Transgender Alabama woman to lawmakers considering treatment ban: ‘Talk to one of these kids’

A month after her 16th birthday, Jessica Fuller took a long walk as she wrestled with whether to tell her father she was transgender.

She wrote a note, rewrote it over and over, and left it in his desk at home. She thought about throwing it away.

“I was hoping he didn’t see it, but he did,” Fuller said. “And he hugged me and told me he loved me. But of course that was the initial reaction because he loves me. I’m his child. He was shocked and confused, yes.”

UPDATE: Alabama ban on transgender treatments for minors closer to becoming law

Last week, Fuller, now 21, came with her father to the Alabama State House because lawmakers are on the verge of taking away treatments for transgender youth and their families.

They are considering a bill that would make it a felony to prescribe or provide medications to block or delay puberty and sex hormones to anyone under 19. The bill also bans gender confirmation surgeries. The pediatrician who leads the program for transgender youth at UAB said surgeries are never done on minors in Alabama.

The Alabama House Health Committee held a public hearing last Wednesday and is scheduled to vote today.

The bill, by Sen. Shay Shelnutt of Trussville and Rep. Wes Allen of Troy, has strong support in the Republican-controlled Legislature. The Senate passed it 23-4.

Jessica’s father, Gadsden Police Sgt. David Fuller, has been one of the most outspoken opponents of the legislation, speaking at public hearings. A single father whose wife passed away, he said Jessica’s transition was a shock to him but he turned to professionals at UAB for help on a subject he knew nothing about.

He learned transgender teens are more likely to consider and attempt suicide than other teens.

“The health care that she got there was vital to her staying alive,” he told lawmakers. “As far as what she got, they didn’t just let us walk in and say, ‘Hey, now we’re going to go ahead and make you a girl.’ No, just the opposite. They put us on a journey that has been slow and meticulous. And I made sure when we first started that it was reversible. There was no talk of any kind of operations. It was just, we’re going to take this one step at a time and see where we are.

“We’re five years later, we’re still baby-stepping. So, to say that these people or the parents are creating these transgender kids or putting them in harm’s way is ridiculous.”

The same debates are playing out across the country.

Lawmakers in 19 other states have considered bills banning transgender treatments for minors, according to the American Academy of Pediatrics -- Arkansas, Arizona, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Missouri, Montana, Mississippi, North Dakota, New Hampshire, Oklahoma, South Carolina, Tennessee, Texas, Utah, and West Virginia.

The Alabama Chapter of the American Academy of Pediatrics opposes the bill and said in a position statement that it misrepresents the care that transgender youth receive in Alabama and at more than 50 medical centers across the nation.

“This multi-disciplinary evaluation occurs, not in primary care offices, but in a specialty clinic with experts in psychology, pediatrics, and endocrinology to determine what, if any, treatment and medication are recommended. ... Rather than protecting children, this bill would prevent community pediatricians, families, and youth from being able to access medical experts to help guide them through their journey,” the statement says.

The Alabama bill, called the Vulnerable Child Compassion and Protection Act, also has support in the medical community.

‘I don’t think they’re born that way’

Dr. Den Trumbull, a Montgomery pediatrician for more than 30 years, calls the puberty blockers and cross-sex hormone treatments “child abuse.” Trumbull has also spoken at the public hearings.

“Children fare better in their development if their innate biological sex is confirmed and affirmed by parents and authority figures in their life,” Trumbull told the Health Committee. “Until recently, this was an obvious fact.”

“It’s not uncommon for pre-adolescents to experience temporary periods of confusion where they feel insecure with themselves and their sexuality,” Trumbull said. “If emotionally supported and reassured of their biological sexuality, 80 to 95% will embrace their natural bodies by young adulthood.”

Eric Johnston, a Birmingham lawyer who has led legislative efforts in Alabama to restrict abortion, helped write the bill. Johnston said doctors opposed to the treatments for minors brought the issue to his attention. He said he met with a pediatrician, a counselor and others before the bill was introduced last year.

“We’re not saying adults can’t do what they want to do,” Johnston said. “We’re saying children. And there’s a big difference between an adult making a choice. And I think I’ll say this about transgenderism -- it’s a choice that a person makes. And I don’t think they’re born that way necessarily.”

Johnston said states have the constitutional authority to pass laws to protect general health and welfare.

“We’re well within the state’s right, the legislative right, to look at the facts, take the evidence, and make a decision on whether they need to intervene in this,” Johnston said. “And I think here, until the science is clear that children can have this done and it’s OK to be done, that we don’t need to permit it.”

‘We give the youth space to talk to us’

Dr. Morissa Ladinsky is one of the two physicians leading the team that treats transgender youth at UAB. Ladinsky, a pediatrician, said the group has treated about 300 patients from across Alabama, as well as Mississippi and the Florida panhandle, over the last five and a half years.

Patients and families receive psychological, psychiatric, and pastoral support, Ladinsky said. The problem for many pre-teens and teenagers who feel their body is at odds with their inner sense of gender is “getting up the nerve to come out to their parents or grandparents or somebody who cares, and who isn’t going to punish me, beat me up, demean me or kick me out of the house,” Ladinsky said. “So they’ve often been kind of keeping it within for a long time.”

Some come into the care of the UAB team after suicide or self-harm attempts.

“More than anything we give the youth space to talk to us about what they think or feel,” Ladinsky said. “How long has this been going on? When did you first realize that your sense of gender was in conflict with what your body is telling you and what people around you have told you?”

The medical team usually takes three to six months to determine if medications that delay puberty are appropriate for pre-teens or early teens and that the families support that decision, Ladinsky said.

Hormones are an option for ages 16-18, or 15-year-olds who are exceptionally mature, she said. The approval process is extensive. The patient and family have a say but don’t make the final call, she said.

“Kids don’t drive this bus. Parents don’t drive this bus. This is a team,” Ladinsky said.

Before receiving hormones, teens must be in behavioral therapy for an extended period and must have written endorsement from mental health caregivers, she said.

“So, it’s a pretty strict longitudinal process,” Ladinsky said. “I hate to shatter the myth. But nobody is just giving scripts for hormones. This is a big deal.”

‘I would’ve killed myself’

It was November 2015 when Jessica Fuller took the long walk and left the note for her father. After counseling, Jessica said she had her first appointment with an endocrinologist in May 2016. She began receiving testosterone blocker in September 2016. In March 2017, about 16 months after coming out, she said she began receiving a small dose of estrogen, one-eighth of the full adult dose.

Jessica said the doctors and counselors at UAB repeatedly probed her for doubts and second thoughts.

“There’s plenty of times where they would ask me over and over again if I really wanted this,” she said. “Over and over. I kept annoyed at them because they kept asking me. I knew what I wanted. I knew exactly what I wanted. I put some really long, good thought into it.”

Jessica did not speak during the public hearing last Wednesday but talked to reporters outside the State House. She said legislators should understand the issue by now.

“I don’t know how there’s a misunderstanding,” she said. “People have been talking to them and telling them what’s up. If they’d just research, use the little Google and type all the words and eventually they will learn all kinds of things about trans people. If they want to look at both sides, they absolutely can. There’s websites who are for that bill but against trans people.”

“But unfortunately, I hate to say this, but I feel like a lot of them just don’t care,” Jessica said. “And their lives don’t get affected by me. I say they need to go and actually talk to one of these kids, or somebody who went through it.”

Jessica, whose first name was Jonathan before her transition, said she struggled with coming out because she was afraid of regrets. Even after that long walk when she decided to tell her dad, she second-guessed herself a little, wondering if she should wait until the following year.

“But then I realized I can’t wait,” she said. “I can’t wait any longer. This is going to kill me if I wait any longer. I’m not a good liar.”

Five years later, Jessica says she’s a calmer person and is comfortable with her decision. She likes video games, Dungeons & Dragons, and, most of all, writing.

“I write a lot of stuff but what gets me motivated is normally urban fantasy,” she said. “I write whatever strikes my fancy at the time. Normally something I’m reading, watching, or doing. Sometimes songs inspire me to write.”

“I don’t have a single regret,” Jessica wrote in an email responding to questions from AL.com. “If anything, I wish I could have done it sooner so my mom could have been in on it but I can’t blame myself for that. The things I do regret were the dumb things I said during those dark times. I had an attitude problem then. But doesn’t every teenager?”

Had the ban on transgender therapies proposed by the legislation been in place five years ago, Fuller said she would have been devastated. She said she would probably have left the state to receive hormones.

“Yes, I was pretty suicidal, but I wasn’t dumb,” she wrote. “I was a woman with a plan and extreme motivation. Nothing would have stopped me from achieving my goals.

“Of course, I don’t know what would win first: The Motivation or the Suicidal Ideation. Either way, had I been someone less driven, I would’ve killed myself seeing not much of a point in continuing my existence if it was just gonna be continual suffering and pain. I live for the happy moments, not the ones that cause me pain. A little morbid, but I was a teenager going through emotions a teenager should never have.”