Efforts to restrict transgender health care continue into 2024, with more adults targeted

Efforts to restrict transgender health care continue into 2024, with more adults targeted

Republican-led state Legislatures are considering a new round of bills that would limit health care for transgender youth and sometimes adults, returning the issue a year after a series of high-profile bills became law and sparked lawsuits On to this issue.

As legislative bodies begin work this year, lawmakers in several states have proposed enacting or tightening restrictions on puberty-blocking drugs and hormone treatments for minors. Bills regulating which pronouns children can use in school, which sports teams students can join and which bathrooms they can use are also back, along with bills that would limit drag performances and restrict some books and school curricula.

Among them was Mandy Wong, a mother in Santa Barbara, California, who said she was tired of conservative politicians using transgender children as “campaign fuel.” Huang said that while she doesn’t expect such a policy to pass in a Democratic-led state, her child and his friends are feeling mentally exhausted.

“It was heartbreaking to tell him…I don’t think this is going to go away anytime soon,” she said. “All the negative attention that trans kids, and even us as parents, get because of these recommendations doesn’t seem to go away.”

In Ohio, House Republicans voted Wednesday to overturn Republican Gov. Mike DeWine’s veto of legislation banning all forms of gender-affirming care for minors. The Senate is expected to follow suit this month. Despite DeWine’s veto, he signed an order banning rare sex-reassignment surgeries before adulthood. He also proposed rules that would require the creation of a single care team for children and adults, which critics said could severely limit care for all patients.

South Carolina is one of the few Southern states without a ban on gender-affirming care for minors, and a House committee voted Wednesday to send a ban to the House. The bill, sponsored by the state’s Republican House speaker, would also prevent Medicaid from providing such treatment to anyone under 26. Last week in New Hampshire, the House of Representatives voted to ban gender reassignment surgery for minors.

At least 22 states have enacted bans on gender-affirming care for children, most of which were approved last year. Those who support the ban say they want to protect children and have concerns about the treatment itself. Major medical groups, including the American Medical Association and the American Academy of Pediatrics, oppose the bans and support such care, saying it is safe if administered properly.

The bill filed in Missouri includes an effort to remove two provisions that are critical to overcoming Democrats’ ban on gender-affirming care for teenagers in the state. The new Missouri Freedom Caucus is prioritizing a bill that would make the ban on gender-affirming care for minors permanent and remove a provision that would have allowed the ban to expire in 2027. The legislation would also remove a provision that would have allowed minors to begin care before the law go ahead.

Republican state Sen. Mike Moon is sponsoring a bill that would repeal medical restrictions and require schools to tell parents if a student wants to use a name or pronoun other than the one the parent used to register their child or pronoun. For schools, minor transgender medical restrictions were compared to age thresholds in smoking, drinking, and driving laws.

“Kids, especially young kids, don’t make good decisions and sometimes they’re not sure what reality is,” Moon said.

LGBTQ+ campaigners have called laws requiring schools to tell parents that students want to change their names or pronouns “forced out” and say schools may be the only safe place for trans or non-binary students to express their gender identity.

A slew of bills filed in Missouri have drawn attention from activists, but Republican legislative leaders say they see little interest in revisiting the restrictions and don’t want to prioritize them.

“Last year we passed a bill that I thought was strong and quite broad,” Missouri Senate President Pro Tempore Caleb Rowden said of the medical ban.

In Oklahoma, at least two gender-affirming care bills for adults remain in effect from last year. One proposal would ban coverage for surgeries for adults, while another would ban public funds from going to any entity that provides such care.

Both measures stalled in the Republican-controlled Legislature last year but could be revisited during the legislative session that begins in February.

The rules DeWine proposed in Ohio last week would impose new restrictions on adults that advocates say would make treatment difficult or even impossible for some. These include requiring the formation of a team of individuals consisting of at least an endocrinologist, a bioethicist and a psychiatrist. The rules also require departments to collect data submitted by health care providers regarding gender dysphoria and subsequent treatment.

Several bills have been filed in Florida, including a measure that would require employees of state agencies or any entity that receives state funding to use pronouns consistent with their assigned gender at birth.

Legislation introduced in West Virginia on Wednesday would ban gender-affirming care for people under 21 and prohibit mental health professionals from supporting what lawmakers call “delusions” about transgender patients’ gender identity.

In California, which provides asylum to transgender teens and their families from states with medical bans, conservatives are working to put a measure on the rights of transgender minors on next year’s ballot.

Nebraska Senator Kathleen Kauth, who last year sponsored the state’s ban on gender-affirming care for people under 19, said partisan politics was not behind her push for a bill targeting LGBTQ+ people. This year, she is again pushing for a bill she introduced last year that would restrict transgender students from participating in sports and restrict their access to bathrooms and locker rooms.

Cowes’ medical ban led progressive lawmakers to filibuster nearly every bill in last year’s session.

“I don’t think it’s designed to be re-elected because, you know, my district is actually half and half – slightly more conservative than liberal,” Kaus said. “I am committed to resisting federal overreach, whatever that looks like, and protecting children.”

Across the country, challenges to existing laws are getting closer to the U.S. Supreme Court. The American Civil Liberties Union has asked a court to block restrictions on youth care in Kentucky and Tennessee.

The full 8th U.S. Circuit Court of Appeals is also considering Arkansas’s request to overturn a ruling that struck down the state’s nation-first ban on gender-affirming care for adolescents.

So far, federal rulings against the ban have come from judges appointed by Democratic and Republican presidents.


DeMillo reported from Little Rock, Arkansas, and Schoenbaum reported from Salt Lake City. Contributors to this report were Associated Press writers David Lieb and Summer Ballentine in Jefferson City, Missouri; Margery Beck in Omaha, Nebraska; Sean Murphy in Oklahoma Horse City; and Sophie Austin in Sacramento, California.

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