Ban in Most Southern States Prohibiting Gender-Affirming Care for Transgender Minors

A wave of restrictive laws has swept through much of the Southern United States, effectively barring transgender minors from accessing gender-affirming care such as puberty blockers. This legislative attack, aimed at youths under 18, has rendered such vital care inaccessible for transgender individuals across these states. The Campaign for Southern Equality approximates that around 90% of transgender youths in the South now reside in states with bans on gender-affirming care, forcing families to seek distant healthcare providers.

According to Logan Casey, a senior policy researcher at the Movement Advancement Project, it isn’t surprising in the South, where the prevalence of Republican-dominated legislatures has contributed to the emergence of these restrictive healthcare laws. Despite popular support for LGBTQ-inclusive policies, gerrymandering and voter suppression have hindered the election of officials who mirror voters’ sentiments.

Legislative bodies in 12 out of the 16 states categorized as Southern by the U.S. Census Bureau have passed laws obstructing medical professionals from administering gender-affirming healthcare to transgender minors since 2021. This constitutes over half of the bans implemented nationally. Notably, Florida and Missouri, among others, have similarly limited access to care for certain transgender adults.

“We’ve seen a long history of the South being used as a laboratory for anti-LGBT legislation”, says Adam Polanski, director of communications at the Campaign for Southern Equality, adding that “There’s some level of experimentation that’s going on in the South because it’s so easy to pass things ” because of its lopsided state legislatures.

The Hill reports that a three-judge panel from the 11th Circuit wrote on Monday “The use of these medications in general — let alone for children — almost certainly is not ‘deeply rooted’ in our nation’s history and tradition,” citing the Supreme Court decision overturning Roe v. Wade.

As of the end of August 2023, the ACLU reports that these bills are part of the 495 anti-LGBTQ bills introduced, or debated, in 2023, surpassing the all-time record 315 anti-LGBTQ bills in 2022, according to the Human Rights Campaign.

Democratic governors in states such as Kentucky, Louisiana, and North Carolina vetoed gender-affirming healthcare bans in their regions this year. However, they were ultimately overruled by Republican majorities in their legislatures. Challenges to these bans have often resulted in court orders temporarily blocking implementation. Arkansas’s ban was recently deemed unconstitutional and overturned. However, in July, the 6th Circuit Court of Appeals lifted injunctions on Tennessee and Kentucky bans, and Alabama’s previously blocked ban was reinstated by the 11th Circuit Court of Appeals. This legal rollercoaster has left transgender youths and their families in a state of uncertainty, undermining their ability to lead stable lives.

According to recent surveys by Human Rights Campaign, a majority of voters oppose legislation prohibiting gender-affirming care for transgender minors. A Data for Progress poll in March indicated that over 60 percent of respondents believed there was an excess of bills limiting the rights of transgender and gay individuals in the U.S.

Despite their best efforts, Delaware, Maryland, South Carolina and Virginia, and Washington, D.C. have not been able to enact bans on gender-affirming care. Virginia and South Carolina introduced bills this year to restrict care, but these initiatives have also failed to progress through their respective legislatures.

A program launched earlier this year by the Southern Trans Youth Emergency Project has already distributed more than $250,000 to families to help cover the cost of things like travel expenses.

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