the bizarre medical experiments. I don’t want that to happen to our kids. And that’s what’s going on right now.”

Medical professionals in Idaho, however, say HB 465 would do more harm than good. Jessica Duvall, a pediatrician with the Saint Alphonsus Hospital in Boise, says the legislation is “hateful” and “cruel,” especially considering the already high rate of suicidal ideation among transgender youth across the country. According to a 2018 survey from the American Academy of Pediatrics, 50.8 percent of trans boys between the ages of 11 and 19 had attempted suicide during their lifetimes, while 29.9 percent of trans girls said the same.

If the legislation passes, Duvall predicted it would only increase “depression, anxiety, and general isolation” among the population she treats. “To me, there is no medical rationale for this bill,” she says. “There's no reason other than just discrimination and hatred.”

Sara Swoboda, a primary care pediatrician at a general pediatrics clinic in Boise, said physicians would also be impacted because they would be forced to choose between following their Hippocratic oaths or complying with the law. “Both the American Medical Association and the American Academy of Pediatrics have spelled out evidence-based guidelines regarding how we should provide gender-affirming care to our patients,” she said. “Being in a place where we can't provide those standards of care and would put our patients at a huge disadvantage and really tie our hands.”

Swoboda said the end result would likely be that physicians would either leave Idaho—in fear of violating the law—or avoid practicing there in the first place. Being unable to recruit medical professionals to treat its youth population could prove a major problem, as a 2018 report from the American Board of Pediatrics showed that Idaho has already the lowest number of pediatricians per capita of any state in the nation.

While Swoboda said she personally “wouldn't feel comfortable abandoning patients and families” if HB 465 becomes law, its passage would “impact any sort of medical care that [she’s] providing, even if it's outside of dealing with gender and sexuality.”

“Your doctor certainly needs to be that space where you can come in and be honest,” she said. “It would be difficult for me to provide any medical care to patients if they felt uncomfortable telling me the truth about themselves.”

HB 465 is currently awaiting a public hearing in the House State Affairs Committee, which could take place as soon as next week, and if passed, it would head to the Idaho Senate. Both the House of Representatives and Senate are dominated by conservatives —who command exactly 80 percent of seats in each chambers. If the bill is allowed to move to the Senate, both houses approve the legislation, the decision would be up to Gov. Brad Little, also a Republican. Little has not stated whether or not he is open to signing the bill but recently told local press he is “not a big discrimination guy.”

Even if the bill fails to move forward, HB 465 isn’t the only anti-trans measure that’s being debated in Idaho’s legislature this year. Another bill would prevent transgender people from updating the gender listed on their birth certificates, while a third piece of legislation would prevent trans student athletes from playing on sports teams that align with their gender identity. The latter bill, HB 500, is headed for a full vote in the House after passing the House State Affairs Committee on Thursday along party lines.

Megan Carter, vice chair of the LGBTQ advocacy group Add the Words, believes that these bills “work in tandem.” For instance, trans girls who compete in school athletics have to be prescribed medication to suppress their testosterone levels for one year before they are allowed to participate. The passage of legislation preventing them from receiving gender-affirming care could, thus, jeopardize their eligibility to compete.

“Even if the athlete bill were to not to pass but the health care one did, it would have an impact on athletics, who would be allowed to compete in sports, and how they would be allowed to compete,” Carter said. “There's some very deep frustration, anger, and fear — fear for our safety and fear for our children.”

While parents of trans kids remain concerned that any combination of these bills being signed into law would put more stress on their families—including hours-long drives to another state for gender-affirming care—it doesn’t change their love and support for their children. Heather Platts, whose son came out as trans just five months ago, said her only worry about her 16-year-old’s transition has been making sure that he’s happy and healthy. The first thing she did after he opened up to her was read books about parenting trans kids, which is when she learned that access to transition care greatly decreases the risk of suicidal ideation among trans youth.

“My first thought was: I have to keep my child safe just from the emotional and psychological impact of what they’re experiencing,” Platts said. “To read this bill that is claiming to be defending and upholding the health of these children, I think it’s just so crazy because it’s doing the opposite.”

Even though this is all new for their family, the introduction of legislation like HB 465 has forced them to become advocates almost overnight. Although they initially planned to wait until her son became an adult to change the gender listed on his birth certificate, they started the process after these bills were introduced, fearing that even more policies are headed down the pipeline. Platts says the prevailing feeling among parents of trans kids is that they need to stand up and fight for their children “because we feel like we’re the only ones that will.”