Transgender people in South Carolina are suing the state over its ban on their health care, challenging one of the nation’s toughest anti-trans laws that deprive youth and adults of access to essential medical care.
The complaint, filed by the American Civil Liberties Union (ACLU) on Thursday, challenges a bill passed by Republicans in May that banned gender-affirming treatments for trans youth under 18 and prohibited the use of government funds for transgender health care.
The law prompted the Medical University of South Carolina (MUSC), the state’s only public, statewide hospital, to systemUnpleasant cancel gender-affirming treatment for youth and adults in July. LGBTQ+ rights advocates said the sudden loss of care illustrated how the Republican Party’s attacks on trans rights under the guise of “protect children” also interfered with the personal medical decisions of trans adults.
“We’ve been watching and waiting to see how these politicians would move beyond transgender youth and tell transgender adults what we can do with our bodies,” said Gillian Branstetter, communications strategist at the ACLU’s LGBTQ & HIV Project. “Now we’re seeing how these funding restrictions are limiting access.”
South Carolina is one of 26 GOP controlled states who have passed bans on transgender care, as part of a wave of anti-LGBTQ+ laws who want to limit participation in sports, bathroom use, student rights and strange literature and culture.
The ACLU is challenging South Carolina’s H4624, which would have prohibited doctors from providing puberty blockers and hormone therapy to youth. These treatments ease medical transition and are options families can consider when trans children are persistent about their identity. They are part of the model of care endorsed by big US medical associationswho have opposite the forbidden, quote research linking treatment to improved mental health.
The law is also prohibited to confirm operations for minorswhich are rare in the US, and which blocked government funding for adult care, including hormones and surgery.
Representative David Hiott, the lead sponsor of H4624, promoted the bill by explanatory: “When God created us, he created us male and female… There is no other choice, and all those other people who want to change that… we have to stand up against that.”
A spokesman for the state attorney general declined to comment on the lawsuit but said in an email, “We will vigorously defend the state’s laws.” Spokespeople for Hiott and Gov. Henry McMaster did not immediately respond to requests for comment Thursday afternoon.
“I’m an adult. It’s ridiculous that the state has a say in the health care that I receive,” Sterling Misanin, a 32-year-old Charleston man and one of the ACLU’s plaintiffs, said in an interview.
Misanin, a trans man, had been a MUSC patient for years and underwent long-planned gender confirmation surgery, a hysterectomyscheduled for this summer. But a few days before his surgery, he said he got a call saying it had been canceled because of the law. “It was really hard to process,” he said. “There was a lot of frustration and anger mixed with the fear that I would never be able to get this.” He said he contacted the ACLU because he felt “desperate to try everything I could.”
Misanin said he jumped through a lot of hoops to secure his surgery appointment, including getting insurance approvals, and was devastated that he had to look for an alternative. The surgery is a critical part of his transition, he said, recounting how a previous affirmative procedure, top surgery, had such a positive impact on his gender dysphoria. “It was like a weight was lifted off my shoulders — the feeling that I’ve been holding my breath, hoping I could hide this thing, and now I don’t have to. The moment you start to feel a little bit of reprieve, you want to feel the rest of the reprieve … It’s hard for me to see a future if I can’t get this kind of care.”
He was recently able to schedule his surgery through a privately funded provider, but not through the center where he had long received care. “I’m still recovering,” he added.
Misanin, who works as a manager for a shipping company, said he felt compelled to fight the law. “I have the mental, financial and social stability to speak out against what’s happening to me, and I know that many people in similar situations in South Carolina don’t.”
The plaintiffs in the class action lawsuit include two other adults who have faced disruptions in their health care and parents of transgender children.
Similar lawsuits have had some success. A federal appeal court recently governed against restrictions on transgender health care funding in North Carolina and West Virginia, saying the policies were “clearly discriminatory.”
Sruti Swaminathan, an ACLU staff attorney, noted that South Carolina’s law prohibits care for trans youth but allows cisgender youth to continue receiving the same treatments. For example, some cisgender youth are prescribed puberty blockers if they experience early puberty, and that care continues uninterrupted.
“A law like this sets a pretty dangerous double standard for medical care that is clearly discriminatory,” they said. “There is no question here that this law violates the constitutional rights of transgender people.”