“Gender-affirming care” has come to include both gender reassignment surgery as well as the administration of drugs such as puberty blockers. In the last few years, the practice of providing this type of “care” to children under the age of 18, has become far more widespread across the United States.
This week, Mississippi became the latest state to push back on this trend when it banned these controversial procedures. Here are the 7 states that have passed legislation to either restrict or completely outlaw so-called “gender-affirming care” on minors.
Governor Tate Reeves (R) signed into law H.B. 1125, also known as the Regulate Experimental Adolescent Procedures (REAP) Act, which clearly and effectively bars anyone who “aids or abets” the administration of “gender transition procedures on a person under eighteen years of age.” It also allows patients to sue clinics that perform these operations up until 30 years after the fact.
Gov. Reeves, who is up for re-election in November, stated that this sweeping change was enacted to combat “a dangerous movement spreading across America today.”
He added that this increasing trend in addressing gender confusion in children with chemical or surgical means “is advancing under the guise of a false ideology and pseudo-science is being pushed…through radical activists, social media and online influencers.”
On Tuesday February 28, 2023, the same day Governor Reeves signed the REAP Act into law, a governor of a neighboring state has indicated that he will soon do the same.
Governor Bill Lee (R) stated that he will sign a group of bills that includes provisions to ban so-called “gender-affirming care” for minors, including surgery and puberty blockers. The bill passed the Tennessee legislature in a landslide margin just the week before. Another one of the bills Gov. Lee signaled he would sign a law criminalizing “adult cabaret entertainment,” including drag, in front of children.
On February 13, 2023, Governor Kristi Noem (R) signed H.B. 1080, banning all so-called “gender-affirming care” for minors who are identified as transgender. This encompasses both gender reassignment surgery and chemical “treatments” including puberty blockers.
“I will always stand up for the next generation of South Dakotans,” said Gov. Noem, as she assured voters that her governorship is “protecting kids from harmful, permanent medical procedures.”
[Note: Back in March 2021, Gov. Noem issued a “style and form” veto of H.B. 1217, which would have banned biological males from taking part in women’s sports, across various levels of competition. Noem, who prior to the surprising veto presented herself as a staunch defender of the integrity of women’s sports, and even stated on Twitter that she was “excited to sign” the bill, just over a week before. She later backtracked and eventually signed a similar bill into law, albeit almost a year later in February 2022. Noem has been since floated as a potential 2024 Republican presidential candidate.]
On January 28, 2023, Governor Spencer Cox (R) signed into law S.B. 16, or the “Transgender Medical Treatments and Procedures Amendments.” The bill, sponsored by State Senator Mike Kennedy (R) and State Representative Katy Hall (R), imposes a number of restrictions on so-called “gender-affirming” medical practices, especially on minors. Sen. Kennedy, a family physician, stated that he proposed the bill to counteract “a radical and dangerous push for children to enter this version of health care.”
His new law expressly “prohibits performing sex characteristic [surgery] on a minor for the purpose of effectuating a sex change.” It also bans “hormonal transgender treatment” on demand, making an exception for people diagnosed with the psychiatric condition known as gender dysphoria.
Gov. Cox’s signing of the law represents a departure from his previous stances on gender ideology. In March 2022, Cox, a self-styled “woke Republican,” vetoed a bill that, like the one Governor Noem vetoed in South Dakota, would have banned biological males from playing girls’ sports.
At the time, Gov. Cox noted, “I always try to err on the side of kindness, mercy and compassion.” Utah’s legislature, which has a Republican supermajority, overrode his veto. The governor is also known for listing his pronouns, “he, him and his,” to a group of schoolchildren on an April 2022 Zoom call.
In April 2022, Governor Kay Ivey (R) signed S.B. 184, banning and criminalizing various types of so-called “gender-affirming” medications and surgeries for people under the age of 19. Violations of the law carried a punishment of up to 10 years in prison, making Alabama the first state to explicitly declare providing puberty blockers or gender reassignment surgery to minors as a felony. Ivey explained her decision saying, “I believe very strongly that if the Good Lord made you a boy, you are a boy, and if he made you a girl, you are a girl.”
However, in May 2022, just one month after it was signed and days after it went into effect, a provision of the law that dealt with chemical interventions, such as puberty blockers, was blocked by U.S. District Court Judge Liles Burke. Judge Burke, who was appointed to his position by President Trump, declared that the law “[infringed] on” parents’ “fundamental right to direct the medical care of their children.”
In March 2022, then-Arizona Governor Doug Ducey (R), signed S.B. 1138 which stated “a physician may not provide irreversible gender reassignment surgery to any individual who is under eighteen years of age.” Ducey clarified the bill, saying it “delays any irreversible gender reassignment surgery until the age of 18.”
He continued, “The reason is simple, and common sense – this is a decision that will dramatically affect the rest of an individual’s life, including the ability of that individual to become a biological parent later in life.”
Since the beginning of this year, newly elected Governor Katie Hobbs (D), who following Ducey’s signing of S.B. 1138, slammed the new law as an “ax to civil rights.”
Hobbs, who at the time was serving as Arizona’s Secretary of State, had said of the bill, “My heart goes out to the entire LGBTQ+ community, especially our youth, who are being targeted and discriminated against by their own government, and being denied their freedom of identity.” Hobbs is married to Patrick Goodman, a child psychiatrist who in 2020 was sued by parents of a then 10-year-old child, on whom he practiced “gender-affirming care.”
In April 2021, Arkansas became the first state to ban “gender-affirming” surgery and puberty blockers for children, and they did it in spite of opposition from then-Governor Asa Hutchinson (R).
Hutchinson vetoed Act 626, also known as the Save Adolescents from Experimentation (SAFE) Act, calling it “vast government overreach” and dismissing it as “a product of the cultural war in America.” He further commented that child gender transition was too “complex and sensitive” of a matter for the Arkansas government to deal with. A supermajority of both the State House and the State Senate overrode his veto.
In August 2022, a panel of three federal judges on the U.S. Court of Appeals for the 8th Circuit blocked the SAFE Act saying it “[discriminated] on the basis of sex.”
In November, the entire 11-judge 8th Circuit, narrowly declined a request from the state to reinstate the law, with five judges voting for, five voting against, and one abstaining. The law’s fate will be decided by Judge James M. Moody, Jr., an Obama appointee. While the trial concluded in December of last year, a ruling has yet to be released.
Meanwhile, another law, S.B. 199, has been introduced and is making its way through the Arkansas Senate. It is different from the SAFE Act in that it does not ban child gender transition or puberty blockers, but instead allows people to sue doctors and clinics who provide these services up to 30 years after the surgery or chemical treatment.
The bill’s sponsor, Senator Gary Stubblefield (R), clarified that the bill is meant to be a deterrent. He went on to state, “There’s no such thing as gender-affirming care. You cannot affirm something that does not exist.”