(INDIANAPOLIS, Ind.) -- People who attended a total solar eclipse event at a children's museum in Indiana may have been exposed to measles, according to museum and health officials.

An infected individual traveled to the event at the Children's Museum of Indianapolis on April 8 from out of state, the Marion County Public Health Department (MCPHD) said in a news release late Friday afternoon. Melissa McMasters, administrator of infectious disease and immunizations at the MCPHD, told ABC News the local county department was informed about the infected patient from the state Department of Health.

"Measles is one of those reportable diseases that's required to be reported by law because of the public health significance of it," she said.

No information will be made available about the patient including name, age, sex, race/ethnicity or what state they are from due to privacy laws, McMasters said.

Anyone who was exposed to measles, and is susceptible, would likely see symptoms before Monday, April 22, but symptoms could appear as late as April 29, according to the health department.

There were 3,527 people in attendance on April 8, the children's museum said, adding that it sent out emails notifying households in attendance that day for whom it had contact information, as well as notified all staff and volunteers.

The first symptoms of measles typically begin seven to 14 days after exposure and include fever, cough, a runny nose and red, watery eyes, according to the Centers for Disease Control and Prevention (CDC).

About two to three days later, tiny white spots, known as Koplik spots, may appear inside the mouth, the CDC says. Not long after that, a rash breaks out, usually beginning on the face -- at the hairline -- and spreading downward, according to the CDC.

Complications from measles can be relatively benign, such as rashes, or they can be much more severe, including viral sepsis, pneumonia or encephalitis, which is inflammation of the brain.

McMasters said the risk to the general public is low because most people are vaccinated against measles and no cases have been reported yet in the county. However, anyone who suspects they may have measles is advised to stay home and to call a health care provider immediately, she said.

"We take the health and safety of our visitors, staff, volunteers and community very seriously and are following the lead of the Indiana Department of Health and the Marion County Public Health Department," the children's museum said in a statement to ABC News.

"In support of their communication, we have also shared information regarding the possibility of a measles exposure with as many individuals as possible who were here on Monday, April 8, 2024. We urge anyone with questions or concerns to reach out to their local health department or a medical professional."

This comes amid a rapid increase in the number of measles cases during the first quarter of 2024, in part due to several localized outbreaks, including at a children's hospital and daycare center in Philadelphia, an elementary school in Florida and a migrant center in Chicago.

In February, the Indiana Department of Health confirmed the state's first measles case in five years in a Lake County resident who sought medical care at three Chicago hospitals, Chicago ABC station WLS reported.

Measles is a highly transmissible virus. It's so infectious that a measles patient could infect up to 90% of close contacts who are not immune, either through prior infection or vaccination, according to the CDC.

The CDC currently recommends that everyone receive two doses of the measles, mumps and rubella (MMR) vaccine, with the first dose between ages 12 and 15 months and the second dose between ages 4 and 6.

One dose of the measles vaccine is 93% effective at preventing infection if exposed to the virus, and two doses are 97% effective, according to the CDC.

"It's really upsetting that we're investing so much time and energy, money, resources into this when we know that if we have a highly vaccinated public, we won't be seeing these cases," McMasters said. "Yes, I've been in public health for 25 years, and it kind of feels like going backwards."

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(NEW YORK) -- A public health alert has been issued by the U.S. Department of Agriculture's Food Safety and Inspection Service for ground beef products that may be contaminated with E. coli bacteria.

Raw ground beef produced by Greater Omaha Packing Co., Inc. on March 28, 2024, is no longer available for purchase so "a recall was not requested." Still, the government agency issued an alert last week to warn consumers and food service institutions who may have the product in their freezers.

"Consumers who have purchased these products are urged not to consume them and food service institutions are urged not to serve these products," the USDA alert stated. "These products should be thrown away or returned to the place of purchase."

The beef products have a "Use/Freeze by" date of April 22, 2024, and a packaging date of "032824."

Click here for the full list of products subject to the public health alert with additional label information from FSIS here.

The products have an establishment number, "EST. 960A," inside the USDA mark of inspection.

"The problem was discovered by the establishment while conducting an inventory of product that was on hold because it was found positive for E. coli O157:H7," the USDA stated. "The company notified FSIS that they inadvertently used a portion of the contaminated beef to produce ground beef products that they subsequently shipped into commerce."

At the time of publication, there have been no confirmed reports of illness due to the consumption of these products.

Greater Omaha Packing Co., Inc. did not immediately respond to ABC News' request for additional comment.

According to the Centers for Disease Control and Prevention, some E. coli can cause diarrhea, and germs can spread through contaminated food or water.

Anyone can get sick from E. coli, but adults over the age of 65, children younger than 5 and people with weakened immune systems, have an increased chance of infection.

Symptoms of E. coli, which can usually last five to seven days, include "diarrhea, which can be bloody, and most have stomach cramps that may be severe," according to the CDC, as well as vomiting and possible high fever.

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(GRANADA HILLS, Calif.) -- A mom-of-three in California is speaking out after surviving two near-death experiences in a span of six weeks.

Christina Aleksanian, 36, of Granada Hills, was recovering in the hospital after giving birth to her third child, a daughter named Stephanie, when she said she felt her hand start to go numb.

Aleksanian said she thought she was getting a migraine, but as she was talking to her daughter's pediatrician, who happened to be in the room at the moment, she became unresponsive.

"My pediatrician came in and was trying to talk to me and I don’t remember after that," Aleksanian told "Good Morning America." "My husband describes me as laying there with a very blank face."

Aleksanian's husband, Gary Galfayan, told "GMA" that just hours after he watched his wife deliver their healthy child on May 23, 2023, he saw her being rushed away for lifesaving treatment.

"I heard, ‘Code blue, code blue, stroke,’ and I remember doctors just coming in," Galfayan said.

Aleksanian was rushed into an operating room, where doctors performed a cerebral angiogram to check the blood vessels in her brain. She then underwent an emergency thrombectomy to remove a blood clot from her brain, according to Dr. Onkar Marwah, the interventional cardiologist who led Aleksanian's care at Dignity Health - Glendale Memorial Hospital and Health Center.

"This was quite immediate action that was taken to save her brain and save her life," Marwah told "GMA." We reestablished blood flow to that part of the brain so the brain could start recovering."

Doctors later determined that Aleksanian suffered a stroke due to a patent foramen ovale, or PFO, a congenital heart defect she was unaware she had.

In Aleksanian's case, the hole between the left and right atria in her heart, which typically closes shortly after birth, did not close naturally, leaving her with PFO, according to Marwah. When a blood clot formed in her body amid childbirth, it moved through the hole, bypassing her lungs and causing a stroke.

Marwah described what happened to Aleksanian as very rare, noting that most people with PFO are unaware they have the condition and that most women with PFOs go through pregnancy and delivery normally, as Aleksanian did with her two previous pregnancies.

He pointed out, though, that pregnancy does increase the risk of stroke, so women should be aware of the signs and symptoms. Signs of a stroke include sudden numbness or weakness in the face, arm or leg, sudden confusion or difficulty speaking, sudden vision changes, loss of balance or coordination and a sudden severe headache with no known cause, according to the U.S. Centers for Disease Control and Prevention.

The CDC uses the acronym F.A.S.T. to remind people of what to do if a stroke is suspected -- Check if one side of the Face drops, ask the person to raise both Arms and check if one drifts downward, check if Speech is slurred or strange and if you see any of the signs, call 911 right away to not waste Time.

"The risk [of stroke] increases at the third trimester of pregnancy and the postpartum time after delivery," Marwah said. "And when a stroke happens, the most important thing is to recognize it early and get to a stroke center ASAP, so call 911, call an ambulance to get there immediately."

Marwah said in Aleksanian's case, had the pediatrician not been in the room with her and noticed her stroke symptoms, she may not have survived.

Galfayan said doctors told him his wife was a "ticking time bomb" as they rushed her off for treatment to save her life.

In the days after Aleksanian's stroke, Galfayan rushed back and forth between her hospital room and his newborn daughter, who had to be transferred to the neo-natal intensive care unit, NICU, while Aleksanian recovered.

"I would go by the baby, and my mind is downstairs [with my wife]," Galfayan recalled. "I don’t know how we came out alive, but we did."

Aleksanian survived the stroke with no lasting complications, but spent several days in the intensive care unit before she was able to be reunited with her newborn daughter, Stephanie.

"That 10 to 15 minutes [holding Stephanie] meant the world to me," Aleksanian said. "When I saw her, I was like, 'Okay, I have to get better. I have to do everything I possibly can, all for her.'"

Around one week after suffering the stroke, Aleksanian was discharged from the hospital, and was reunited with Stephanie and her older two daughters, ages 8 and 5, at home.

She returned to the hospital in mid-June to undergo a second procedure, known as a PFO closure, to close the hole in her heart.

While recovering from that procedure, Aleksanian's life changed again when she and her family were in a multi-vehicle crash that sent them to the hospital once again.

Aleksanian, Galfayan and their three children were driving in between doctors' appointments for Aleksanian and Stephanie on June 28, when a car careened off the highway and struck their car. Los Angeles ABC station KABC-TV reported at the time that the crash injured six people, including one person who had to be extricated from the car.

"I just remember waking up to [Galfayan] screaming my name, 'Chris, wake up,'" Aleksanian said. "I get up ... and I'm just profusely bleeding."

Aleksanian and her family members were transported by ambulance to a local hospital, but all survived with no major injuries, including Stephanie, who was just 1-month-old at the time.

Now, as Aleksanian and her family prepare to celebrate Stephanie's first birthday, she said it feels like her own second birthday, jokingly describing herself as a cat who has used two of her lives in the past year. Both Aleksanian and Galfayan added that they are thankful for the "guardian angel" they feel has kept their family safe.

"It's incredible what we went through and that we're out and we're able to share our story," Aleksanian said. "I tell the story. I've lived the story. But, emotionally, I have a hard time accepting the story."
 

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(NEW YORK) -- Jazmin Evans is one of more than 14,000 Black kidney transplant candidates who found out that an outdated medical test may have inappropriately calculated their need for a transplant.

Evans, 29, was diagnosed with chronic kidney disease in January 2012. She started dialysis and was put on the kidney transplant waitlist in 2019.

"I just remember feeling, like, this is never gonna happen for me," she said, speaking with ABC News.

The U.S. faces a dire kidney organ shortage, meaning patients with kidney failure must meet certain criteria to be considered good candidates for a transplant.

One of those considerations is a test called the "eGFR" calculation, which is a measure of a person's kidney function. This metric takes into account factors like age, sex, body weight and -- until recently -- a person's race. The decision to include race was based on outdated studies that relied on an assumption that Black patients had differences in kidney function compared to other groups.

In many cases, the use of a race-based score may have contributed to Black patients being placed lower on the waitlist.

"That really was problematic, but it was very widely accepted," said Martha Pavlakis, former chair of the kidney committee with the Organ Procurement and Transplantation Network, an organization that administers the transplant system in the U.S. and maintains transplant policies. "It was what we were taught. It was what we turned around and taught other people."

In 2020, the National Kidney Foundation and American Society of Nephrology established a national task force to reassess how race is taken into account when diagnosing kidney related illnesses. The task force's final report outlined guidance stating that race variables shouldn't be applied to kidney transplant candidates, which the Organ Procurement and Transplantation Network later implemented.

As a result, some people suddenly found themselves higher on the waitlist.

In January 2023, the algorithm evaluating kidney disease changed, eliminating race as a factor.

Evans said she was shocked when she received notice of her movement up the transplant list in 2023. She shared the news on TikTok at the time, showing a letter stating that she was eligible for a "waiting time modification."

"My original wait time started April of 2019," she says in the TikTok video. "With the new calculation for Black Americans, my 'start date' would have started [in] 2015."

"At this point, I am eight years on the transplant list," she continues. "For my blood type, the average waiting time is about four to five years. I could've [had] a kidney already."

Evans' story is just one of many examples of health inequities historically ingrained in the kidney transplant system.

"Everyone says, you know, we live in this post-racial society here in America, but that's really not the truth," Evans said, speaking with ABC News.

The 29-year-old, who finally received a new kidney in July 2023, has since dedicated her TikTok account to kidney health advocacy and education.

Michelle Josephson, former president at American Society of Nephrology, called the inclusion of race factors in the previous kidney transplant waitlist evaluations inappropriate.

"Race is a social construct and it should not be included in these [tests]," she said. "It's not appropriate."

Dr. Samira Farouk, a transplant nephrologist and volunteer at the National Kidney Foundation, echoed that sentiment, stating that race is not a risk factor for kidney disease.

"One risk factor that is related to race is the racism," Farouk said, "so, thinking about decreased access to care and decreased access to medications, decreased access to optimal diabetes, and high blood pressure control."

Carole Johnson, administrator at the Health Resources and Services Administration, said the agency had long heard from families and people in the transplant field that there was room for improvement in the evaluating systems.

"Families were waiting too long and individuals were struggling with the system," she said. "It is absolutely unacceptable that there would be anything in the algorithm for allocating organs that would in any way be weighted based on race, without the science to support that."

As a result of the evaluation changes, 14,280 Black kidney transplant candidates were moved up the waitlist between January 2023 and mid-March 2024, according to Organ Procurement and Transplantation Network data. Of that group, nearly 3,000 have received a kidney transplant.

Experts say this is an example of identifying the inappropriate use of race in medical care.

"We not only attempted to eliminate it from influencing care, but [can look at it] and say, for those people for whom it may have impacted their care, can we fix that?" Pavlakis said.

The inequities don't end with kidney transplant waitlists, nephrologists pointed out. Racial biases also exist in calculations for the kidney donor profile index, which determines the quality of a donor kidney for a transplant.

"It really goes back to this initial assumption that race is a biological variable [which isn't accurate]," Farouk said.

A new mandate is in the works which would omit the race bias in calculations for kidney donor allocations. An Organ Procurement and Transplantation Network vote to change the biased donor test is set for June.

"There's a lot of issues in medicine and many other parts of our culture that speak to our very challenging history. And I think this is one of them," Josephson said. "The good news is that we have pulled race out and we've tried to rectify some of the inequities that occurred because of it."

Evans, too, said she feels "hopeful" for the future, adding that she hopes the changes end up "bringing more equity to the donation process or the transplant process."

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(NEW YORK) -- A community health initiative that partnered with the National Park Service has doctors writing a "prescription" for wellness by getting more people outdoors.

"When I look across our medical system and the ability of doctors to use all the tools that they can — our parks prescription program is probably a key to that," National Park Service Director Chuck Sams told ABC News. "Getting [people] outside into the national parks, or any park for that matter, so that they can enjoy and get through recovery, so that they can reduce their stress level, so that they can center and focus on their own personal well-being — you can't ask for a better program."

ParkRx is part of the NPS "Healthy Parks, Healthy People" effort to encourage wellness through visits to the country's 429 national parks and other green spaces.

Founded in 2013 by the Institute at the Golden Gate and the National Recreation and Parks Association (along with NPS), the ParkRx "park prescription" program has since swept across the nation.

"ParkRx is a great movement by wonderful physicians around the country trying to motivate — also to get their patients into nature," cardiologist and ParkRx advocate Dr. David Sabgir told ABC News. "The benefits are amazing. It lowers our cortisol, which lowers our blood pressure, lowers our heart rate, makes our hearts healthy and mentally just being [outside] is incredible."

Research has shown that spending time outdoors can benefit your mental and physical health in a number of ways.

Exposure to sunlight can help build vitamin D, improving immune health and muscle function, according to the Harvard T. H. Chan School of Public Health. The American Psychological Association also notes time spent outdoors can create improvements in mood, cognitive function and overall well-being, among other impacts.

Sabgir is the founder of Walk with a Doc, one of dozens of ParkRx programs across the country. The program encourages patients to get outside and walk.

He sat down with ABC News medical correspondent Dr. Darien Sutton to discuss the program in Rock Creek Park, a National Park in Washington, D.C.

"I love Walk with a Doc," Sabgir said. "Physical activity is so important for our health. And, I was failing at motivating my patients to get out, so one day, I just said, 'how about if you join my family and I at the park?' And next thing we know, it's just been a ride of a lifetime."

Sabgir said walking 150 minutes a week, or 20-25 minutes per day can provide patients with the physical and mental benefits walking has to offer.

"And if you miss a day, it's okay," he added. "The key is just sticking with it."

"And I always think about this — walking versus running," Sutton said. "Do I have to be extra — exert myself beyond or can I just simply walk?"

"Walking really gets it done," Sabgir said. "Running gets it done a little faster, but you get all the benefits from walking and it's lower impact."

Walk with a Doc board member Chaun Hightower told ABC News that, for her, "walking is medicine."

"For me, it's a form of medicine. I use walking to sort of help me decompress from work — and taking care of a family keeps you super busy," Hightower added. "And when I get outside and I start walking, it just feels freeing — like the weight of the world starts to fall off of me when I have a chance to walk."

Sams echoed the benefits of spending time in the National Parks, calling them "America's crown jewel."

"England has its crown jewels. We have the national park system," he said. "Sometimes there's the question between nature and nurture, but you get both when you actually go into a national park. You become inspired. You become relaxed. It has so many benefits of learning our history, our culture, and also just interacting with the flora and fauna."

April 22 is Earth Day, a global celebration of the environment, and a part of National Park Week in the U.S.

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(NEW YORK) -- A 4-year-old girl was discharged from Texas Children's Hospital on Thursday after waiting on the organ transplant waiting list for 1,025 days, or nearly 3 years.

The staff at Texas Children's Hospital in Houston lined the halls on April 18 to give 4-year-old Arctura, who received a donor heart on March 29, a celebratory send-off parade.

"I like my new heart," Arctura said ahead of her discharge, adding that she was looking forward to seeing "the ducks and the turtles" at the local park.

Arctura's journey has been a long one. According to her parents and doctor, the 4-year-old was born with a congenital heart defect, which the Centers for Disease Control and Prevention notes is the most common type of birth defect.

In Arctura's case, her heart's tricuspid valve didn't form as it should, causing issues with blood flow through the heart. Her heart was also dilated, causing it to be enlarged and impacting her lungs.

Arctura's parents Madelyn and Joshua Nowak told "Good Morning America" that learning of their daughter's condition at their 20-week anatomy scan was completely "devastating."

"That moment when they said something might be wrong with her heart, I knew immediately that this wasn't a little thing," Madelyn Nowak recalled. "The world slowed down and dropped out from under me. My entire reality changed in a matter of a minute."

Arctura was born April 1, 2020, in Tennessee, but after a couple of days, she was flown to Texas Children's for further treatment, and she spent the first seven months of her life in the hospital. She received surgery to try to repair her heart and was able to be discharged in time for her first Christmas at home.

After a while, however, the Nowaks said they noticed Arctura's health declining: She started vomiting more, showed signs of tiredness and had trouble breathing, they said.

In 2021, Arctura was re-admitted to Texas Children's after she went into heart failure.

Dr. William J. Dreyer, a medical director at Texas Children's, whose clinical interests include heart failure, cardio myopathy and cardiac transplantation, has been seeing Arctura since she was listed for a pediatric heart transplant.

"In her case, attempting to repair her heart didn't go well and it resulted in her developing heart failure," Dreyer explained to "GMA." "And given the symptoms that she had and the condition of her heart, it was really necessary to move forward with a heart transplant plan."

According to Dreyer, looking for a new heart for Arctura was complicated by the fact that she had developed HLA sensitization, where high levels of a certain antibody can lead to organ rejection.

"Part of what we had to do was look for a donor to which she was not sensitive to before transplant, which would have affected our ability to maintain immunosuppression in her and keep her from rejecting the new heart that she received," Dreyer said.

After nearly 3 years, Arctura qualified to receive a donor heart.

On March 29, she underwent an orthotopic heart transplant, where her old heart was removed and replaced with a full donor heart in a transplant surgery at Texas Children's that took about eight to ten hours.

Since her transplant, Arctura has been making steady progress and taking multiple medications that her care team hope to reduce over time.

"I think her prognosis is good," Dreyer said. "She will need to recover, of course, from her surgery and adapt a bit to the medicines that she's taking, which will diminish over the course of time, but at three months after transplant, I would expect her to be fully operational, if you will."

With April being National Donate Life Month, the Nowaks and Dreyer hope to encourage others to consider organ donation.

"When you look at Arctura and you see how well she's doing, I hope that people will think about the possibility of organ donation, should the circumstance occur, because it can be a very meaningful thing not only for the patient that receives the organ, but even for the donor family," Dreyer said. "At a time of tragedy, it can really can make a tremendous difference."

Madelyn Nowak, who called Arctura "the strongest person" she has ever had the privilege of meeting, also said she hopes her daughter's story will also boost awareness about congenital heart defects.

"I had not heard of congenital heart defects or fully understood them until my 20-week ultrasound, and if you go to the 5,000 foot view, that's scary that it is so common and never talked about," the mom of two said. "How many people do you know that you don't realize are affected?"

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(LOS ANGELES) -- Two couples have filed lawsuits against in vitro fertilization provider Ovation Fertility alleging its clinic destroyed their embryos when a lab employee wrongly used hydrogen peroxide instead of a sterile solution in an incubator.

The couples allege that the clinic still used the embryos despite knowing they were nonviable. Neither woman got pregnant.

In two nearly identical lawsuits filed on Thursday against Ovation Fertility in Newport Beach, California, two unnamed couples are asserting multiple claims, including negligent misrepresentation, fraud, negligence and medical battery. The couples are not revealing their names in the lawsuits to protect their privacy, according to the suits.

Embryos belonging to likely dozens of patients were destroyed by hydrogen peroxide in the latter half of January 2024, the couples' attorney, Adam Wolf, said in a press conference Thursday.

The clinic did not realize there was a problem with the embryos until they saw low success rates for implantation in January and investigated why, Wolf told ABC News. Wolf said Ovation Fertility then reached out to at least some of the impacted patients.

Pennsylvania board's cancellation of gay actor's school visit ill-advised, education leaders say
Ovation Fertility told ABC News it has protocols in place to protect the "health and integrity of every embryo under our care."

"This was an isolated incident that impacted a very small number of patients, and we have been in close contact with those patients since this issue was discovered. We are grateful for the opportunity to help patients build a family and will continue to implement and enforce rigorous protocols to safeguard that process," Ovation Fertility said in a statement to ABC News.

The couples allege they may not be able to have children who are biologically related to them -- since they say they have no more viable embryos -- because of Ovation Fertility's actions.

In the suits, the couples claim the hydrogen peroxide killed their embryos before they were transferred and that there was no chance they would become pregnant.

The suits, filed in California Superior Court, seek jury trials and are asking for an unspecified amount of damages.

The couples allege that the clinic put an extremely unsafe amount of hydrogen peroxide in an incubator used to store the embryos and failed to have the proper procedures and protocols in place to ensure the toxic incubator would not harm their embryos despite the clinic's claims to the contrary.

"Hydrogen peroxide is something that can be in the lab of a fertility clinic; there is nothing wrong with that," Wolf said. "What was entirely wrong about this was the levels and concentration of hydrogen peroxide that was used in this incubator apparently having mixed up hydrogen peroxide and a sterile solution," Wolf said at the press conference.

"This was an error that had massive implications for likely dozens of patients," Wolf said. "This killed their embryos. In certain states, those are human beings."

They also allege that the clinic did not properly train their employees on how to operate, manage or maintain the embryo incubator.

The couples also allege they were told their embryos were viable and had not been harmed at the time of the transfer, despite allegedly knowing that this was not true.

Pennsylvania board's cancellation of gay actor's school visit ill-advised, education leaders say
One couple said they only had one genetically normal embryo and it was destroyed in the incubator.

The other couple said they underwent two separate egg retrievals and had two high-quality embryos that were destroyed in the toxic incubator.

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(NEW YORK) -- Misty Stamm was working tirelessly to figure out the details: waking up early, the hourslong drives, booking hotels and finding doctors who could legally administer gender-affirming hormone therapy to her 16-year-old transgender daughter.

Stamm is living in one of the 24 states where legislation is restricting gender-affirming health care for transgender youth, so she and parents like her must make long, expensive trips out of their home states to find the care their children need, according to a new report from the Southern Equality Research and Policy Center.

“If we didn't have the care, I don't think she'd be alive,” said Stamm.

Stamm, who lives in Tennessee, drove five hours to get her daughter to a gender clinic in Ohio when her family first started considering care options. She wanted her daughter to be seen by a physician in person.

With new gender-affirming care restrictions set to go into effect soon in Ohio, Stamm and her daughter have since turned to a telehealth provider in Virginia.

However, they still have to drive two hours to Virginia for the online appointment, as to not break Tennessee law, which also bans telehealth providers from providing care and treatments like puberty blockers and hormone therapies to a minor located in the state.

Stamm told ABC News that the time, effort and money they’re spending to access care is worth it.

When she came out as transgender at 13, “the mental health issues stopped completely,” said Stamm. “That affirmed to us that this was the right thing.”

Stamm's daughter had been in counseling and therapy since she was in fifth grade, struggling with her mental health and experiencing depression, anxiety and suicidal ideations.

At age 14, Stamm's daughter received puberty blockers to temporarily pause the development of physical sex characteristics. As her daughter grew older, the family and physicians together decided to move forward with hormone therapy. Throughout this process, they said, psychologists and therapists were consulted and were required for approvals.

“There's no talk of surgery or anything like that,” said Stamm. “That's a decision that she can make when she is an adult.”

Meanwhile, her mental health has progressed exponentially -- Stamm said her daughter has since been released by her therapist and is only seen occasionally, as needed.

"She's just doing so well, and if we didn't have access -- we have to have it. She has to have it," she said.

Gas, airfare, lodging and other expenses to cross state lines and access gender-affirming care could cost hundreds to thousands of dollars, the Southern Equality report states.

Stamm says she and her husband have spent likely thousands of dollars in travel costs to get care and are anxiously awaiting the day their daughter turns 18 so she can access care more freely.

The report from Southern Equality Research and Policy Center found that it could take almost 20 hours of driving roundtrip for some families across the South and Midwest to reach a state where trans youth care is legally accessible.

Families with transgender children across southern Florida, Louisiana, Missouri and Texas are the hardest hit, according to the report -- they would need to take a more than eight-hour car ride one way to get to a clinic that serves trans youth.

Jennifer, an Austin, Texas, resident who asked to go by a pseudonym for safety concerns, said the health care bans in her state threw her family into logistical and financial chaos.

Her 15-year-old daughter’s appointments to begin hormone therapy were canceled before the law in Texas even went into effect. When they sought out care in Louisiana, providers also were canceling appointments.

She sought out the help of local advocacy groups to help her family find a provider in Texas' neighbor to the west, New Mexico.

However, the costs continue to mount: “We are in a position that we could afford to buy plane tickets and stay in a hotel for a couple of nights and pay all of the out-of-pocket expenses for the medical care,” said Jennifer. “For a lot of people, that's probably not an option.”

Though telehealth has expanded opportunities for access to care, policies like those in Tennessee restrict these appointments for prescriptions from happening in the state and force some families like the Stamms to cross borders for online appointments.

Tennessee Gov. Bill Lee, who signed the gender-affirming care ban, has defended the bill against legal challenges.

"Tennessee is committed to protecting children from permanent, life-altering decisions," said Lee in a post on social platform X after the Justice Department argued the law violates the Fourteenth Amendment's Equal Protection Clause.

Supporters of gender-affirming medical care bans argue that children should wait until they’re older to make these medical decisions, and that there needs to be more research on the impact of these procedures on patients.

In the state’s court filings in opposition to a lawsuit against the ban, the state invokes Dobbs v. Jackson Women’s Health Organization -- the decision which overturned Roe v. Wade and ended federal protections for abortion rights.

The state argues that Dobbs allows states “to regulate medical treatments” and that it does not discriminate against transgender people because “not all transgender individuals use puberty blockers, hormones, or surgery.”

“This Court should acknowledge divergent views and hold that the responsibility to choose between them rests with the people acting through their elected representatives,” read the state’s filing.

The Tennessee Legislature is now considering a bill that could make it a felony to help a minor access gender-affirming care out-of-state without parental consent.

Transgender care for people under 18 has been a source of contention for state politicians in recent years, impacting a group estimated to make up less than 1.5% of the population ages 13-17, according to an estimate from researchers at the University of California, Los Angeles.

Often due to discrimination, stigma, and gender-related stress, trans youth are at increased risk for poor mental health and suicide, substance use, experiencing violence, and other health risks, according to the Centers for Disease Control and Prevention.

Major national medical associations, including the American Academy of Pediatrics, the American Medical Association, the American Academy of Child and Adolescent Psychiatry, and more than 20 others have argued that gender-affirming care is safe, effective and medically necessary.

“Allowing them to live in their identity is what saves their mental health,” Jennifer said in response to criticism over transgender medical care.

As families continue to seek out avenues for care, Jennifer and Stamm want lawmakers to know that they're just a "normal, regular family."

“I want them to see us as people,” Jennifer said. “We are their neighbors, we are people who teach their kids in school. We are people they work with.”

Stamm adds, "She's just a regular kid, just trying to be a regular kid. … This has just presented so many challenges for her and we feel isolated. Our circle is tight and small ... Hopefully, people will be a little bit more empathetic to what we're going through. And how ridiculous all of this is."

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(NEW YORK) -- Heat-related emergency room visits increased in 2023 in the U.S. compared to previous years, according to new federal data.

Between Jan. 1, 2023 and Dec. 31, 2023, there were a total of 119,605 ER visits for heat-related illnesses, with 92% of those visits occurring between May and September, according to a report published Thursday by the Centers for Disease Control and Prevention.

July and August had higher than average ER visits due to heat than other warm-season months, including May, June and September, according to the report, which looked at data of ER visits caused by heat in 2023 and compared it t visits between 2018 and 2022. These findings are "consistent with record-breaking temperatures observed … in 2023." said the CDC.

The risk of heat-related ER visits during July and August 2023 was more than three times that seen in May, June, and September.

By comparison, the risk during July and August from 2018 to 2022 was about twice as high as in May, June and September of the same period.

The study also found some regions of the U.S. -- as defined by the Department of Health and Human Services -- saw higher risk in 2023 than others. The states of Arkansas, Louisiana, New Mexico, Oklahoma and Texas were most impacted with reported risk of nine times the risk of New York and New Jersey.

These regions also saw their daily ER visits for heat-related illness rates in 2023 exceed the 95th percentile reported between 2018 and 2022.

Every U.S. region saw at least one day in 2023 above the 95th percentile. In the southwestern and western U.S, heat-related ER visit rates in July 2023 exceeded the 2018 to 2022 95th percentile for 16 and 18 consecutive days, respectively.

Additionally, the southwestern and lower Midwestern U.S. experienced days with the highest rate of heat-related ER visits recorded for the respective region since 2018.

When broken down by sex and age, the report found more men than women sought care in ERs for heat-related illnesses in 2023 at a rate of 271 per 100,000 ER visits for males compared to 104 per 100,000 visits for females.

Adults between ages 18 and 64 also had higher rates in 2023 with a range of 207 to 222 per 100,000 visits compared to the range of 120 to 173 per 100,000 visits for adults aged 65 and older.

This data aligns with how extreme heat events in the U.S., and around the globe, are becoming more frequent and more intense. Summer 2023 was Earth's hottest since global records began in 1880, according to NASA.

Several cities across the U.S. saw record-breaking triple-digit temperatures in summer 2023. El Paso, Texas, saw a record stretch of 44 consecutive days at or over 100 F in June and July, and Phoenix, Arizona saw a record of 31 days at 110 F or higher.

Additionally, Americans could see an average of 53 more days of extreme heat by 2050 if greenhouse gas emissions aren't reduced, according to climate modeling data from the the ICF Climate Center.

"Deaths and illnesses associated with heat exposure are a continuing public health concern as climate change results in longer, hotter, and more frequent episodes of extreme heat," the authors of the report wrote. "Near real-time monitoring of weather conditions and adverse health outcomes can guide public health practitioners' timing of risk communication and implementation of prevention measures associated with extreme heat."

ABC News' Julia Jacobo contributed to this report.

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(NEW YORK) -- Racial and ethnic disparities in health care are evident in every state, even those with robust health systems, according to a new analysis from the Commonwealth Fund.

In the analysis from the organization, which is aimed at promoting equitable health care, researchers found health system performance is markedly worse for many people of color compared to white people.

"Even among high performing states, we see significant disparities," Joseph Betancourt, M.D., president of the Commonwealth Fund, said in a report on the organization’s updated findings.

Six states were found to have better-than-average health system performance among all racial or ethnic groups, including Rhode Island, Massachusetts, Connecticut, Hawaii, New Hampshire and New York. However, even among these high-scoring health systems, racial disparities were observed.

"This report demonstrates that if you don't look under the hood, you won't identify where you're failing people and where you're leaving people behind," Betancourt said.

Particularly when looking at health outcomes, large disparities in premature deaths from avoidable causes are apparent in all states. Black, and American Indian and Alaska Native (AIAN) people are more likely to die before age 75 from preventable and treatable causes, including, but not limited to, some infections such as appendicitis and certain cancers, than white populations, according to the analysis.

There are also large disparities in health care access between white people and other racial or ethnic groups across all states. Despite coverage expansion by the Affordable Care Act in recent years, states' uninsured rates are generally higher and more variable for Black, Hispanic, and AIAN adults compared to Asian American, Native Hawaiian, and Pacific Islander (AANHPI) and white adults, according to the analysis. In particular, Hispanic people had the highest uninsured rates and cost-related difficulties in accessing care in almost all states.

"These groups have more problems accessing care and if quality of care is lower, then they have worse health outcomes compared to white people in many states," Senior Scientist David Radley, Ph.D., of the Commonwealth Fund, said in the report.

The analysis, which was done using publicly available databases reporting outcomes from more than 328,000,000 people during the years 2021 and 2022, concluded that achieving health equity requires policy action and health system action, including:

• Ensuring affordable, comprehensive, and equitable health insurance coverage for all
• Strengthening primary care
• Improving health care quality and delivery
• Health systems and providers prioritizing and centering equity
• Investing in social services
• Improving the collection and analysis of racial and ethnic data to identify gaps
• Developing equity-focused measures to inform and evaluate policy

"Some of the major takeaways of this work is that we still have a lot of work to do," Senior Scholar and Commonwealth Fund Vice President Sara R. Collins said in the organization’s report. "Maybe in a decade we'll look at this data and we'll see some of these gaps closing.”

Dr. Laurie Zephyrin, a senior vice president for the Commonwealth Fund, said undertaking the prescribed action will likely help.

"The reality is we can't improve healthcare if we're not accurately measuring and tracking these outcomes and experiences and using real data as a guidepost to ensure that we are advancing towards equity. ... All these comprehensive actions are truly a start. It really can help us move forward to advance health equity and address many of the inequities that we talked about today," she said in the report.

The Commonwealth Fund’s State Scorecard on Health System Performance series evaluated each state’s health care system and is a tool developed to understand health inequities and disparities. It uses 25 data indicators to designate a "State Health Equity Score," which indicates each state health system’s performance based on health care access, quality, service use and health outcome. Scores were also determined for each of five racial or ethnic groups (Black, AIAN, AANHPI and Latinx/Hispanic) during the years 2021 and 2022, notably incorporating post-pandemic effects on health disparities.

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(NEW YORK) -- Nobel Prize-winning molecular biologist Venki Ramakrishnan sat down with ABC News Live to discuss the science and ethics of extending the human lifespan.

In his new book, "Why We Die: The New Science of Aging and the Quest for Immortality," Ramakrishnan explains why we may not want to lengthen our lives much longer.

Ramakrishnan's thought-provoking argument is that a society where people lived for hundreds of years could potentially become stagnant, as it would consist of the same group of people living longer, raising important questions about societal dynamics and progress.

He discussed the cycle of life and why we die.

ABC NEWS LIVE: If you think it might be wonderful to live forever, you may want to hear what a Nobel Prize-winning molecular biologist has to say that could change your mind. Venki Ramakrishnan has examined the latest science, weighed the possibilities and researched the ethical cause of lengthening our lifespans in his new book, 'Why We Die The New Science of Aging and the Quest for Immortality.' Doctor, thank you so much for joining us.

RAMAKRISHNAN: Thank you.

ABC NEWS LIVE: So humans now live twice as long as we did 150 years ago. But you raise some, some caveats to why we may not want to lengthen our lives that much longer. Why is that?

RAMAKRISHNAN: Well, I think a society where everybody lived indefinitely or very long time, say, hundreds of years would be a very different society. It would be quite stagnant. It'd be the same group of people just living longer and longer.

You wouldn't have that turnover between generations. You know, maybe new ideas, things like that. But I think that's still in the realm of science fiction. I think biology is looking at the causes of aging, and that's allowing us to tackle some of these causes. But most of the focus is how to live healthily for longer, because all developed societies are living longer lives.

So we're having more and more older people well past retirement. And we want to see how can we keep older people healthy and productive, you know, and energetic and and actually lively. So I think a lot of biology is trying to understand those causes so we don't suffer some of the debilitating consequences of aging.

ABC NEWS LIVE: Explain why it is that sometimes our biological age doesn't match our chronological age.

RAMAKRISHNAN: That's because aging you can think of as an accumulation of damage as over time. And we have very sophisticated repair mechanisms, and we have ways to deal with the problems of old age, of the accumulation of damage, accumulation of garbage in the cells. We have recycling mechanisms and all those things break down. And the rate at which they break down is different for different people.

ABC NEWS LIVE: Explain the new research, though, that talks about how there are certain blood markers that indicate why people age faster than others, and we could say this is separate from drinking and smoking or lack of sleep.

RAMAKRISHNAN: Yeah. So blood -- there are different markers for aging. So some markers are on our DNA. Our DNA acquires marks called epigenetic marks as we age. And that changes the pattern with which we express different genes.

So it changes how our biology works. There are also markers in our blood. And this was found because when they connected an old animal with a young animal and allowed them to exchange their blood supply, the old animal benefited from the young blood. And that suggested these things in younger blood that deteriorate or don't exist or have changed in older blood. And people are trying to find what those markers are.

ABC NEWS LIVE: Let's say in the next few decades, we're able to come up with cure for, for cancer, high blood pressure, diabetes. What's the best-case scenario, do you think, for the longevity of human life?

RAMAKRISHNAN: So someone did a calculation. And if we eliminated some of the major causes of fatality today, like the things you mentioned, you would only gain about 15 years. But what biologists think is if you tackle the underlying causes of aging, then you could really, expect to, live a longer and healthier life.

ABC NEWS LIVE: Really fascinating. Doctor, we thank you so much for joining us. Want to let our viewers know "Why We die? The New Science of Aging and the Quest for Immortality" is now available wherever books are sold.

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(NEW YORK) -- The New York Department of Health and Mental Hygiene has released a health advisory after multiple cases of human leptospirosis -- an infection that is associated to exposure to rat urine -- have been reported so far this year in New York City.

There were 24 cases of leptospirosis in the city in 2023, higher than in any prior year, according to the NYC Department of Health and Mental Hygiene.

However, in the first quarter of this year alone, there have already been six to date.

“For comparison, the average number of locally acquired cases during 2021 to 2023 was 15 per year, and 3 cases per year during 2001 to 2020,” health officials said. “This year, 6 cases have been reported as of April 10, 2024.”

“Among the 98 locally acquired cases reported from 2001 to 2023, the median case age was 50 years (range 20 to 80 years), usually male (94%) and, reported most often from the Bronx (37), followed by Brooklyn (19), Manhattan (28), Queens (10), and Staten Island (4),” said the NYC Department of Health and Mental Hygiene.

Those suffering from severe leptospirosis have acute renal and hepatic failure and, occasionally, severe pulmonary issues, health officials in New York City said. However, symptoms may include fever, headache, chills, muscle aches, vomiting, diarrhea, cough, conjunctival suffusion, jaundice, and rash, the city said.

The incubation period is usually five to 14 days but it is possible for it to last between two to 30 days. If leptospirosis is not treated, kidney failure, meningitis, liver damage, and respiratory distress can occur.

There were a total of six deaths caused by leptospirosis from 2001 to 2023 in New York City, according to the NYC Department of Health and Mental Hygiene.

“In NYC, locally acquired cases typically have a history of a residential or occupational exposure to rat urine or environments (including soil and water) and materials contaminated with rat urine (e.g., handling trash bags or bins containing food waste)," health officials said in their press release regarding the uptick in cases of leptospirosis. “Person-to-person transmission is rare. The NYC Health Department conducts inspections and works with property owners to remediate rat conditions, if indicated.”

According to the NYC Department of Health and Mental Hygiene, leptospira bacteria are fragile and can die within minutes in dry heat or freezing temperatures.

“The cold winters of NYC likely limit the extent to which leptospires can survive in the environment,” health officials said. “However excessive rain and unseasonably warm temperatures, factors associated with climate change, may support the persistence of leptospires in more temperate areas like NYC.”

In 2023, half of the locally acquired cases were reported in the months of June (five) and October (five), months that were warmer and wetter with excessive rain and unseasonably warm days compared to prior years, according to the NYC Department of Health and Mental Hygiene.

Cases of leptospirosis must be reported to the NYC Health Department within 24 hours and more information about the illness can be found on the New York City Health Department and CDC websites.

“As always, we appreciate your collaboration in improving the health of New Yorkers and helping us direct remediation efforts in New York City,” said Celia Quinn, Deputy Commissioner of the Division of Disease Control in New York City.

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(NEW YORK) -- A trade association is calling on melatonin makers to follow new guidelines on labeling and packaging for their products amid a rise in emergency room visits and calls to poison centers for accidental ingestion of melatonin by children.

The new guidelines, announced Monday by the Council for Responsible Nutrition, which represents the dietary supplement and functional food industry, call for melatonin-containing products to be sold in child-deterrent packaging and to caution consumers on the label that the products are for intermittent use only, may cause drowsiness and should not be taken with alcohol.

The guidelines also focus specifically on melatonin products that are sold in the shape of gummies, which can be more appealing to kids.

The guidelines call for melatonin-containing gummy products to also be packaged in child-deterrent packaging, and in packaging with clear warnings on the label that the gummies are to be used "under appropriate conditions and guidance."

Labels on melatonin-containing gummy products intended for children under 4 years old should also contain a warning that they could "present a potential choking hazard," the group said.

Melatonin is a hormone that plays a role in sleep, according to the National Institutes of Health.

In the United States, melatonin supplements are considered dietary supplements, which means they are accessible to the public without the regulations of a prescription drug.

The new guidelines issued by the CRN are voluntary, meaning it will be up to the manufacturers of melatonin products to decide if they are put into effect.

In March, the U.S. Centers for Disease Control and Prevention released new data showing that between 2019 and 2022, there were approximately 11,000 emergency room visits involving children aged 5 years and under who ingested melatonin unsupervised.

The data followed previous findings from the CDC that over the past decade, the number of children overdosing on melatonin has increased by 530%.

In 2021 alone, more than 50,000 calls were placed to poison control centers in the United States regarding melatonin ingestion by kids, the CDC found.

According to the study's authors, "increased sales, availability, and widespread [melatonin] use have likely resulted in increased access and exposure risk among children in the home."

Because melatonin is a hormone, there is a possibility that taking it by supplement for several years could impact a child's hormonal development like puberty and menstruation, according to the NIH. However, studies have produced inconsistent results and more studies involving children are needed to understand the extent of effects on development.

Even in adults, according to the NIH, the long-term impacts of melatonin are not well-known, even if the supplement does appear to be mostly safe with short-term use.

The American Academy of Pediatrics recommends any use of melatonin by kids be directed by a pediatrician.

When a child ingests melatonin without adult supervision, it is a medical emergency that requires immediate action, such as calling 911 or calling a poison control center at 800-222-1222.

Symptoms of melatonin ingestion in kids includes abdominal pain, nausea or vomiting, excessive tiredness and labored breathing.

ABC News chief medical correspondent Dr. Jennifer Ashton, a board-certified OB-GYN and obesity medicine physician, said parents should not only keep medications out of sight and reach of children, including teenagers, but also should have conversations with their kids about medication safety.

"You always want to use any medication exposure as an opportunity to really teach that child about medication, that it should only be given by an adult, is not candy and can have consequences both good and bad," Ashton said previously on ABC's Good Morning America.

The CDC also has additional tips here for keeping medication safely away from kids.

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(NEW YORK) -- The Centers for Disease Control and Prevention -- alongside the U.S. Food and Drug Administration and local and state health departments -- is continuing to investigate after 19 people across nine states have experienced harmful reactions after being given botulinum toxin injections.

The injections were either counterfeit or administered by unlicensed or untrained individuals and/or in non-health care settings, including homes or spas, according to the CDC.

On Tuesday, the FDA issued an alert to health care professionals and consumers that "unsafe counterfeit versions of Botox" were found in multiple states, warning that bogus or mishandled Botox products can lead to serious complications.

What is Botox?

Botulinum toxin is a neurotoxic protein made from a toxin produced by the bacterium Clostridium botulinum.

It blocks chemical signals from the nerves that cause muscles to contract. The muscles temporarily relax, reducing the appearance of wrinkles. Botox is the most common brand name of the injection.

Botox is most often used on the face to reduce forehead lines, frown lines and crow's feet but can also be used for people with excessive underarm sweating, muscle disorders such as cerebral palsy, neck spasms, overactive bladder, migraines and other conditions.

Why can Botox injections be dangerous?

Forms of purified botulinum toxin are approved by the FDA for certain medical and cosmetic treatments, according to the Mayo Clinic.

They are considered safe when administered by licensed health care providers who meet medical control standards as dictated by the FDA.

However, when Botox is not correctly prepared, stored or administered, it can lead to a rare but serious illness called botulism, which is when the toxin attacks the body's nerves. This can cause muscle paralysis, difficulty breathing and even death.

Botulism is treated with an antitoxin, which prevents the toxin from causing any more harm, according to the CDC. Fewer than five of every 100 people with botulism die, the agency says.

But even with antitoxins and medical care, people may suffer from fatigue or shortness of breath for years after the infection has cleared.

What to know about the latest series of illnesses?

So far, 19 people across nine states -- including Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee and Washington -- have reported harmful reactions, according to the CDC.

The patients -- all of them female -- received the injections from unlicensed or untrained individuals or in non-health care settings.

The patients' ages ranged from 25 to 59 years and the overwhelming majority, 95%, reported receiving injections for cosmetic purposes.

Patients said they experienced a variety of symptoms including blurry vision, double vision, drooping eyelids, dry mouth, difficulty sweating, slurred speech, fatigue, weakness sand difficulty breathing.

Nine were hospitalized and four were treated with botulism antitoxin because of concerns the botulinum toxin could have spread beyond the injection site.

According to the CDC, five patients were tested for botulism. The results were negative.

If you are considering botulinum toxin injections

If you are considering getting Botox, the CDC recommends asking the provider if they are licensed and trained to administer the injection. Some states have tools that allow patients to look up if the provider or setting has the appropriate license.

Additionally, patients should ask if the product has been approved by the FDA and if it has been obtained from a reliable source.

If there is any doubt about the provider, the setting or the product, the CDC advises against the injection.

"Botox injections are a medical procedure and should only be performed in a medical office by board-certified dermatologists or an appropriately trained non-physician clinician, under the direct on-site supervision of a board-certified dermatologist," according to a statement from the American Academy of Dermatology.

If you receive the injection and are experiencing any symptoms of botulism, the CDC says to see your health care provider or to go to the emergency room immediately.

How to tell if a Botox product is counterfeit

AbbVie and Allergan -- which is part of AbbVie -- are the only approved Botox manufacturers and there is currently no evidence the harmful reactions are linked to the genuine product, according to the FDA.

There are some signs that a version may be counterfeit, including the outer carton and vial containing lot number C3709C3 as well as the outer carton displaying the active ingredient as "Botulinum Toxin Type A" instead of "OnabotulinumtoxinA."

If the outer carton and vial indicates 150-unit doses, this is counterfeit because it is not a unit made by AbbVie or Allergan. Genuine products come in 50-, 100- and 200-unit doses.

Additionally, outer cartons that contain a language that is not English are counterfeit.

People who suspect counterfeit Botox products are encouraged to file a report with the FDA.

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(TOPEKA, Ks.) -- Kansas Gov. Laura Kelly, a Democrat, vetoed a ban on gender-affirming medical care for transgender youth in the state.

"This divisive legislation targets a small group of Kansans by placing government mandates on them and dictating to parents how to best raise and care for their children," said Kelly in a veto message on Friday. "I do not believe that is a conservative value, and it's certainly not a Kansas value."

She vetoed a similar bill almost one year ago, saying, "Companies have made it clear that they are not interested in doing business with states that discriminate against workers and their families."

She continued, "By stripping away rights from Kansans and opening the state up to expensive and unnecessary lawsuits, these bills would hurt our ability to continue breaking economic records and landing new business deals."

State GOP legislators may be able to override Kelly's veto.

The legislature would need a two-thirds vote to override the veto -- 84 in the House and 27 in the Senate. The Republican-backed bill has enough votes in the Senate to override the veto. In the House, two House Republicans who were previously registered as absent would need to also vote in favor of the bill to override the governor's veto.

This bill restricts puberty blockers, which trans minors may use to delay the development of gendered characteristics. Puberty blockers are reversible and widely used on children who experience puberty earlier than what is typical.

The bill also restricts hormone therapy, which older minors may use for desired changes to certain gendered characteristics that are less reversible, including their body, hair or voice. The bill also restricts surgeries, which physicians say are rare for minors and only done in severe cases.

However, the bill allows exceptions for these procedures on minors who are intersex, have ambiguous sex characteristics, or have disorders of sex development.

Health care providers who violate these provisions could be subject to civil action and have their license revoked if the bill is passed.

The bill also restricts state employees or state facilities from supporting a minor's social transitioning -- including a change in pronouns or name, how they are dressed, and more.

Supporters of gender-affirming care bans say gender-affirming care is harmful for minors. Some argue trans youth should wait until they're older to access gender-affirming care.

Kansas Senate President Ty Masterson, a Republican, applauded the legislation's passage through the legislature.

"The Senate took a firm stand in support of helping and not harming children by making it clear that radical transgender ideology and the mutilation of minors is not legal nor welcome in Kansas," Masterson said.

Critics of the gender-affirming care ban called the bill "more extreme and misinformed than similar bills in other parts of the country."

"In addition to depriving parents and families of medical freedom, this bill actually punishes teachers, doctors, nurses, and more for just doing their jobs by respecting and supporting Kansas kids, including transgender kids," said the ACLU of Kansas in a statement asking Kelly to veto the bill.

Transgender youth, often because of gender-related discrimination and gender dysphoria, are more likely to experience anxiety, depressed mood, and suicidal ideation and attempts, according to the Centers for Disease Control and Prevention.

A recent study in the New England Journal of Medicine found that hormone therapy can improve the mental health of transgender adolescents and teenagers.

Restrictions on access to gender-affirming care for transgender youth have been passed in at least 23 states, some of which have faced legal challenges that argue such bans violate the rights of the youth, their families and their medical providers. Gender-affirming care bans have been blocked in court in Arkansas, Idaho, Florida and Montana, but have been allowed in others.

According to the ACLU, more than 480 anti-LGBTQ bills have been introduced across the the U.S. At least 135 of those bills are no longer progressing through state legislatures, according to the ACLU.

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