Health Care

5 states finalizing gender-affirming care bans

The bills in Georgia, Indiana, Missouri, Nebraska and Texas are similar, but some carve out exceptions.
Glenda Starke wears a transgender flag as a counterprotest during a rally in favor of a ban on gender-affirming health care legislation, Monday, March 20, 2023, at the Missouri Capitol in Jefferson City, Mo. (AP Photo/Charlie Riedel)

Lawmakers in five states are moving to finalize bans on gender-affirming care for transgender minors as part of a national push by conservatives that has yielded an unprecedented wave of legislation this year.

The Georgia Senate on Tuesday gave final approval to a bill banning gender-affirming hormone replacement treatments and surgeries for those under the age of 18, sending the measure to Gov. Brian Kemp (R). 

In Missouri, senators advanced a similar ban after overnight negotiations that will allow treatments already in place to continue.

The Indiana House Public Health Committee approved a ban on gender-affirming care that had previously passed the state Senate. If the bill wins approval in the full House, where Republicans hold a substantial majority, it will go to Gov. Eric Holcomb (R) for a signature.

Nebraska’s nonpartisan, unicameral Senate has begun debate on a similar ban after a weeks-long filibuster. In Texas, the Senate State Affairs Committee advanced a bill banning therapies for minors suffering gender dysphoria.

The bills have many similar provisions, but some carve out exceptions. Georgia’s bill will allow doctors to prescribe medicines that block puberty, though it will allow physicians to be held criminally or civilly liable for pursuing other treatment.

“We’re preventing minors under 18 years old from having irreversible changes in their lives,” Georgia Sen. Ben Watson (R), a physician who sponsored the bill, said on the Senate floor on Tuesday. “Physicians should not be above the law by any means.”

Opponents of the bills say the measures will further ostracize an already marginalized community of transgender youth who disproportionately struggle with mental health issues and suicidal ideation. In Georgia, state Sen. Elena Parent (D) said Republican lawmakers were acting hypocritically. 

“There’s a lot of talk about trusting parents to make the best decisions for their children when it comes to all sorts of things,” Parent told fellow senators. “The rule does seem to be that we are for parental rights when those parents make decisions we agree with. And when we don’t like the decisions they make, then we intend to outlaw those decisions.”

The four measures come after governors in three states — Mississippi, South Dakota and Utah — signed bills barring gender-affirming treatments for minors earlier this year. 

Lawmakers around the country have also taken up bills to ban transgender athletes from playing in sports leagues that conform to their gender identity. Missouri lawmakers approved a sports ban early Tuesday, after hours of Democratic filibusters. 

Measures that ban transgender people from the bathrooms that conform to their gender identity in schools are also on the rebound, years after massive protests over a North Carolina law that was, at the time, the first of its kind.

Bathroom bans have passed in Alabama, Oklahoma and Tennessee this year, while Idaho Gov. Brad Little (R) and Iowa Gov. Kim Reynolds (R) are likely to sign measures passed in their states in recent weeks.

Arkansas Gov. Sarah Huckabee Sanders (R) on Tuesday signed a bathroom bill. Sanders allowed another bill, which would allow those who received gender-affirming care as a minor to sue the physicians who provide the treatment, to become law without her signature. 

Nationally, lawmakers have introduced 428 bills that target the rights of LGBTQ individuals, according to a database maintained by the American Civil Liberties Union, which has planned to sue in many states that have passed the measures. About a third of those bills specifically target transgender people, according to the Human Rights Campaign.