At least 11 U.S. states have imposed restrictions or outright bans on gender-affirming treatments for children.
Two states in the Southern United States have advanced laws restricting access to gender-affirming therapies for transgender children, part of a wave of Republican-led legislation that critics have labeled discriminatory and dangerous.
Kentucky and West Virginia join at least nine other states in introducing restrictions on treatments that leading medical groups such as the American Academy of Pediatrics say could be necessary and even life-saving for transgender children.
But proponents of the restrictions argue that people under 18 are too young to undergo gender-affirming treatments, which can range from temporary, reversible measures such as puberty suppressants — which interrupt sexual development — to hormone treatments and surgery.
However, medical research suggests that regret for such gender-affirming treatment is rare.
The first of Wednesday’s bills came in Kentucky, where a heavily Republican legislature used its supermajority to override an earlier veto by Democratic Gov. Andy Beshear.
After a vote of 29 to 8 in the Senate, the Kentucky House of Representatives passed the bill by a vote of 76 to 23.
If a sudden cessation of care is detrimental to the patient, the law requires doctors to establish a time frame for ending treatment. Those restrictions will take effect in three months.
Kentucky’s bill also extends beyond medical therapies. Schools are not allowed to have discussions about sexual orientation and gender identity, while education districts are required to enact policies to ensure students use restrooms that match the gender on their birth certificates.
Debate at the Kentucky State Capitol grew heated as the vote approached. State police later reported that 19 people had been arrested for trespassing after protesting from the home’s gallery.
“We are denying families, their doctors and their therapists the right to make medically informed decisions for their families,” Karen Berg, a Democratic state senator, told the bill. Her 24-year-old child was a transgender activist who committed suicide in December.
Meanwhile, Berg’s colleague, Republican Senator Robby Mills, condemned gender-affirming treatment as “dangerous to the health” of children.
That rhetoric resonated Wednesday in West Virginia, where Republican Governor Jim Justice signed into law his state’s ban on gender-affirming therapies for children.
The law, which takes effect in January 2024, includes a rare exception: allowing prescription puberty suppressants and hormone therapy for teens shown to be at risk of harming themselves. But in those cases, patients must have parental consent and a diagnosis of severe gender dysphoria from two doctors.
According to a 2017 study by the Williams Institute, a think tank at the UCLA School of Law, West Virginia has the highest number of transgender youth per capita in the US.
The laws in both Kentucky and West Virginia join a wave of Republican legislation across the country that critics have labeled an assault on LGBTQ+ rights. And they’re both likely to be taken to court.
Federal judges have already blocked enforcement of laws restricting gender-affirming therapies in Alabama and Arkansas, and the American Civil Liberties Union of Kentucky has already announced it plans to “take this fight to court.”
“To all trans youth who could be affected by this legislation, we stand with you and we will not stop fighting. You are cherished. You are loved. You belong,” the organization said in its statement.
Nearly two dozen states in the US are currently considering restrictions on gender-affirming care.