The Story: Now that the state of Oregon requires Medicaid to pay for gender-reassignment (i.e., sex-change) surgery, children as young as 15 can have the procedure performed without getting parental consent—or without even notifying their parents at all.

The Background: After being lobbied by a transgender rights group last year, Oregon’s Health Evidence Review Commission (HERC) changed its Medicaid policies to approve coverage for cross-sex hormone therapy and gender reassignment surgeries. In 2013, the commission approved coverage for puberty suppression hormones for gender-questioning youth. All of these changes took effect January 1, 2015.

HERC apparently ignored the compelling evidence that sex-reassigned persons have “considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population” and that 70-80 percent of children who report having transgender feelings eventually grow out of them. In fact, according to a Fox News report, the policy “was passed without any opposition or even discussion about teenagers’ new access to undergoing a sex change.”

Members of HERC are appointed by the governor and paid by the state of Oregon, but few parent in the state were even made aware of the change before it was implemented.

Why It Matters: In evaluating a story like this, it’s important that we maintain a proper perspective on why this issue matters. To date, there have been no minors who have obtained gender-reassignment surgery under this policy change. The number who do so in the future will likely be small and the number who do so without parental consent/notification will likely be close to zero.

Of course any physical mutilation of a child as a treatment for a psychological disorder such a gender dysphoria is tragic and should be opposed. But this is merely one among many destructive transgender policies that are being implemented and that will hurt children. In that respect, it’s not different from other policies.

The primary reason this issues does matter is because it reveals a pattern of how the law is being used—and will be used in the future—to undermine the religious liberty and parental rights of Christians.

Notice that it wasn’t the medical consent law for minors that had changed. That had been on the books since 1971—years before the public even imagined it’d apply to abortions and sex-change surgery. All that was needed  to institute a radical change affecting teenagers was for an unelected group of advisors to determine that the “science is settled.” The proposal was enacted into state law before the state’s residents were ever aware of what was happening.

If a parental rights group had not brought the story to the attention of the media, most parents would have never known about it at all. Since most Oregon parents would never have been affected by this policy, ignorance of the change wouldn’t be of much direct concern. But it does raise the question of what similar policies that would affect parents are being quietly implemented by activists without most citizens even knowing about it. We’ve already seen this in the area of abortion, where parents in many states are shocked to find their child was allowed to obtain an abortion without their consent. And once such laws are on the books, it can be difficult to change them. On the issue of parental notification for abortion it has taken years—and thousands of harmed family—before changes can be implemented.  (Currently, only thirty-nine state have parental involvement laws related to abortion.)

In the past, threats to religious liberty were mainly confined to the fringes and could be safely ignored by most Christians. But societal changes, especially in the area of sexuality, have caused an overlap between issues of religious liberty and parental rights. Religious liberty is no longer just a concern we face in our churches or businesses—it’s quickly becoming an issue that affects us in our homes. Increasingly, our desire to bring up our children in the discipline and instruction of the Lord (Eph 6:4) will conflict with the state’s desire to increase individual and sexual autonomy. For the sake of our children, we need to pay attention to the policy changes that are occurring and be prepared to defend our parental duties from governmental overreach.