Due to recent laws that severely restrict or outright forbid such care for children under the age of 18, transgender youngsters in most of the South are no longer able to get gender-affirming treatments like hormones, puberty blockers, and surgeries.
More over half of the nationwide restrictions that have been established since 2021 prohibit medical professionals from providing gender-affirming health care to transgender children. These laws were passed by legislators in 12 of the 16 states that the U.S. Census Bureau considers to be geographically South. Laws established in states like Florida and Missouri also limit certain transgender adults’ access to care.
Delaware, Maryland, South Carolina, and Virginia are four Southern states as well as Washington, D.C., that do not have laws or policies that forbid gender-affirming medical treatment. However, it’s not through lack of trying. This year, bills that were presented in South Carolina and Virginia failed to pass their state legislatures before the session ended.
The gender-affirming health care bans in Kentucky, Louisiana, and North Carolina were overridden by Republican legislators this year despite the Democratic governors’ vetoes. The first-in-the-nation restriction was overridden by Arkansas’ GOP-controlled legislature in 2021, which also voted to override then-Gov. Asa Hutchinson’s veto.
Logan Casey, a senior policy researcher at the Movement Advancement Project, said that the South, where the majority of states have either Republican trifectas or conservative supermajorities in the legislature, has become a breeding ground for legislation limiting access to transgender health care.
In a March Data for Progress poll, more than 60% of voters said there is “too much legislation” aimed at “limiting the rights of transgender and gay people in America.” Recent polls indicate that majorities of voters oppose legislation that would outlaw gender-affirming medical care for transgender minors.
According to the World Health Organization, gender-affirming care is a broad category of social, psychological, behavioral, and medical interventions “designed to support and affirm an individual’s gender identity” when that identity differs from the gender to which they were born.
According to the Campaign for Southern Equality, a group that fights for LGBTQ rights in the South, 90% of transgender youth in the region currently reside in a state where gender-affirming medical care is illegal. This means that for many families with transgender children, the nearest medical facility may be hours or even hundreds of miles away.
The Southern Trans Youth Emergency Project, a program the organisation started earlier this year, has already given out more than $250,000 to families to deal with costs including travel bills, according to Polanski.
Southern appeals courts rule on side of gender-affirming health care bans
The bulk of gender-affirming health care bans implemented in the South have faced legal challenges, and the majority of them have been temporarily overturned by court decisions. The prohibition in Arkansas was the first of its kind to be declared unlawful and overturned in June. The state is contesting that judgment.
But in July, a panel of the Sixth Circuit Court of Appeals granted the state of Tennessee’s attorney general’s request to overturn an injunction that had been given by a lower court, making it the first federal court to permit a prohibition on gender-affirming medical therapy to go into effect. The same judge lifted the injunction against Kentucky’s prohibition six days later.
This past week, the previously halted gender-affirming health care prohibition in Alabama was reinstated, making it the third state in the union to do so. Monday, the 11th Circuit Court of Appeals lifted an injunction that had prevented Alabama officials for more than a year from enforcing a 2022 law that makes it a felony, punishable by up to 10 years in prison, for doctors to give hormone replacement therapy or puberty blockers to transgender people under the age of 19.
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