Topline
The Republican-led Texas legislature on Thursday passed a bill banning gender-affirming care for minors in the states, following a call from Governor Greg Abbott to investigate hospitals offering similar care as Texas is expected to join a growing list from other states, including 15 this year – with legislation targeting transgender health care.
Most states have issued restrictions this year.
Timeline
The Texas legislator approved a bill it prohibits doctors from performing operations “for the purpose of changing a child’s biological sex”, operations that “sterilize the child” — including vasectomies and hysterectomies — and prescribing puberty blockers for minors, though it makes exceptions for children who are already receiving care until they “wean” all the drugs they are taking.
Florida Gov. Ron DeSantis (R) signed a bill which prohibits state doctors from providing gender reassignment services to minors, including “sex reassignment prescriptions” or medications such as puberty blockers, and includes a provision restricting adult access unless they sign a consent form (the Florida Board of Medicine previously forbidden gender transition surgeries and puberty blockers for most minors in November).
The Missouri legislature – after Governor Mike Parson said he would convene a special session to approve a ban bill which prohibits healthcare providers in the state from performing sex reassignment surgery or prescribing puberty blockers on minors unless they were already being treated before Aug. 28, and includes a provision restricting access to surgery for incarcerated adults.
Oklahoma Gov. Kevin Stitt (R)—who called for a ban on gender-affirming care was signed last year bill which prohibits doctors in the state from offering “gender transition procedures” including sex reassignment surgery or prescribing puberty blockers, with a stipulation that doctors could be charged with a felony and lose their medical license if they violate the law.
Montana Gov. Greg Gianforte (right) signed a bill that “bans Montana children from permanent, life-altering medical procedures until they reach adulthood,” and includes a provision stating that doctors could lose their one-year medical license if they violate the law.
a bill signed by North Dakota Gov. Doug Burgum (R) is banning doctors in the state from performing sex reassignment surgery and prescribing gender-affirming medications, such as those that block puberty, though exceptions are made for minors currently receiving gender-affirming care, or for minors with “genetic condition[s] sexual development” who receive parental consent.
Indiana Gov. Eric Holcomb (R) signed a bill that prohibits health care providers from “knowingly” offering “gender transition procedures” to minors, including sex reassignment surgery, hormone therapy and puberty blockers.
a bill signed by Idaho Gov. Brad Little (R) bars health care providers from providing gender-affirming care to minors if it is intended to “confirm” a gender identity other than their sex at birth, and offenders face up to 10 years in prison.
West Virginia Gov. Jim Justice (R) signed one bill which prohibits “irreversible sex reassignment surgery” and the prescription of “sex reassignment drugs”, with the exception of people born intersex – when a person’s reproductive organs do not match properly a certain gender.
Republican lawmakers Kentucky over – after to override the veto power of Democratic Gov. Andy Beshear -a bill which prohibits health care providers from providing gender affirming services to minors “for the purpose of changing the appearance or perception of the minor’s gender”.
a bill signed by Georgia Gov. Brian Kemp (R) prohibits doctors from performing hormone therapy or gender transition surgery on minors, though exceptions are made for anyone born intersex.
Doctors in Iowa were given six months to discontinue gender-affirming care for minors after a bill signed by the Republican government Kim Reynolds banned health care providers from prescribing drugs that block puberty and hormone therapy.
Tennessee Gov. Bill Lee (R) signed a bill which prohibits healthcare providers in the state from performing sex reassignment surgeries on minors, and doctors can be sued by parents or the state.
Doctors in Mississippi are allowed to offer sex reassignment surgeries, drugs that block puberty or hormone therapy to minors, according to a bill signed by Republican Governor Tate Reeves.
Healthcare providers in south dakota could lose their medical licenses and face civil prosecution if they provide gender-affirming care “for the purpose of attempting to change a minor’s appearance or validate a minor’s perception of the minor’s gender,” according to a bill signed by Republican Governor Kristi Noem.
Utah Gov. Spencer Cox (R) signed a bill which prohibits healthcare providers from providing gender affirming services and imposes an unrestricted ban on access to hormone therapy and puberty blockers.
Alabama Gov. Kay Ivey (R) signed a bill which prohibits health care providers from performing sex reassignment surgery and from prescribing hormone therapy and puberty blockers, with offenses punishable by up to ten years in prison – though the bill was blocked by a federal judge the following month.
a bill signed by then Arizona Governor Doug Ducey (R) prohibits doctors from performing sex reassignment procedures on anyone under the age of 18, though exceptions are made for anyone born intersex.
Arkansas became the first state exile gender-affirming care for minors after the state legislature voted to override a veto by then-Governor Asa Hutchinson (R).
Large number
300,000. So many children between the ages of 13 and 17 identify as transgender, according to according to estimates from UCLA’s Williams Institute, nearly 27% of whom are estimated to live in states that have banned gender-affirming care.
Chief Critic
former president earlier this year Donald Trump said he would direct federal agencies to “stop” providing gender-affirming care — which he said constituted “child abuse” and “child sexual mutilation” — for minors if he were reelected. Governor of Florida Ron DeSantis (R) has referred to gender-affirming care as “an example of waking ideology infecting medical practice.” representative Marjorie Taylor Greene (R-Ga.) said she wanted to introduce legislation that would block federal funding for gender affirming services because “the Republican Party has a duty” to be “the party that protects children.” Ivey said in a statement that she supported a bill that would ban gender-affirming care in Alabama because “if the good lord made you a boy, you’re a boy, and if he made you a girl, you’re a girl.” Reynolds supported a bill because “we just need to pause” to better understand how gender-affirming care affects children. representative David Mede (R), speaker pro tempore of Kentucky’s House, said a ban was necessary to “ensure” that gender-affirming care “isn’t something we should allow until they reach adulthood.”
contra
Several politicians and medical organizations have resisted efforts to ban gender-affirming care, arguing that treatment is often necessary because transgender children are more likely to become depressed and commit suicide. The American Medical Association said, “Medical care decisions are part of the sanctity of the patient-doctor relationship.” In 2018, the American Academy of Pediatrics said transgender youth experience “disproportionately” homelessness, physical violence, substance abuse and are often victims of harassment. The Human Rights Campaign criticized Indiana lawmakers for introducing a bill banning gender-affirmative care, saying it was “another example of extremist politicians using their power to marginalize LGBTQ+ people, particularly transgender youth.” Hutchinsona Republican, said he vetoed a bill that would ban gender-affirming care because it “puts a very vulnerable population in a more difficult position.” Beseer said after vetoing a bill banning gender-affirming care that the bill would “cause an increase in suicide among Kentucky’s youth” and “could put the children of Kentucky at risk.” After the state legislature passed a bill that would provide state funding for gender-affirming care, Gov. Wes Moore (D-Md.) said he wanted “every person in this state to know that their authentic self is good enough.”
tangent
Access to gender-affirming care in Europe varies from country to country, as national health services have debated whether there is a lack of evidence supporting hormonal treatment for minors. England, which previously had alone one facility who provided gender reassignment services, expanded access to hormone therapy and other sex reassignment treatments after a judgement indicated by the National Health Service that a single provider was “unsustainable”. The review also found that there was a “lack of consensus and open discussion” about gender dysphoria and how medical services should respond. Dr. Hilary Cass, who wrote the review, too interrogated whether children were supported if they decided not to switch. The Swedish National Board of Health and Welfare has its healthcare guidelines last year to prevent minors from accessing gender-affirming care, after that noted the “evidence base for hormonal interventions” for minors is “of low quality, and that hormonal treatments may involve risks”. The Finnish health authority issued similar restrictionsalthough both Finland and Sweden made exceptions for children showing “distress” by experiencing gender dysphoria.
Read further
Kansas approves ban on gender-affirming care – likely the next state to join wave of state restrictions (Forbes)
Indiana becomes 14th state to ban gender-affirming care, despite GOP governor’s concerns about “vagueness” (Forbes)
Kentucky becomes 12th state to ban gender-affirming care after GOP lawmakers override governor’s veto (Forbes)
