The law will amend existing public health legislation to allow children under the age of 18 who are classified as “refugees or homeless youth” or RHYs to consent to medical, dental, health and hospital services and comes in the background on a wave of legislation targeting trans children elsewhere in the nation.
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New York lawmakers voted Thursday to allow homeless teens to make their own health care decisions without parental consent, including when it comes to gender-based care that they are denied in other states.
The bill will amend existing public health law to allow children under the age of 18 who are classified as “refugees or homeless youth” or RHYs to consent to medical, dental, health and hospital services and comes amid on a wave of legislation targeting trans children elsewhere in the nation. In Florida, Gov. Ron DeSantis banned minors or people with Medicaid from accessing hormone therapy or pubertal blockers; in Texas, the U.S. Children’s Services Agency has launched an investigation into families whose children receive gender-based care. Following a vote in the Senate last month, the Assembly approved the measure on Friday, sending it to Governor Katie Hochul for signature.
“Today is a good day for fleeing and homeless youth in New York State,” said Jamie Poulovic, executive director of the CHY Homeless Youth Coalition, who supports the measure. “At a time when many countries are passing anti-trance legislation or trying to limit the autonomy that people have over their own bodies, this legislation is really something to celebrate.
However, the legislation covers more than gender-based care. A document released by CHY and youth service providers reminds lawmakers that the bill will allow homeless young people to make routine medical decisions, such as scheduling a physical examination, seeking therapy, filling a dentist’s cavity and taking prescription drugs.
“We can offer vaccines, physicists, all the things we’ve been limited to,” said Dr. Uri Belkind, associate clinical director of adolescent care at Callen Lorde. “It’s certainly very important for sex-promoting care, but it’s certainly much more than that.”
The term “refugee and homeless youth” applies to unaccompanied young people under the age of 25 or parents who do not have stable housing, many of whom are served by a network of non-profit organizations across the state that run housing programs and offer a range of social and health services.
About 3,659 young people have been admitted to the RHY Crisis Shelter or New York State Transition Program in 2020, according to the latest figures released by the Office for Children and Family Services. About a third of them are under 18 years old. But these data do not paint a complete picture because they exclude young people who have visited accommodation centers, used other RHY-compliant services without entering a shelter, or who have never engaged a provider.
Refugees and homeless young people over the age of 18 – like almost all adults – can now take control of their own health. Current legislation also allows people under the age of 18 who are married or parents, as well as young people who are emancipated or imprisoned, to make their own medical decisions.
Extending the law to cover RHY will enable “some of New York’s most vulnerable populations,” the New York Civil Liberties Union wrote in a note to lawmakers.
“The vast majority of runaway and homeless youth simply do not have access to health care, period,” said NYCLU lawyer Ali Bom. “Refugees and homeless youth by definition have no parents to give their consent.”
Many runaway and homeless teenagers who flee their homes or otherwise end up in New York identify themselves as LGBTQ + and seek a more receptive environment with significant support services than other parts of the country, said Nadia Swanson, director. for technical assistance at the Ali Forney Center (AFC). Their New York-based organization serves LGBTQ + young people between the ages of 16 and 24 who are homeless.
Swanson said the current restrictions on health consent were a “huge barrier” for minors visiting the AFC center or staying in their temporary housing. Teenagers under the age of 18 make up about 5 percent of AFC customers, they said.
Although the organization may provide mental health counseling, staff may not prescribe psychiatric medications or perform routine medical examinations without the guardian’s consent. Still, most AFC-served minors have fled a hostile home environment or been rejected by their families because of their gender or sexual identity, Swanson said. About 40 percent of AFC’s customers come from outside of New York.
“Minors who face family rejection then come to a place that needs security and support, but then they can’t provide the care they need,” Swanson said. “Young people are falling through the cracks.”
In the metropolitan area, refugee and homeless youth usually come from counties in the northern part of the state or have experienced trafficking from New York, said Andy Gilpin, who runs the Saratoga-based provider CAPTAIN Community Human Services. CAPTAIN provides shelter for about 100 minors a year and engages 4,000 young people under the age of 21 through its street work program, he said.
“Most of the children we encounter have problems with their parents or carers, often with health and well-being issues – mental health, LGBTQ problems, vaccines,” Gilpin said.
Legislation comes when states across the country adopt or propose policies that harass or even criminalize transgender children – including bills in Kansas, Ohio and Alabama that will criminalize hormonal treatment for minors.
As these harsh anti-transsexual laws are imposed, more and more young people may choose to come to New York to access the health care they need, said Richard Gottfried, a sponsor of the bill’s assembly.
“We are just beginning to see this kind of legal hostility to appropriate medical services for transgender young people, and if this continues, New York could be a haven and host for these young people,” Gottfried said. “If that happens, I would certainly like New York law to be ready to provide appropriate care.
But discrimination against transgender people is not just a phenomenon in conservative countries. Transgender New Yorkers also face bigotry, which contributes to a disproportionately high suicide rate.
U.S. Senate sponsor Jabari Brisport said the measure was crucial to access even routine health care and acknowledged the potential impact on transgender youth in New York and beyond.
“If you live in New York, you’re a New Yorker, and that bill is for you,” Brisport said. “It is sad, but also disgusting, right-wing attacks on trans people, and if New York can be a beacon and an oasis, New York will be that beacon.