The transgender medicalization of children has exploded in popularity over the last few years, prompting red and purple states to respond with a wave of restrictions.
Last year, about 300,000 American teens 13 to 17 identified as transgender, a sharp increase over the previous few years.
From 2017 to 2021, gender dysphoria diagnoses in children nearly tripled. Over the same period, gender hormone treatments and surgeries have become trendy despite alarm from parents and medical professionals. Young people who previously identified as transgender have also spoken out about regretting getting medical intervention.
By 2021, nearly 5,000 younger children had been put on puberty blockers, and nearly 15,000 trans-identifying teens had been put on cross-sex hormones. More than 700 teen girls had their healthy breasts removed. At least 56 minors had genital sex-change surgery.
Although at least 31 states have proposed restrictions on the practice of child sex change treatments and procedures, only some states have managed to get their restrictions approved.
Ten States With Active Bans
Florida, Alabama, Utah, Iowa, and Mississippi have bans that are currently in effect. Arizona, Georgia, Tennessee, South Dakota, and Kentucky have bans that are set to take effect soon.
Florida – In November, Florida’s medical boards approved a rule pushed by Governor Ron DeSantis that bans puberty blockers, cross-sex hormones, and sex-change surgeries. The ban went into effect in March.
Alabama – In April last year, Republican Governor Kay Ivey signed a ban on puberty blockers, cross-sex hormones, and gender surgeries for minors. Doctors who provide such services could face up to 10 years in prison. A federal court blocked the puberty blockers and cross-sex hormones part of the ban, but the gender surgeries part remains in effect. The ban went into effect in May.
Utah – In January, Republican Governor Spencer Cox signed a law that puts a moratorium on puberty blockers and cross-sex hormones for minors who are not already on them and bans gender surgeries for minors. The ban went into effect in late January.
Iowa – In March, Republican Governor Kim Reynolds signed a ban on puberty blockers, cross-sex hormones, and gender surgeries for minors. Doctors have six months to pull children off these treatments. The ban took effect immediately.
Mississippi – In February, Republican Governor Tate Reeves, signed a ban on puberty blockers, cross-sex hormones, and gender surgeries for minors. The ban went into effect immediately.
Arizona – Last year in March, Republican Governor Doug Ducey signed a ban on gender surgeries for minors. The law is less restrictive than some and does allow puberty blockers and cross-sex hormones. The ban takes effect on April 1 of this year.
Georgia – In March, Republican Governor Brian Kemp signed a ban on cross-sex hormones and gender surgeries for minors who are not already on them. The law does allow puberty blockers for children. Hospitals and doctors who violate the ban can lose their permits and licenses, and doctors can face criminal liability. The law takes effect on July 1.
Tennessee – In March, Republican Governor Bill Lee signed a ban on puberty blockers, cross-sex hormones, and gender surgeries for minors. Doctors must pull kids off hormone treatments by March 31 of next year. The law allows minors to sue anyone who violates the ban and gives them hormone treatment drugs. The ban takes effect on July 1.
South Dakota – In February, Republican Governor Kristi Noem signed a bill that bans puberty blockers, cross-sex hormones, and gender surgeries for minors. Doctors have until the end of the year to pull kids off hormone treatments. Doctors who violate the ban can have their medical licenses revoked. Minors have until they turn 25 to sue doctors who violate the ban. The ban takes effect on July 1.
Kentucky – In March, the legislature overrode Democratic Kentucky Governor Andy Beshear’s veto of a Republican-led ban on puberty blockers, cross-sex hormones, and gender surgeries for minors. The bill will go into effect in late June.
Three States With Restrictions Stuck In Court
Arkansas – In 2021, Arkansas overrode Republican Governor Asa Hutchinson’s veto to become the first state to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. The ban also prohibits doctors from referring children elsewhere for those treatments. However, the ban has been blocked by a federal court since July 2021.
However, in March, Republican Governor Sarah Huckabee Sanders signed another law that makes it easier to file malpractice lawsuits against doctors who provide gender treatments to minors. This new law could effectively halt much of the child gender treatment industry in Arkansas by making it almost impossible for doctors to get malpractice insurance. This law takes effect this summer.
Texas – Last year in February, Republican Governor Greg Abbott directed the Texas Department of Family and Protective Services to investigate parents subjecting their children to “abusive gender-transitioning procedures.”
In June, an Austin judge blocked Abbott’s directive. The Texas attorney general is fighting the courts to allow the child abuse investigations to move forward.
Alabama – Alabama’s gender surgery ban is in effect, but a federal court blocked the state’s ban on puberty blockers and cross-sex hormones. Alabama is fighting the court’s decision.
Four Bans Awaiting Governor’s Signature
West Virginia – The legislature passed a bill in March that bans puberty blockers, cross-sex hormones, and gender surgeries for minors. The bill is currently sitting on the desk of Republican Governor Jim Justice, but it is not yet clear whether he intends to sign it.
Indiana – The legislature passed a bill in March that bans puberty blockers, cross-sex hormones, and gender surgeries for minors. The bill was sent to Republican Governor Eric Holcomb, but he has not yet signed it.
Idaho – The legislature passed a bill in March that bans puberty blockers, cross-sex hormones, and gender surgeries for minors. The bill was sent to Republican Governor Brad Little, but he has not yet signed it.
Montana – The legislature passed a bill in March that bans puberty blockers, cross-sex hormones, and gender surgeries for minors. Doctors who violate the ban are legally liable and face a yearlong license suspension. The bill was sent to Republican Governor Greg Gianforte, but he has not yet signed it.
12 States With Restrictions In Progress
A majority of states have introduced restrictions or bans on child sex change treatments and procedures, but many are unlikely to advance far in the legislature. Here are some of the prominent bills.
Missouri – The Missouri Senate passed a bill in March that seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. The restrictions on puberty blockers and hormones expire in 2027, while the gender surgeries ban does not expire.
Meanwhile, Missouri’s attorney general is seeking an emergency regulation on medical gender procedures for children.
Kansas – The Kansas Senate passed a bill in March that strips doctors’ licenses if they perform gender surgery on a minor and allows a person who received gender surgery as a child to sue the doctor who performed the surgery.
Oklahoma – A bill introduced in February and quickly advancing through the Republican-controlled legislature seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. Doctors have six months to pull kids off these treatments. The bill also prohibits health facilities that receive state funds from providing these treatments to anyone of any age. Insurance companies are also banned from covering the treatments.
Ohio – A bill introduced in February seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. The bill also says children must be screened for abuse and comorbidities before being diagnosed with gender dysphoria.
South Carolina – A bill introduced in March seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. Doctors who violate the ban could have their licenses revoked for at least a year. Under the bill, South Carolinians would be able to sue doctors for violating the ban.
North Carolina – A bill introduced in February seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. Doctors who remove “nondiseased” or otherwise healthy body parts or tissue could lose their license and face a $1,000 fine.
New Jersey – A bill introduced back in September seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. Violating the ban is punishable by up to five years in prison and a $15,000 fine. The bill is unlikely to pass since New Jersey’s legislature is controlled by Democrats.
Michigan – A bill introduced in March seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. Violating the ban would be punishable by life in prison. The bill is unlikely to pass since Michigan’s legislature is controlled by Democrats.
Nebraska – A bill introduced in January seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors and 18-year-olds.
North Dakota – A bill introduced in January seeks to ban puberty blockers, cross-sex hormones, and gender surgeries for minors. The bill makes it a felony for doctors to perform gender surgery and a misdemeanor to administer puberty blockers or cross-sex hormones. The felony charge carries up to 10 years in prison and a $20,000 fine.
Oregon – A bill introduced in January bans gender surgery for minors.
Hawaii – A bill introduced in January bans gender surgery for minors and makes performing such surgeries a felony.