MEDIA CONTACT: Rebecca Farmer, Movement Advancement Project
rebecca@mapresearch.org | 303-578-4600 ext 122
April 20, 2023
(Update, April 20, 2023: shortly after this report was launched, North Dakota enacted a ban on medical care for transgender youth. 16 states currently ban or restrict best-practice medical care for transgender youth. View our real-time Equality Map here.)Nearly 1 in 5 Transgender Youth Live in a State Where Medically Necessary Care is Banned
Bills to ban best-practice medical care for transgender people are growing in number, growing in scope, and growing more extreme, according to a report released today by the Movement Advancement Project (MAP). The new MAP report, LGBTQ Policy Spotlight: Bans on Medical Care for Transgender People, provides the most comprehensive look to date at the sweeping attempts to ban and restrict medical care for not only transgender youth—but also transgender adults. The report argues that when Michael Knowles called for the “eradication of transgenderism” at the Conservative Political Action Committee conference, he was in fact expressing what these bills, in their totality, aim to do. Just last week, Missouri became the first state to effectively ban medically necessary care for both youth and adults. MAP analyzed the more than 250 bills introduced in recent years that attack access to medical care for transgender people. These bills come amid a broader climate of record-breaking anti-LGBTQ efforts: this year alone, state legislatures have introduced more than 650 bills attacking LGBTQ people, including more than 125 bills that would specifically ban or limit transgender people’s access to health care. (Please note: the report includes updates as of April 15, 2023. Due to this quickly changing political landscape, please refer to our Equality Maps, which are updated in real time.) Through this detailed analysis, the new MAP report illustrates the extent of how recent bills targeting medically necessary care for transgender people are expanding and becoming more extreme, including: - Expanding from youth under 18 to include adults, as evidenced by Missouri’s recent ban;
- Ever-growing penalties for providing this medically necessary care, including felony or even child abuse charges for healthcare providers, parents, and even teachers.
- Efforts to ban any insurance coverage for care, including through both state funded programs like Medicaid and through private insurers.
The fact that more and more bills each year also target transgender adults—and that in a growing number of cases, they would effectively ban medically necessary care for all transgender people under any circumstances—reveals the extremist goals at the heart of these efforts: to prevent openly transgender people from existing at all. Last week, the Missouri attorney general released an emergency order which blocks access to medical care for transgender adults as well as youth, the first state in the country to do so. Prior to 2021, no states banned medical care for transgender youth, but now 15 states have bans on at least some forms of medical care, and many more states are actively pursuing similar bans.
As a result, nearly one in five (19%) transgender youth currently live in states where they are banned from receiving best-practice medical care, in addition to transgender adults living in Missouri.
“These bills are part of a much broader, coordinated effort to prevent transgender people from being our authentic selves,” said Logan Casey, Senior Policy Researcher at MAP and an author of the report. “Across the country, anti-transgender extremists and politicians are putting the lives and well-being of transgender people at risk by attempting to outlaw access to best practice medical care not only for youth, but for all transgender people.” Snapshot of the broader policy landscape impacting access to health care for transgender people (outlined in more detail in the report): Snapshot of legislative attempts in 2023 and recent years to block medically necessary care for transgender people (outlined in more detail in the report): (Please note: the report includes updates as of April 15, 2023. Due to this quickly changing political landscape, please refer to our Equality Maps, which are updated in real time.)
- Just three months into 2023, more bills attacking access to health care for transgender people have been introduced than in the last six years combined.
- Currently, 15 states have passed laws restricting care for transgender youth, including one state that has effectively banned care for both youth and adults.
- Nearly three in 10 (29%) bills introduced in 2023 would ban or restrict care for both transgender children and transgender adults. This includes bills that define “minor” to include adults up to ages 19, 21, or 26, as well as bills that would ban care for adults through other means.
- Nearly half of bills this year would prevent state funding for medical care for at least some transgender people, such as through state employee health plans and Medicaid.
- Since 2020, roughly one out of seven (14%) bills would ban or restrict private insurance companies from covering or reimbursing the costs of best-practice medical care for transgender people, or would explicitly allow insurance companies to refuse coverage outright.
- The most common penalty in these bills is to revoke the medical license of—or otherwise punish—healthcare providers through the state’s professional licensing board.
- The number of bills that make it easier for people to sue doctors who provide medical care to transgender people nearly quadrupled from 16% in 2020 to 61% in 2023, illustrating the increasing privatization of the enforcement of these bans, similar to tactics used in anti-abortion efforts. Likewise, the bills that empower state Attorneys General to enforce these bans have increased nearly five-fold, illustrating the increasing efforts to allow the state to take extreme measures to prevent transgender people from accessing medically necessary care.
- More than 80% of bills attacking transgender health care also contain explicit exceptions that would allow non-consensual surgeries on intersex children, surgeries that are typically performed in infancy.
- Since 2017, at least 39 states have considered a bill to ban or restrict health care for at least some transgender people.
The health care targeted by anti-transgender extremists is medically necessary care that is prescribed by experienced doctors who utilize best practices that are endorsed by all major medical groups, including the American Academy of Pediatrics and the American Medical Association. “It can be hard at first to understand what it’s like to have a transgender child, but everyone should understand that these decisions should be left to parents, healthcare providers, and the patient, in accordance with best practice medical standards,” said Ineke Mushovic, Executive Director of MAP. “These bills allow the state to overrule parents and take best practice medical care off the table, limiting parents’ options for how to best support their child. And now they are even saying transgender adults shouldn’t be trusted to make the decisions about the care they want and need.” ###
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