A fresh round of bills restricting medical care for transgender students and, in some cases, individuals, is being considered by Republican-led state legislatures. This legislation comes in the wake of a series of high-profile bills becoming law and sparking legal challenges.
In several states, legislators have proposed new or strengthened restrictions on puberty-blocking medications and hormone therapies for minors as they begin their legislative sessions for the year. Additionally, bills to control the use of pronouns in schools, dictate participation in sports teams, regulate restroom use, limit drag performances, and restrict access to certain books and educational materials are being reintroduced.
LGBTQ+ activists note that most states prone to passing laws restricting gender-affirming care have already done so and anticipate these laws will expand further. Transgender students and their families are concerned about being targeted once again as many state legislatures are up for election this year.
One concerned parent in Santa Barbara, California, Mandy Wong, expressed dissatisfaction with how politicians are using transgender children for political purposes. While she doesn’t expect such policies to pass in her Democrat-led state, she mentioned that her child and his friends are emotionally affected, and the negative media attention on trans kids doesn’t seem to be going away.
In Ohio, House Republicans voted to override Republican Governor Mike DeWine’s veto of legislation that would have banned all forms of gender-affirming care for minors. The Senate is expected to follow suit later this quarter. Despite his veto, DeWine signed an order prohibiting gender-transition therapies for minors and proposed rules that critics argue could severely limit access to care for all patients and establish a care team requirement for both minors and adults.
South Carolina is considering a bill that would bring gender-affirming care restrictions to the House floor. This state, one of the few in the South without such restrictions, has also proposed forbidding Medicaid from covering these treatments for individuals under 26. Last week, New Hampshire passed a bill banning gender-transition therapies for minors.
Gender-affirming care for minors has already been outlawed in at least 22 states, with most of these laws enacted in the past year. Supporters of these restrictions argue that they are protecting children, while major health organizations like the American Medical Association and the American Academy of Pediatrics oppose them, asserting that the care is safe when used appropriately.
Florida passed legislation last year that made it nearly impossible for some transgender adults in the state to access gender-affirming care. Florida Governor Ron DeSantis, who is seeking the Republican nomination for president, has touted these restrictions as one of his accomplishments.
In Missouri, where lawmakers have introduced over 20 bills targeting LGBTQ+ people, advocacy groups are unsure of what to expect in 2024. Bills filed in Missouri include measures to permanently ban gender-affirming treatment for minors and repeal a clause that would have allowed it to sunset in 2027. There are also bills seeking to mandate schools to inform parents if a student wishes to use a different name or pronoun.
Democratic state senator Mike Moon has compared restrictions on transgender health care for minors to age restrictions on tobacco, alcohol, and driving. Moon is sponsoring bills to amend the expiration date of these restrictions and require schools to inform parents when a student wants to use a different name or pronoun than the one listed for school records.
Protesters argue that laws requiring schools to inform parents about name or pronoun changes could forcibly out transgender or nonbinary students to their families, potentially endangering them.
Although there are concerns about these bills, Republican legislative leaders in Missouri believe the restrictions should not be revisited or prioritized.
In Oklahoma, two bills related to gender-affirming care for individuals were introduced last year but were defeated in the Republican-controlled legislature. They may be reintroduced during the upcoming legislative session.
Advocates argue that the new regulations proposed in Ohio’s rules next week could make it challenging or even impossible for some individuals to access treatment. The regulations require a care team composed of at least endocrinologists, bioethicists, and psychiatrists. They may also mandate the collection of information on gender dysphoria and its treatment.
Florida has seen the introduction of bills that would require employees of state agencies or organizations receiving state funding to use pronouns that align with their assigned sex at birth.
West Virginia introduced legislation on Wednesday that would prohibit mental health professionals from affirming a transgender individual’s gender identity and ban gender-affirming treatment for individuals up to age 21.
In California, Republicans are making a long-term effort to put measures addressing transgender minors’ rights on the ballot. The state has provided a refuge for transgender students and their families from states with medical bans.
Nebraska State Senator Kathleen Kauth is pushing for bills aimed at LGBTQ+ individuals, despite being a Democrat in a Republican-controlled state. Last year, she sponsored a bill that restricted gender-affirming care for those under 19. This year, she is reintroducing a bill that would limit transgender students’ restroom and locker room access and participation in sports.
Obstacles to existing laws are moving closer to the U.S. Supreme Court in various states. The American Civil Liberties Union has asked the court to overturn restrictions on youth care in Tennessee and Kentucky. Arkansas has also requested that the Eighth Circuit Court of Appeals consider overturning a decision that struck down the state’s ban on gender-affirming care for students.
So far, judges appointed by both Democratic and Republican leaders have issued nationwide decisions against these bans.
Schoenbaum reported from Salt Lake City, while DeMillo came from Little Rock, Arkansas. Authors from Jefferson City, Missouri, Margery Beck, Omaha, Nebraska, Sean Murphy, and Sacramento, California all contributed to this statement, along with David Lieb and Summer Ballentine from the Associated Press.
