Which States Restrict Transgender Health Care
Data: ACLU; Map: Alice Feng/Axios
Politicians in red states are imposing new limits on gender-affirming care for transgender people, creating a patchwork of sanctions against health providers who offer such services and limits on access.
By the numbers: More than 100 pieces of legislation introduced in state legislatures in 2023 focus on banning certain aspects of gender-affirming medical care, according to data from the American Civil Liberties Union.
Proponents of the measures have called treatments claiming the genre “harmful” and “experimental” medical procedures. But such care has been deemed medically necessary and potentially life-saving for transgender youth by leading medical associations, including the American Medical Association and the American Academy of Pediatrics.
State of play: Utah enacted a law in January banning gender-affirming health care for transgender youth. Since then, Mississippi, South Dakota and Tennessee have followed suit.
Arkansas in 2021 became the first state to outlaw gender-affirming care for patients under 18, but the ban is being challenged in court. A similar law in Alabama is also pending. Arizona enacted a law in 2022 banning the provision of gender-affirming care to trans people under the age of 18. This law is expected to come into force in March. Florida last year became the first state to enact a ban by a non-legislative body, using a medical board appointed by Governor Ron DeSantis. Legal experts fear this will set a precedent for restrictions on other forms of health care. Florida Republicans have turned to executive action by DeSantis – who has openly opposed gender-affirming care for minors – after a failed legislative attempt, legal experts say. In Texas, Governor Greg Abbott issued a directive ordering state agencies to investigate child abuse parents for seeking gender-affirming care for their trans children.
Reality check: 71% of LGBTQ youth — including 86% of trans and non-binary youth — say the debate over state restrictions on LGBTQ youth has had a negative impact on their mental health, poll finds by The Trevor Project, which features crisis intervention and suicide. prevention services for LGBTQ youth.
Between the Lines: Most anti-trans bills seek to ban gender-affirming care for people under 18, but some states have introduced measures that extend to adults.
Kansas, South Carolina, Oklahoma and Texas have bills pending in their legislatures to ban care for people under 21. Texas also proposes a ban for people under 26.
Zooming in: Texas and Wyoming have bans that also classify gender-affirming care as child abuse under state law.
What else is going on: State legislators like Indiana, Kentucky, Missouri and Oklahoma have introduced bills banning the use of public funds to pay for medical care claiming the gender, as well as to prevent insurers from providing coverage.
What they say: Opponents say the measures impose restrictions on the doctor-patient relationship.
“Decisions about transgender medical care should be made between trans patients, their families, and their doctors — not by politicians,” said Kasey Suffredini, vice president of advocacy and government affairs at The Trevor Project.
Meanwhile…Lawmakers in at least 21 states are working on “trans refugee laws” that would allow foreign patients to seek gender-affirming care within their borders to avoid criminal prosecution, a said Elliot Imse, executive director of LGBTQ Victory Institute, an advocacy group working with state lawmakers across the United States
Below are the top barriers to anti-trans healthcare in the 2023 legislative cycle.
Anti-trans health care bills that have been signed into law
Arkansas: SB 199 makes it easier to sue health care providers who provide gender-affirming care to a minor, bringing back the state-blocked ban.
Mississippi: HB 1125 states that healthcare providers cannot offer gender-affirming surgeries, puberty blocking, or hormone therapy to trans youth under age 18. If a provider breaks the law, they could lose their license and face civil action.
South Dakota: Under HB 1080, a health care provider may not provide gender-affirming care “for the purpose of attempting to alter the appearance or validate a minor’s perception of the minor’s gender “.
A medical service provider risks losing their license and incurring civil lawsuits if they supply this type of car to trans youth.
Tennessee: SB 1 says a health care provider cannot “perform or offer to perform” any kind of gender-affirming care to trans minors. This exposes the provider to legal action by the minor, his guardian or the State Attorney General.
Utah: SB 16 specifically prohibits state health care providers from performing gender-affirming surgeries on trans youth and places an indefinite moratorium on their access to hormone therapy and puberty blockers.
Going Deeper: Axios Explains: Gender-Affirming Care in the United States