A Kansas Republican voted for a gender-affirming care ban. But then she flipped.

When Kansas state Rep. Susan Concannon learned that the state’s proposed gender-affirming care ban would gut mental health services for kids across the state, she knew she would have to break from her party. Concannon, a Republican who has represented Beloit and the surrounding counties in the Legislature for 11 years, would have to change her vote and oppose the ban.

Two hospitals — Stormont Vail in Topeka and Children’s Mercy in Kansas City — told Concannon and her Republican colleague Rep. Jesse Borjon that if the state banned gender-affirming care for trans youth, they would be forced to halt behavioral and mental health services for at-risk kids. The bill’s language was ambiguous enough to make the hospitals concerned that they would be held liable if they didn’t stop those services.

Concannon had already been in conversations with parents of transgender kids, therapists, and medical providers about the harms of the bill. But she knew she could not allow mental health services for Kansas children to be cut.

“That’s when I just decided somebody needs to take a stand,” she said.

On April 29, Concannon and Borjon, who had both voted for the bill in March, voted against overturning Democratic Gov. Laura Kelly’s veto of the proposed ban on gender-affirming care. Those two votes prevented Republicans from getting the two-thirds majority they needed to overturn Kelly’s veto. Conannon believes it was the right decision — but it has opened her up to more backlash than she expected. She’s received dozens of hate emails and text messages, primarily from people who don’t live in Kansas, alongside messages of gratitude from local clinics and hospitals.

“As you can imagine, I’ve been called everything you can think of,” she said. “But my reasoning is absolutely because I care about these kids. If we’re going to pass a bill like that, we owe it to them to get it right.”

When Concannon took the House floor to explain her vote to her colleagues, she depicted the bill to prevent health care professionals from prescribing puberty blockers and hormone treatment to trans youth as government overreach. She still believes that gender-affirming surgeries should not be performed on minors. Most transgender youth receiving gender-affirming care do not undergo surgery.

“We hear bullying and ask authorities to make it stop. We hear about mental health, about suicide, and ask why. We’re not listening to the impacted youth,” she said. “Government involvement is not the answer. I voted for this bill in the past, due to concerns about the surgery. With further consideration, this bill is vague beyond the surgery. These decisions belong between the team of professionals and the parents.”

Decisions about transgender youth taking hormone therapy and puberty blockers should be left to parents and medical professionals, Concannon told The 19th. And, she said, hospitals have told her surgeries are not being performed on minors in Kansas as part of gender-affirming care.

“As a Republican, I support smaller government and parental rights. This just seems like it goes against core Republican beliefs,” she said.

The bill would have banned hospitals or any other entity that receives state funds from being able to “pay for or subsidize the treatment of children for psychological conditions, including gender dysphoria.” The bill also bans state employees who take care of children from promoting social transitioning, which refers to using new pronouns or wearing new clothes to match one’s gender expression.

Concannon asked the statehouse legislative legal department, which writes bills and drafts amendments, for an opinion on what impact the bill would have on hospitals’ counseling and mental health services. The department agreed that there was enough gray area in the bill to cause potential liability concerns for Kansas hospitals.

The bill’s language also caused social workers and teachers to worry that they would lose their jobs for helping the kids under their care explore their gender identities, the Associated Press reported.

For LGBTQ+ advocates in Kansas, the stakes of allowing the state to pass a gender-affirming care ban were incredibly high — especially because of how many losses LGBTQ+ Kansans took last year.

In 2023, four of Kelly’s five vetoes against anti-transgender bills were overridden by Republican lawmakers, enabling those bills to become law. State lawmakers redefined “sex” to exclude transgender people from nondiscrimination protections, which allowed Kansas to be the first state in the country to ban transgender people from being able to update their driver’s licenses. They also enacted one of the most expansive anti-trans bathroom bans in the country and passed a school sports ban for transgender youths over the governor’s veto.

Concannon voted with her party in support of those bills and to override Kelly’s vetoes, enabling them to become law.

But last year, the state’s gender-affirming care ban failed to gain enough support in the Kansas Senate to overturn Kelly’s veto; which local LGBTQ+ advocates attribute to less political pressure to get a health care ban into law.

After last year’s legislative session, LGBTQ+ advocates felt like underdogs.

Two other Republicans in the state House, Kansas Reps. Mark Schreiber and David Younger, had been against the gender-affirming care bill from the beginning. But to uphold Kelly’s veto, LGBTQ+ advocates needed at least one House Republican to flip their vote.

During April recess, advocates launched a pressure campaign on a list of Kansas House Republicans who they thought could be swayed to change their vote. That list, which included Concannon and Borjon, a legislator since 2021, was eventually narrowed down to 11 target districts.

Advocacy groups bought radio and social media ads and sent mailers and doorknockers out in these Republicans’ districts. They recruited constituents to submit testimony at legislative hearings and speak at news conferences about harms to state employees; brought teachers, medical providers and parents to the statehouse; met directly with House Republicans; and directed volunteer phone banks, trying to connect the lawmakers with constituents.

“This is one of the hardest campaigns I’ve ever worked on. To defeat it, it took everything we had,” said Melissa Stiehler, advocacy director at Loud Light, a Kansas-based organization focused on issues like LGBTQ+ rights and voting rights.

“We felt like we were fighting an uphill battle,” said D.C. Hiegert, LGBTQ+ legal fellow at the ACLU of Kansas. Hiegert said they hoped that work helped to move Republican lawmakers against the gender-affirming care ban. The ultimate goal, they said, was to convey to lawmakers that Kansans did not want this bill to go into law — especially after the number of anti-LGBTQ+ bills that passed last year.

Kansas’ 2024 legislative session has now ended without the passage of any anti-LGBTQ+ bills. One law, meant to shield minors from sexual content online, has been portrayed as anti-LGBTQ+, but local advocates don’t think it will be used to curtail LGBTQ+ content in schools or libraries.

Across other states this year, anti-LGBTQ+ bills have repeatedly failed to become law — in Florida, West Virginia, Georgia, and Kentucky. Like Kansas, Kentucky in 2023 passed one of the most extreme anti-trans laws in the country; this year, Republicans failed to pass anything to restrict LGBTQ+ rights.

Still, reaching that point has not been easy for LGBTQ+ advocates. At one point during this year’s Kansas legislative session, Hiegert and other trans and queer activists were kicked out of a committee hearing while lawmakers debated banning gender-affirming care. And the ACLU of Kansas has legal fights ahead; five transgender Kansas are challenging the state attorney general’s effort to prevent trans people from obtaining accurate gender markers on their driver’s licenses.

“There is a lot of uncertainty and fear when bills like this are being debated in your state. And I think it causes a lot of pain and anxiety and angst in our community. But there’s also beautiful moments of togetherness in the advocacy,” Hiegert said. Those moments at the statehouse after anti-trans bill hearings, when queer and trans Kansans and their loved ones hugged each other, laughed and talked, are the little moments that kept him afloat this year.

For changing her vote and halting a gender-affirming care ban from taking effect in Kansas, Concannon has received messages and emails accusing her of being “despicable,” “evil” and “sick.” She has spent her legislative career trying to make kids safer, working to overhaul the state’s foster care system. The accusations that she’s somehow harming kids have been hard for her to read. They’ve also made her think about the youth who would have been most hurt by the legislation.

“If I’m hearing these kinds of responses from people for a week, I just can’t imagine what these kids have to deal with on a day-to-day basis,” she said.