GOP-Led States Expand Crackdowns on Transgender Care

South Carolina’s legislature is poised to pass a bill prohibiting doctors from offering some health-care services to transgender minors — part of a new wave of anti-trans legislation from Republican-led states.

The South Carolina bill, which passed the state House of Representatives in January and is under consideration in the Senate, would bar health-care providers from performing gender-transition surgery, prescribing puberty-blocking drugs and overseeing hormone treatments for patients under 18.

It would also mandate that school officials notify parents of a student’s transgender identity and block the state Medicaid program from paying for gender-affirming care to patients under the age of 26. 

Nationwide, high-profile Republicans including Florida Gov. Ron DeSantis have made crackdowns on transgender rights central to their political agendas, which has helped encourage state-level legislation that critics call bigoted. Twenty-three states had passed laws restricting gender-affirming care as of the end of February, according to KFF.

Anya Marino, director of LGBTQI equality at the National Women’s Law Center, a nonprofit that advocates for women’s rights, said apart from the legal concerns some of these bills raise, she also worries about other consequences, including acts of violence against transgender people.

“It’s part of a larger objective to control people through body policing to determine how they love and how they navigate their daily lives,” Marino said.

South Carolina and Virginia are the only two states in the South that haven’t passed laws or policies limiting youth access to gender-affirming care, according to KFF.

Republican-led legislatures in other states are advancing bills to restrict medical care and access to public restrooms for transgender people — so-called “bathroom bills” that have been heavily criticized by Democrats and transgender people.

In January, Utah passed a law modeled after the “Women’s Bill of Rights” created by the conservative nonprofit Independent Women’s Law Center. The bill establishes strictly biological definitions for “male,” “female” and other terms related to sex that don’t include gender identities like nonbinary and trans.

Similar bills are under consideration in Arizona, Georgia, Idaho, Iowa, New Mexico and West Virginia. Last year, leaders in Kansas, Montana, Nebraska and Oklahoma approved versions of the policy through legislation or executive order.

South Carolina Gov. Henry McMaster (R), who signed a 2022 law that bans transgender students from playing girls’ or women’s sports in public schools and colleges, said at a January news conference that he thought the transgender health-care bill was a “good idea.”

If children “want to make those decisions later when they’re adults, then that’s a different story,” McMaster said. “But we must protect our young people from making irreversible errors.”

South Carolina Senate Democratic leader Brad Hutto said the point of the bill is to boost Republican fundraising and predicted it would face immediate legal challenge if it became law. “It’s clearly a far-right agenda item that doesn’t have anything to do with reality or facts,” he said. “It’s just red meat for that segment of the far right.”


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