Mar 31, 2023 - Health

Blue states push to protect trans health care

Illustration of a collage featuring the states Colorado, Minnesota, Oregon, Vermont, and Washington with snippets of legislation.

Illustration: Brendan Lynch/Axios

While Republican politicians in some states work to limit gender-affirming care for transgender young people, a number of Democratic-controlled legislatures are doing the opposite.

What's happening: Democratic lawmakers in more than a dozen states, including Colorado, Washington, Oregon, Minnesota and Vermont, want to shield patients and providers.

Why it matters: Leading medical associations say gender-affirming care can be medically necessary treatment for transgender young people and helps reduce their likelihood of committing suicide.

Reality check: These states are in the minority compared to the slew of Republican pushes to restrict access.

  • Nationwide, more than 100 pieces of state legislation have been introduced to ban or restrict such health care for minors, according to data from the American Civil Liberties Union.
  • Iowa, Kentucky and Georgia were among the latest GOP-controlled states to act this month, joining Utah, Mississippi, South Dakota and Tennessee in banning gender-affirming health care for transgender youth.

What they're saying: "The situation for trans people in America is dire,” said Minnesota state Rep. Leigh Finke, a St. Paul Democrat who made history as the first openly transgender person elected to the state's Legislature.

  • She's calling the legislation, which passed the House on a party-line vote this month and awaits action by the Senate, a "trans refuge" bill.
  • "People are scared, people need help," she said.

The other side: Opponents to the "refuge" bills say they threaten to strip parents of their involvement in major decisions that impact their children's lives.

  • In Minnesota, Republicans have also raised concerns that the language could become an issue in custody disputes.

Between the lines: The proposed protections are similar to so-called shield laws seeking to protect abortion patients and providers in the wake of the U.S. Supreme Court's decision to overturn Roe v. Wade.

  • Like the abortion laws, many of the trans protection measures working through Democratic legislatures ban courts from enforcing subpoenas, arrest warrants or extradition requests related to treatment.

Of note: Some states, such as Illinois and California have already adopted such protections into law.

  • Gov. Gavin Newsom signed the state’s “Refuge for Trans Kids” bill — which is seen as a model for much of the new legislation — last year.

What we’re watching: This year, another California bill to protect the privacy of transgender kids by sealing minors' petitions for gender or sex changes is moving through the legislature, Axios San Francisco's Megan Rose Dickey reports.

  • Legislators in Oregon, meanwhile, are considering expanding the list of all gender-affirming treatments that insurance must cover to include things like hair removal and facial feminization surgeries, per Axios Portland's Emily Harris.
  • In January, Colorado became the first state to make gender-affirming care an essential health benefit, and this year lawmakers are expanding protections for transgender people in legislation that also protects abortion rights, Axios Denver's John Frank writes.
  • Washington lawmakers are also weighing a bill to allow youth shelters to house young people seeking affirming care without notifying their parents, Axios Seattle's Melissa Santos reports.
Go deeper