The bill makes it a felony for any person to “engage in or cause” a transgender minor to receive any of these treatments, punishable by up to 10 years in prison or a fine up to $15,000. In April 2022, the Alabama governor signed a bill into law that prevents transgender minors from receiving gender affirming care, including puberty blockers, hormone therapy, and surgical intervention. Alabama, Arkansas, and Texas have been temporarily blocked from enforcing these laws by court order. What is the status of state policy restrictions aimed at limiting youth access to gender affirming care?įour states (Alabama, Arkansas, Texas, and Arizona) recently enacted laws restricting youth access to gender affirming care and, in some cases, imposing penalties on adults facilitating access. Gender-affirming care is a model of care which includes a spectrum of “social, psychological, behavioral or medical (including hormonal treatment or surgery) interventions designed to support and affirm an individual’s gender identity.” Not all transgender or gender diverse people experience dysphoria.” Gender dysphoria refers to “a concept designated in the DSM-5 as clinically significant distress or impairment related to a strong desire to be of another gender, which may include desire to change primary and/or secondary sex characteristics. Somebody who is transgender has a gender identity different from that traditionally associated with sex assigned at birth. Gender identity may or may not align with sex or gender assigned at birth. Gender identity is one’s internal sense of being male, female, some combination, or another gender. This analysis explores the current state and federal policy landscape regarding gender affirming services for youth and the implications of restrictive state laws. Separately, the Biden administration, which has been working to eliminate barriers and expand access to health care for LGBTQ+ people more generally, has come out against restrictive state policies.
At the same time, other states have adopted broad nondiscrimination health protections based on gender identity and sexual orientation. Four states (Alabama, Arkansas, Texas, and Arizona) have recently enacted such restrictions (though the AL, AR, and TX laws all have been temporarily blocked by court rulings) and in 2022, 15 states are considering 25 similar pieces of legislation. Numerous states have implemented or considered actions aimed at limiting LGBTQ+ youth access to gender affirming health care.