HELENA (Daily Montanan) - In a Zoom meeting — temporarily hijacked by racist comments and trolling music — medical professionals, LGBTQ people, and other community members said a proposed rule requiring a judge’s order and proof of a gender-affirming surgical procedure to change the designated gender on a person’s birth certificate would harmfully impact transgender people.

“Our ability to have documents that reflect who we are is crucial … this is a life or death matter,” said Missoula psychotherapist Anna Peterson during Thursday’s public hearing. Peterson and more than a dozen other people spoke on the rule change, saying that it would be harmful to the mental health of transgender individuals, who already experience higher rates of suicide.

The hour-long meeting hosted by the Department of Health and Human Services sought public feedback on rule changes drafted by the department in reaction to recently passed legislation modifying vital statistic law. The meeting was bogged down for a short period as administrators tried to deal with blaring music and racist comments.

In public comment, opponents explained that not everyone who is transgender wants to or can afford to receive surgery, but people still want to have their gender marker on their birth certificate to reflect their identity. They also brought up safety concerns about incorrect gender markers.

“Incorrect gender markers can out a trans person anytime they need to show ID, whether that’s applying for jobs enrolling for school, or just getting a drink at a bar, this outing can lead to discrimination, harassment, and violence,” said Izzy Milch, LGBTQ+ advocacy organizer for Forward Montana.

Shawn Reagor, program director of Montana Human Rights Network, said making it more difficult for transgender people to change their gender marker on their birth certificate could have far-reaching consequences on securing housing or getting a job; he also said it sends a broader message of discrimination in the state.

“Changing this rule spreads anti-transgender sentiment and encourages hate speech, not just against the transgender community, but against all minority communities, like many of us just witnessed on this meeting … it’s extremely concerning, and not at all a coincidence, that what just happened, happened during this meeting about transgender individuals in the state of Montana,” he said, referring to the racist messages posted in the Zoom chat.

In 2017, a law was enacted that eliminated the requirement of a judge’s order to change the gender on a birth certificate. But this past legislative session, the process was replaced by Senate Bill 280.

On Thursday, the only supporter to speak in favor of the change was Sen. Carl Glimm, R-Kila, who sponsored SB280, and said the rule change was in line with the legislation passed. The bill’s passage spurred the Department of Public Health and Human Safety to draft the new rule. The rule would also amend the current language of “gender” to “sex.”

SB280 was one of a handful of bills introduced in the recent legislative session that impact the LGBTQ community. And like testimony during the session, Thursday’s meeting saw more people testify against the proposal than for it.

Cherilyn Devries said she was concerned the Legislature ignored testimony during the session by medical professionals and transgender people.

Vice President of the Montana Chapter of the American Academy of Pediatrics Dr. Lauren Wilson is one of those medical professionals. On Thursday, Wilson said the definitions in the rule change and related legislation could create confusion.

“There’s no real defining gender transition surgery,” Wilson said. “There are a number of procedures that can be done, but this is really an individual choice … There’s also no definition of surgery … does surgery involve an injection? Does it involve implants? Does it involve cutting?”

She said she is worried the requirement may make people feel pressured to get surgery, even if it goes against best practice medical guidelines. And she said the rule is unfair to those who can’t afford surgery.

“Our medical system can’t be accessed equally by all, so this excludes people on that basis as well, which is fundamentally unfair.”

Fiona, who did not spell out her last name over Zoom, said the rule was a direct attack on poor people: “If you’re poor, then you can’t transition; that means you don’t get the protection of the correct documents.”