Republican state lawmakers have launched a spate of laws this year trying to restrict access to gender-affirming care for trans adolescents, with arguments over the issue reaching new heights thanks to proposals that would drastically broaden the scope of such medical restrictions.
According to data prepared by the American Civil Liberties Union and shared with AWN, more than 80 laws trying to restrict access to gender-affirming care had been introduced across the country as of February 9.
Gender-affirming treatment is medically necessary, evidence-based care that employs a multidisciplinary approach to assist a person in transitioning from their assigned gender – the one assigned at birth – to their affirmed gender – the gender by which they wish to be known.
Though many of the bills introduced this year have focused on trans youth and their access to gender-affirming care, at least four states have seen bills introduced this session that would restrict such care for people over the age of 18, including at least two states where proposed bans covered people under the age of 26.
LGBTQ supporters are concerned that legislation directed at trans adults, even if it does not become law, will make future laws aimed solely at kids appear to be reasonable concessions.
The avalanche of new laws highlights some conservatives’ shifting policy goals of politicising the lives of transgender Americans by placing limits on a small and vulnerable minority that, LGBTQ advocates argue, is widely misunderstood, making their existence ripe for attack. A number of Republican-led states have been successful in prohibiting trans adolescents from participation on sports teams that correspond to their gender identity in recent years, but it appears that the focus has shifted to gender-affirming care.
“It’s really, I think, a big but significant, notable moment where they’re no longer pretending that this is about caring about young people and making it very clear that all they really want to do is prevent trans folks from receiving medically necessary, life-saving care at any age,” said Cathryn Oakley, state legislative director and senior counsel for the Human Rights Campaign, one of the nation’s largest LGBTQ rights organisations.
“They have abandoned women’s sports totally, but have increased their efforts to harm trans children,” she noted. “So, you know, the through thread here is about trans people being hurt. And, absolutely, they are searching for the next discriminating law to pass.”
Republicans have contended that decisions about health care should be made once an individual becomes an adult, a position that has come under fire this year as some lawmakers have shifted the age goalpost.
Many of the bills are unlikely to advance in the legislative process. According to a recent HRC analysis, only 29 of the 315 anti-LGBTQ measures submitted in 2022 – or less than 10% – became law. Nonetheless, the rush of measures this session is already contributing to the expansion of the tiny group of states that have already adopted bans on gender-affirming care.
Utah became the first state this year to enact a ban on gender-affirming care for transgender adolescents, joining Arkansas, which enacted a similar ban in 2021, and Alabama, which enacted a similar ban last year. In 2022, Arizona also passed limits on gender-affirming care, albeit its ban was less broad than the others.
Two of these statutes have already created a complex legal landscape surrounding the problem. The ACLU sued Arkansas over its prohibition, and a federal judge temporarily stopped it in 2021, while a federal judge partially blocked Alabama’s statute in May.
States will review the hundreds of health-care prohibitions proposed this year under the prospect of federal legal action, as the legislative attempts have piqued the interest of the US Department of Justice.
Last year, the Justice Department’s Civil Rights Division issued a strong warning to state attorneys general, stating in a letter that it “is dedicated to ensuring that transgender adolescents, like all youth, are treated fairly and with dignity in compliance with federal law.”
“Intentionally establishing discriminatory barriers to prohibit individuals from accessing gender-affirming care violates a variety of federal legal guarantees,” according to the letter.
Gender-affirming care is clinically acceptable for infants and adults with gender dysphoria, defined by the American Psychiatric Association as psychological suffering caused when a person’s gender identity and sex assigned at birth do not coincide.
Despite the fact that treatment is very customised, some children may choose to undergo reversible puberty suppression medicine. This stage of the treatment may also entail hormone therapy, which can result in physical changes that are gender-affirming. Surgical interventions, on the other hand, are not commonly performed on children, and many health care providers do not provide them to minors.
LGBTQ groups have long claimed that health care bans further isolate a vulnerable minority and may inflict substantial harm to a group that has historically high suicide rates.
“LGBTQ youth are not predisposed to mental health issues or suicide. “The animosity and discrimination kids endure because of who they are puts them at a higher risk,” said Kasey Suffredini of the Trevor Project, a group that seeks to prevent suicide among LGBTQ adolescents. “It is up to adults to carry young people through this era until we reach a point when lawmakers are no longer targeting these young people.”
