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States Pursue Transgender Health Legislation

Across the country, states are examining access to health services for patients who are transgender, and many of these efforts specifically focus on youth populations.

While states vary in stage and process, many are pursuing policy changes through legislation. At least 29 bills in 17 states involve the transgender community.

Legislation Targets Access to Transgender Health Care

Arkansas was the first state to pass a youth-focused transgender health bill through both chambers of its legislature. The Arkansas Save Adolescents from Experimentation (SAFE) Act would prohibit health care for transgender youth. On April 5, Gov. Asa Hutchinson (R) vetoed the bill, remarking it would be a “vast government overreach.” Hutchinson said the bill was well-intended but added it would have created legislative interference with physicians and parents involving complex and sensitive issues. However, the state legislature on April 6 voted to override the governor’s veto. The American Civil Liberties Union swiftly announced on Twitter it would challenge the law. 

Several other states proposed legislation that would prohibit health care professionals from providing gender-affirming care to youth. For example:

  • a Montana bill would prohibit surgical procedures for the treatment of gender dysphoria in youth; and
  • a Missouri bill would prohibit medical providers from administering medical or surgical treatment for the purpose of gender reassignment for anyone younger than 18 years old.

Further, several states specifically proposed to make it a criminal act for health care providers to provide gender-affirming care to youth:

  • an Alabama bill would prohibit the performance of a medical procedure or the prescription or issuance of medication that is intended to alter the child’s gender or delay puberty;
  • a Kansas bill would make it a crime for a doctor to perform gender reassignment surgery or hormone replacement therapy on those younger than age 18; and
  • bills in both Texas and New Hampshire would classify gender-affirming care for transgender youth as child abuse.

In addition to the bills mentioned above, many other state legislatures are considering legislation in this space. America’s Essential Hospitals will continue to track and monitor bills related to health care for transgender youth populations.

Legislation to Protect Transgender Health Care

Other states have enacted or proposed legislation to improve and protect health care for transgender populations at large. Sixteen states and Washington, D.C., prohibit health insurance discrimination based on sexual orientation and gender identity, and 20 states and the District of Columbia have laws banning conversion therapy for those 18 and younger.

Further, bills currently pending in Hawaii and Washington would prohibit health insurers from denying coverage based on gender identity.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Abigail Painchaud is a policy associate at America's Essential Hospitals.

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