The Rise of Bans on Gender-Affirming Care for Minors

The number of states passing laws banning or restricting minor access to gender-affirming care has increased more than five-fold since 2022.

In 2021, Arkansas became the first state to pass a law prohibiting doctors from providing gender-affirming hormone treatment, puberty blockers, or surgery to individuals under 18.

Although a federal judge blocked the Arkansas ban, similar laws proliferated across the United States, a Kaiser Family Foundation (KFF) analysis shows. Most are being challenged in court, though the majority remain in effect.


Gender-affirming care (GAC) refers to a model of care that includes a spectrum of "medical, surgical, mental health, and non-medical services for transgender and nonbinary people."

The services are aimed at affirming and supporting an individual's gender identity.

For example, gender-affirming care includes hormone therapy, genital and breast reconstruction, and psychiatric services, among others.

As of January 2024, 23 states have enacted laws or policies limiting youth access to GAC. These states are home to 38% of American trans youth ages 13 to 17.

The laws and policies vary in their complexity — from banning only surgical care to prohibiting prescribing puberty blockers to minors or even offering referrals to seek GAC.

Most states impose either professional or civil penalties on healthcare practitioners providing minors with GAC. Five states — Alabama, Florida, Idaho, North Dakota, and Oklahoma — include felony penalties for providers.

Sixteen percent of states are facing lawsuits challenging their laws and policies limiting youth access to gender-affirming care.

Experts warn against bans

Those seeking to enact restrictions say such policies are aimed at "protecting children" and that the potential medical risks linked to gender-affirming care outweigh its benefits.


However, the bans are against the advice of most U.S. medical associations, including the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association, among others.

Another common argument is that children often "outgrow gender dysphoria" despite research suggesting that only a few question their decisions later in life.

A 2021 review of 27 studies that included data from 7,928 transgender patients who underwent GAC surgeries found that only 1% regret having the procedure.

In addition, studies show improvements in mental health following gender-affirming care. For instance, surgeries are linked to a 42% reduction in psychological distress and a 44% decrease in suicidal ideation.

Besides GAC bans, the states are passing other laws, making them more hostile to trans youth. For instance, "bathroom bills" that deny access to public toilets by gender or transgender identity or laws that limit transgender students' access to sports.

The issue of transgender rights may become even more divisive as the 2024 presidential election approaches, leaving trans youth deprived of necessary care.


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