Several states have taken measures to ban or restrict cross-sex hormones, transgender surgeries and puberty blockers despite persistent legal challenges in state courts.
Laws restricting transgender treatments for minors have been enacted in 22 states: Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah and West Virginia. However, the enforcement of these laws remains uncertain in some states due to ongoing court decisions regarding their constitutionality.
Former Republican Arizona Gov. Doug Ducey approved a law in March 2022 that forbids “irreversible gender reassignment surgery to any individual who is under eighteen years of age.” A little over a year later, Democratic Gov. Katie Hobbs issued an executive order banning “conversion therapy,” which the order describes as “any practice or treatment that seeks or purports to change an individual’s non-heteronormative sexual orientation or non-cisgender identity.” On the same day, Hobbs also mandated that state employee health care insurance, funded by taxpayers, cover “medically-necessary gender-affirming surgery.”
Arkansas holds the distinction of being the first state to prohibit transgender surgeries and hormones in April 2021, despite a veto from Republican then-Gov. Asa Hutchinson. U.S. District Judge Jay Moody invalidated the law in June 2023, contending that it infringed upon the due process and equal protection rights of children identifying as transgender. Earlier in 2023, a bill facilitating lawsuits against doctors who administer transgender surgeries and hormones to patients became law.
“Many medical organizations have been captured by trendy gender ideology. As a result, state governments have done the right thing in trying to protect children within their jurisdiction,” Jay Richards, a senior research fellow at the Heritage Foundation, said.
Doctors in Idaho, North Dakota, Oklahoma, Alabama and Florida face felony charges, potentially leading to a decade in prison, if they perform transgender surgeries or provide cross-sex hormones to minors. An Alabama law banning sex changes for minors has received judicial endorsement. Preliminary injunctions currently halt sex change bans in Florida, Georgia and Indiana. Texas experienced a temporary block on its ban, but an appeal from the state attorney general resulted in an automatic suspension of the injunction.
“State governments have done the right thing in trying to protect children within their jurisdiction,” Richards said. “I would expect that in a few years, the pediatric gender clinics will close their doors because of rising costs from civil suits. They need to be sued into oblivion. And given the number of young people they are currently exploiting, that day can’t come soon enough.”
Critics of these legislative actions argue that cross-sex hormones, sex change surgeries and puberty blockers are essential for the well-being of transgender-identifying children. The Human Rights Campaign asserts that these treatments are “medically necessary, safe health care backed by decades of research and supported by every major medical association representing over 1.3 million US doctors.”
Several European nations have limited transgender treatments for children, determining that the potential risks surpass any supposed “benefits” of these treatments.
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