What’s worse than signing bills that will torment transgender children and could drive many to harm themselves?

Pretending you’re doing it reluctantly, because you care about their “best interest.”

Tony Leys is Rural Editor/Correspondent for Kaiser Health News, where this story was first published. Follow him on Twitter @TonyLeys.

KNOXVILLE, Iowa ― Bette Helm was glad to have someone to talk with about her insomnia.

Helm lives in a nursing home in this central Iowa town of about 7,500 people, where mental health services are sparse. On a recent morning, she had an appointment with a psychiatric nurse practitioner about 800 miles away in Austin, Texas. They spoke via video, with Helm using an iPad she held on her lap while sitting in her bed.

Video visits are an increasingly common way for residents of small-town nursing homes to receive mental health care. Patients don’t have to travel to a clinic. They don’t even have to get cleaned up and leave their bedrooms, which can be daunting for people with depression or anxiety. Online care providers face fewer appointment cancellations, and they often can work from home. While use of some other telehealth services may dwindle as the COVID-19 pandemic winds down, providers predict demand for remote mental health services will continue to increase in rural nursing homes.

Republicans took another step last week toward making the Iowa legislature’s 2023 session the worst ever for LGBTQ people. After letting similar bills die without committee approval as recently as 2021, the GOP fast-tracked legislation this year that prohibits transgender people from using the school restroom or locker room that corresponds to their gender identity.

The Iowa Senate passed the latest “bathroom bill,” Senate File 482, on March 7 in a party-line vote. The Iowa House approved the bill on March 16 by 57 votes to 39, with five Republicans (Chad Ingels, Megan Jones, Brian Lohse, Phil Thompson, and Hans Wilz) joining every Democrat present in opposition.

Governor Kim Reynolds is expected to sign the bill, along with legislation banning gender-affirming health care for minors. At this writing, neither bill has been forwarded to her office.

Iowa’s GOP trifecta won’t have the final word on the subject, however. Transgender plaintiffs have challenged restrictive bathroom policies in several states, and I expect one or more Iowa students to file suit soon after Senate File 482 goes into effect.

During the floor debates in the Iowa House and Senate, lawmakers pointed to key issues courts will consider as they weigh the bill’s stated goal (protecting students’ privacy) against its adverse impact on a specific group (students whose sex listed on a birth certificate does not match their gender identity).

U.S. Senator Joni Ernst is the lead sponsor of a bill that would block a new Pentagon policy designed to expand service members’ access to abortion care.

The Defense Department has long covered abortions if the pregnancy resulted from rape or incest, or if continuing the pregnancy would endanger the mother’s life. The policy announced last month affects “non-covered” reproductive care, including abortion and various fertility treatments. Haley Britzky and Oren Liebermann reported for CNN on February 16,

Moving with unusual speed last week, Iowa Republican lawmakers approved Senate File 538, which broadly prohibits gender-affirming care, including puberty blockers, hormone treatments, and surgery, for Iowans under age 18.

Governor Kim Reynolds is expected to sign the bill soon, having used several opportunities over the past year to position herself against transgender youth.

The new law would certainly be challenged in court, as similar bans prompted lawsuits in Arkansas and Alabama.

During hours-long debates in the Iowa Senate and House, lawmakers raised points that would be central to litigation over whether banning gender-affirming care violates the constitutional rights of transgender children, their parents, and medical professionals.

For this post, I’ve pulled video clips to illustrate some of the core legal questions surrounding the bill. But there is much more of value in the passionate speeches delivered about Republicans’ latest attempt to target LGTBQ Iowans. You can watch the full Senate debate here (starting around 7:32:30) and the House debate here (starting around 1:40:45).

Although Florida Governor Ron DeSantis has not formally declared his intent to run for president, he is already testing messages with Republican activists in Iowa.

A survey distributed to Iowans via text shows the governor’s team searching for points that could persuade GOP caucus-goers, not only highlighting what DeSantis has done in office—the focus of his remarks in Davenport and Des Moines on March 10— but also his military service and relative youth compared to former President Donald Trump.