“The Alaska State Medical Board opposes hormonal and surgical treatments for gender dysphoria in minors due to insufficient evidence of long-term benefits and risks of irreversible harm,” the board told the state legislature on March 21, reporting a resolution it unanimously adopted at its March 20 meeting. “The Board urges members of the legislature to consider statutory limits on such treatments.”
Alaska is one of a shrinking minority of states that have yet to legislatively protect minors from gender transition procedures, and the only Republican-controlled state that has not enacted legislative protections for minors. Earlier this year, Kansas became the 27th state to do so when the legislature overrode Democrat Gov. Laura Kelly’s veto.
In 2024, Republican Alaska Rep. Jamie Allard introduced a bill (HB 338) that would create a civil liability for “an injury or condition suffered as a result” of a gender transition procedure performed on a minor. The bill never came up for a vote on the House floor. In the current legislative session, no bill affecting gender transition procedures for minors was introduced, according to the Anchorage Daily News (ADN).
This legislative inaction prompted the medical board, whose members are chosen by Republican Gov. Mike Dunleavy, to pursue its own inquiry over the past two years. “It’s just an issue of bandwidth that we didn’t get to this more than a year ago,” said board member Dr. Matt Heilala. “There’s never a great time, but we felt that remaining silent was tacit approval.”
Alaska taxpayers are currently sponsoring the controversial gender transition procedures even though their elected representatives never voted to do so. In 2021, Alaska’s Medicaid program agreed to cover gender transition procedures following a class action lawsuit, although the state’s law does not require private insurers to cover the procedures.
In November, the medical board asked the Alaska Department of Law to “investigate what other states have done on the issue of medical or surgical treatment of gender dysphoria in minors for the purpose of the Board drafting a statement on this issue.”
The Department of Law refused, stating that the board lacked “clear regularity authority on this kind of issue.” According to ADN, “The medical board is charged with overseeing the licensure of medical practitioners in Alaska,” and even its statement urging the state legislature to act “has no binding authority.”
On the other hand, Alaska Sen. Löki Tobin, a Democrat, granted that the board has the authority to pursue regulatory changes but noted that those regulations may not violate the state constitution’s right to privacy. Section 22 of the Alaska Constitution stipulates, “The right of the people to privacy is recognized and shall not be infringed.”
Consequently, Alaska appears to have a rather libertarian approach to health care policy. Unlike other states, Alaska does not regulate a “standard of care,” said Heilala. “In our state, unconventional practice is not unprofessional. So, if there’s no harm occurring, and if there’s consent—even if it’s unconventional—it’s not to be considered unprofessional in our state.”
Nevertheless, the Medical Board unanimously concluded that gender transition procedures were “lacking legitimacy as standard medical practice.” They added, “We support legislative limits on such treatments and promote psychological support and counseling as safer alternatives. This reflects our duty to protect patients and uphold evidence-based care.”
This was a bold statement, due to the fact that two of the Board’s seven members (there are eight positions but one vacancy) are still awaiting confirmation by the legislature.
While Republicans technically hold a majority of seats in both of Alaska’s legislative chambers (11 out of 20 Senate seats and 21 out of 40 House seats), this does not translate into majority control. Five Senate Republicans caucus with the nine Democrats to form a majority, leaving the other six Republicans in the minority. Likewise, in the House, the majority consists of 14 Democrats, five independents, and two Republicans, leaving the other 19 Republicans in the minority.
As a result, Alaska Republicans are not able to move legislation unilaterally, even though they should technically have a governing trifecta. This explains why Alaska has been less receptive to the recent momentum to protect children from gender transition procedures, which has involved mostly Republican-controlled state governments, even though a few courageous Democrats have braved the wrath of transgender activists to do what they believe is right.
“True care,” said Alaska Rep. Jubilee Underwood, a Republican, “means providing compassionate psychological support—not irreversible interventions that compromise their future.”
The Alaska Medical Board agrees. But will the state legislature?
