19 States Have Laws Restricting Gender-Asserting Care, Some With The Possibility Of A Felony Charge | CNN Politics

19 States Have Laws Restricting Gender-Asserting Care, Some With The Possibility Of A Felony Charge |  CNN Politics



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This year was a record year for anti-LGBTQ legislation, with a particular focus on access to gender-affirming health care for transgender children and adolescents. Nineteen states have passed laws restricting it, but not all bans are created equal.

While some states have enacted laws that can punish health care workers who provide gender-affirming treatment to minors with jail time, others have made limited exceptions to allow minors to continue drug-based or nonsurgical forms of care, according to a review. of CNN data from the Movement Advancement Project, a non-profit think tank advocating for LGBTQ rights. These wide-ranging restrictions have created a complicated legal landscape for trans people to navigate. Many of the bans face legal challenges from health professionals and civil rights organizations.

Gender-affirming care is evidence-based, clinically necessary care that uses a multidisciplinary approach to help a person transition from assigned gender (what the person was designated at birth) to affirmed gender, the gender with which you want to be known.

Transgender medical care for minors continues to be a policy focus, especially in red states, and has quickly emerged as a key issue leading up to the 2024 election. Blue states have responded by protecting access to treatment.

The Human Rights Campaign, the largest LGBTQ advocacy group in the United States, declared the first national state of emergency for the LGBTQ+ community on Tuesday.

All but three of the 19 gender-affirming care bans were enacted this year, MAP data shows.

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The risk of going to jail or prosecution for providing assistance will be a huge disincentive, said Elana Redfield, director of federal policy at the Williams Institute, a think tank at the University of California, Los Angeles School of Law which researches sexual orientation and gender identity law and public order.

If you were to provide the care recommended by the American Medical Association or the American Psychological Association, then it would be considered unprofessional conduct and you could lose your medical license, Redfield said.

The AMA, the largest professional medical association comprising more than 270,000 physicians, opposes restrictions on transgender medical care and believes that medical and surgical treatment for gender dysphoria is medically necessary. While transgender adults may require surgeries, such procedures aren’t typically performed on children, and many healthcare providers do not offer them to minors.

Iowa, Mississippi and Indiana, when it goes into effect in July, will ban people from knowingly behaving in a way that helps or benefits children receiving gender-affirming care. In Iowa and Indiana, this specifically applies to health care workers. In Mississippi, however, this extends to everyone involved, including parents. Mississippi law also allows doctors to be sued for providing gender-affirming care within a 30-year statute of limitations.

The Montana law will prohibit the use of state property or resources to knowingly promote or support social transition which may include adopting new names, pronouns or appearances when it goes into effect in October. Montana is the first state to specifically target social transition, according to MAP.

Several states include exceptions for minors who have already received gender-affirming care when the bans were signed into law. However, most exceptions are limited. In South Dakota, minors with existing hormone prescriptions prior to July 1, 2023 can continue to receive treatment through the end of the year with the expectation that medical providers systematically reduce their prescription during that time. And in Kentucky, minors can only get assistance until the end of June, when the law goes into effect.

Unlike the other 18 states, Arizona, which bans gender-affirming surgeries for most minors, places no restrictions on other gender-affirming treatments such as hormone treatments or puberty blockers.

All 19 states that target gender-affirming assistance have state legislatures under Republican control, with the exception of Nebraska, which is nonpartisan.

Republican lawmakers say these measures are meant to protect children and have described gender-affirming procedures as child abuse. Democrats argue that Americans’ right to health care should be protected and have pointed to medical evidence that gender-affirming care is clinically appropriate.

The presidential candidates have openly expressed their positions on the issue. Former President Donald Trump has said he would make gender-affirming surgeries illegal if he is elected back to the White House. Republican candidate and Florida governor Ron DeSantis signed bills banning care for gender-affirming minors in his state. President Joe Biden has condemned Florida and has suggested passing federal laws to protect access to trans healthcare.

AMA and LGBTQ advocates point out that gender-affirming assistance can be a life-saving treatment for trans youth. Transgender and nonbinary youth are twice as likely to have attempted suicide as their cisgender peers, according to a 2022 survey by the Trevor Project, a suicide prevention and crisis intervention organization for youth LGBTQ.

At least 10 other states and the District of Columbia have passed shield laws protecting access to care since last year. Colorado Governor Jared Polis, a Democrat, has enacted laws making the state a legal safe haven for people from other states seeking gender-affirming treatment or abortions.

Many of the same states that block access to gender-affirming care are also sometimes banning abortions in the same bill. Nebraska lawmakers passed a bill banning gender-affirming care for people under 19 by adding an amendment to the 12-week abortion ban.

The fight for reproductive justice and the fight for trans people’s access to needed best medical practices are intimately connected, said Logan Casey, senior policy researcher and consultant at MAP. These bills are clearly trying to get politicians into doctors’ offices and make those decisions for the people.

Almost three times as many anti-LGBTQ laws were introduced in legislatures across the country this year as in 2022. State lawmakers have introduced nearly 500 anti-LGBTQ laws since January in this legislative session alone. Sixty-three of those bills have been signed into law, according to the American Civil Liberties Union.

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Of the 130 bills specifically targeting trans health care access introduced this year, 18 have been enacted, according to the ACLU.

Montana is the only state with a transgender representative who has banned gender-affirming health care for minors. Democrat Rep. Zooey Zephyr, Montana’s first trans lawmaker, was barred from the House chamber for the remainder of the legislative session after saying lawmakers would have blood on their hands for approving transgender health restrictions.

There are currently eight transgender representatives elected in seven state legislatures. That’s 0.1% of all state lawmakers, according to LGBTQ+ Victory Institute. Transgender adults make up 0.5 percent of the U.S. population, according to a 2022 estimate from the Williams Institutes.

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Not only are the politicians pushing these bills nationwide really up to speed with public opinion and what their constituents actually want, Casey said. We are also literally and directly underrepresented by the fact that there are so few trans people holding elected office.

According to a March NPR/PBS NewsHour/Marist poll, more than half of Americans (54%) say they oppose bills that criminalize the provision of gender transition-related medical care for minors.

Devan Cole of CNN contributed to this report

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