One of the most controversial cultural issues bubbling over in America in recent years has been the topic of transgender rights and deciding what limits should exist on providing transgender care to minors.
The issue has become a political hot potato for one of Wyoming’s largest health organizations, the Wyoming Medical Society (WMS). The Medical Society is a physician’s advocacy group with 1,035 members that is a significant force at the Wyoming Legislature, providing testimony on most health care-related bills.
Over the past two legislative sessions, the organization took a public stance against a bill prohibiting medical practitioners from offering transgender care to minors, arguing that it equated to government interference into the medical field.
“If WMS were to stand by while our members were attacked, demonized and made the victim of cruel rumors, that would be our ultimate failing,” Kris Schamber, president of the Medical Society, told Cowboy State Daily in a Thursday statement. “Ultimately, WMS stood tall in support of the same position we’ve always had, which is to protect the physician-patient relationship and allow doctors to practice without the state legislature standing in the exam room with them and their patients.”
This stance riled up one of its members, Casper radiologist Eric Cubin, so much that he sent an email to all 63 members of the Wyoming House, lobbying them to support the bill and disregard the position of the Medical Society of which he is a member.
He castigated it as a “woke” organization taken over by “extremely liberal” members. Cubin was later removed from the Wyoming Board of Medicine by Gov. Mark Gordon for sending this letter.
“It saddens me very much to have to report that, under their current leadership, the Wyoming Medical Society has been essentially hijacked by the far left,” Cubin wrote in his email. “It seems that they have decided to prioritize politics over their stated mission of physician advocacy.”
Schamber described Cubin’s email as making “misleading and accusatory claims” about WMS and individual licensed Wyoming physicians.
“We have consistently advocated to support the sanctity of the physician-patient relationship and the autonomy of physician decision-making within the spectrum of clinical care,” Schamber said. “That an individual physician removes their own personal beliefs from a vote they render on a specific medical topic as part of their role as a board member for a non-partisan organization does not constitute liberal woke activism.”
Not Represented?
Cubin said the vast majority of medical practitioners he’s spoken with around the state share the same views as him, a stance he believes the Medical Society is failing to represent in its lobbying before the Legislature on transgender issues.
“The vast majority are horrified about the idea of doctors performing trans care on kids,” he said. “They’re (WMS) supposed to be representing our views. People need to know what they’re doing behind closed doors.”
Schamber countered that his volunteer organization did everything it could to solicit the opinion of its members on this matter.
He said it’s rare that one healthcare issue uniformly applies to all providers and patients, so WMS has always given deference to a specialty or specialties that are primarily involved or most affected by a given piece of legislation. On transgender care, these specialties are pediatrics, family medicine, internal medicine/endocrinology, and OB/GYN.
“Decisions are made based on the best evidence available at the time and the expertise of our members practicing the specific medicine in question,” he said.
He also mentioned how the group held a two-hour statewide membership town hall on the topic of gender dysphoria in 2022 where the opinions, thoughts, and questions of members were fully considered and heard. Schamber also mentioned how the group provides an online forum for all of its members to ask any questions and receive real-time results from colleagues. He said Cubin did not participate in either of these two outlets.
“Dr. Cubin’s claims that WMS advocated outside the majority opinion of our members, and failed to do enough to engage the membership in seeking out their opinions, is simply unfounded,” Schamber said. “In truth, Dr. Cubin failed to participate in any of WMS’ efforts to gather its members’ opinions on legislative issues before attacking WMS.”
Schamber also said the fact Cubin waited until when he did during the middle of the legislative session to voice his opinion to the Legislature showed his true intent to undermine the organization.
Where Does Wyoming Stand?
Cubin believes most people who move to Wyoming to practice medicine do so for the state’s conservative politics.
Lonnie Teague is a Casper doctor who runs his own family clinic, but is not a member of the Medical Society. He, like Cubin, said the vast majority of Wyoming doctors he’s spoken with oppose transgender care being provided to minors. Teague also believes the state doesn’t have the proper infrastructure to be offering these services anyway.
“I just see things that are contrary to why I got into medicine with wanting to take care of people and help them be complete and whole individuals,” he said. “This idea of changing their birth sex is kind of against what I think we were created to do.”
Cubin cited a recent poll conducted of 27 Casper physicians, in which a sizable majority said they oppose transgender care being offered to minors, as evidence of where the state’s medical community stands on the issue. He said the fact the organization has never polled all its members about the issue of offering transgender care to minors is telling.
Schamber dismissed the significance of the Casper poll, mentioning how there are around 200 physicians in Casper alone.
The Medical Society has never polled all its members on any issue. The positions of the organization are determined by its 28-member board, whose members are elected regionally throughout the state. Schamber said the board’s trustees go out of their way to talk to their members about health issues before each meeting, which he said Cubin has also not been attending.
Teague questions whether transitioning helps prevent an individual’s suicidal ideations. He also believes a minor is too young to be making decisions about receiving life-altering changes to their body.
“We don’t allow minors to buy alcohol or tobacco or buy a gun even, yet we’re going to let them make this life-altering decision,” Teague said. “It’s such a life-altering decision that they’ll never be able to have children once they’re grown. If they get buyer’s remorse, they’re not coming back from that.”
Many parts of transgender medical care are irreversible. Once the ovaries and uterus are removed from a person’s body, it can be very difficult to reverse that process or have them become pregnant later on. However, a 2013 report from The American College of Obstetricians and Gynecologists did allege 41 transgender men and transmasculine people who had stopped taking testosterone and successfully gave birth.
The viability of performing transgender care on children came under more scrutiny earlier this year when hundreds of messages were leaked from an internal forum belonging to the World Professional Association for Transgender Health, a source often cited in discussions on issues of transgender care.
In the messages, members of the organization discussed many of the negative health effects that can occur as a result of minors receiving gender transgender care.
Some of these comments ran in contradiction to the public statements the group was putting out.
Schamber said the medical community is not divided on the issue of gender dysphoria. He also said surgical treatment of gender dysphoria in minors has never been the standard of care, and WMS has openly opposed it.
“WMS offered to work with the legislature to statutorily ban surgical treatment of gender dysphoria among minor patients as the WMS membership was not divided on that point,” he said.
What the medical community and WMS membership is divided on, he said, is the non-surgical treatment of gender dysphoria, which Schamber said currently available medical evidence supports. He stressed that WMS only asked that the Legislature respect the medicinal process and continue working together and debating the best clinical standards.
“The question about our society addressed with this topic, like any other, has nothing to do with our own personal beliefs on any matter, but rather who should be making medical decisions,” he said. “Physicians' personal beliefs are often incongruent with those of their patients in many ways. This is why we take an oath when we become physicians, to treat each patient with impartiality, regardless of race, religion, gender, political belief or other factors.”
Impartiality
Cubin sent his email to Wyoming legislators while serving as a member on the Wyoming Board of Medicine. He resigned from the board last month after being pressured to do so by the governor.
Gov. Mark Gordon had threatened to remove Cubin from the board as a result of the doctor’s email, which the governor said could have given the impression to the public that he has a conflict of interest on the issue of transgender care, and was speaking on behalf of the board.
“Medical professionals should be confident that their licensure, which is their livelihood, will be handled professionally and clinically examined on merits alone,” Gordon writes in his April 22 letter. “Even the appearance of bias can be disquieting as well as erode confidence in the board’s presumed impartiality.”
Cubin didn’t mention in his email that he was a member of the Board of Medicine. He also told Cowboy State Daily that four of the five physicians on the state board reached out to him after he resigned, offering him support.
The legislation, Senate File 99, gives the power to the Wyoming Board of Medicine to suspend or revoke a physician or health care provider’s license for providing transgender care to minors.
Had he stayed on as a member of the board, Cubin would have had a direct role in determining the future licensing for any doctors who had illegally offered transgender care to minors, a law that goes into effect on July 1.
Sheridan pediatrician Mike Sanderson, who testified against SF 99 on behalf of the American Academy of Pediatrics, was also mentioned in Cubin’s letter.
“The whole ordeal is especially chilling when you consider that SF99 proposed to place the Board of Medicine as the authority of punishment for physicians who are determined to have broken that statute if/when it became law,” Sanderson wrote in an email to Cowboy State Daily. “This all raises the questions, ‘Could Dr. Cubin mete out fair and just punishment if he stood in judgment over a physician who broke the law that SF99 would/might become? Or would he allow his political animus to override his duty to remain impartial?’"
Controversial Email
In Cubin’s email, Sanderson was called out for what Cubin saw as the pediatrician suppressing opposing viewpoints on SF 99, failing to mention a much smaller and more conservative pediatric organization called the American College of Pediatricians (ACP) that had supported the bill.
“You need to know that Dr. Sanderson (and presumably the WMS leadership) were aware of these ACP positions and yet they were ignored and suppressed when the WMS position was established,” Cubin wrote in his email.
Sanderson said Cubin inaccurately insinuated that the Medical Society had teamed up with the American Academy of Pediatrics, of which Sanderson is a member, to oppose Senate File 99. Schamber said he considers the American Academy a leading voice on pediatrics, and the much smaller ACP as a competing group with no members in Wyoming.
“Far from WMS failing to represent the views of Wyoming pediatricians, it is, in fact, Dr. Cubin’s viewpoint that fails to represent the majority of Wyoming pediatricians,” Schamber said.
Sanderson also said Cubin attempted to paint a misleading picture of a “far-left cabal” taking over and manipulating physician representation in Wyoming in order to discredit Sanderson and the Medical Society’s Board of Trustees and nullify their standing with the Wyoming House.
“This egregious act indicates that Dr. Cubin allows his political opinions to rule his judgment to the effect of attacking physicians he disagrees with,” Sanderson wrote.
Cubin said he plans to continue his membership in WMS into the future in order to serve a watchdog role on the group.
“The only reason to be in, in effect, is to be able to report back to other physicians what they’re doing,” he said.
But he does support the positions of the group on other issues and believes in its overarching mission.
“WMS does so much good work on policy issues,” he said. “They need to leave the social issues alone and just remain neutral. There’s a lot that health care professionals in this state need and could be done to help them. Let’s focus on those things.”
Fallout
SF 99 already had strong momentum in the Legislature before Cubin’s letter, passing through the Wyoming Senate on a 26-5 vote the day before he sent it. It ended up passing the House on a 55-6 vote about one week later.
Gordon signed the legislation into law, but expressed some reluctance in doing so, calling the bill “intrusive” to the “personal affairs of families.”
Secretary of State Chuck Gray said he stands with Cubin and that the governor was wrong and hypocritical to remove him from the board.
Gordon nominated Cheyenne OB/GYN physician Rene Hinkle to the board in 2020, a role she held for about two years. During her time on the board, Hinkle testified on various bills at the Legislature, expressing pro-choice views on abortion.
“And yet, Gov. Gordon did nothing about her membership on the Board of Medicine,” Gray said on Facebook. “Gordon’s continued hypocrisy and his clear, deep-seated resentment of conservative positions is deeply disturbing.”
Leo Wolfson can be reached at leo@cowboystatedaily.com.
