This blog originally appeared at NPR.
In recent times, there has been a concerning trend of states passing legislation to limit or ban gender-affirming health care for young people. This year alone, at least 12 states have enacted such restrictions, joining several others that already had similar laws in place. In Missouri, the recently announced restrictions by the state attorney general would apply to individuals of any age, further tightening the limitations.
As legislative sessions continue across the country, it is possible that more states may introduce additional restrictions on gender-affirming health care for young people. These limitations can have significant implications for transgender and gender non-conforming individuals, affecting their access to necessary medical interventions and support.
However, amid this landscape, there are also states that have taken steps to protect transgender health care. Colorado, Illinois, Maryland, New Mexico, and Minnesota have passed bills aimed at providing legal protections, health care coverage, and access to transgender individuals. Recently, the Minnesota legislature passed a bill that extends protections to youth and parents seeking health care, as well as to the providers offering it. Governor Tim Walz, a supporter of the bill, has expressed his intention to sign it into law.
The contrasting approaches in different states reflect the ongoing debates and discussions surrounding transgender rights and access to gender-affirming care. The situation remains dynamic, with differing viewpoints and legislative actions taken across the country.
Activists and community members march into the Minnesota State Capitol building during a Trans Day of Visibility rally on March 31, 2023.
“We are going to lead on this issue,” said Walz, a second-term Democrat at an LGBTQ rights rally last week. “And I want to make note, not only do you belong here, you are needed here, you’re part of the fabric that makes Minnesota the best place in the country to live.”
Last year, California passed a similar bill, calling itself a “refuge” state for transgender youth and their families. Also this year, Oregon Democrats are proposing a constitutional amendment to protect care. Washington State and Vermont have their own protective bills.
Minnesota
The bill’s passage in Minnesota aims to protect individuals receiving or providing gender-affirming health care from out-of-state requests for child removal, extraditions, arrests, or subpoenas. Physicians and families seeking such care have expressed relief, as it ensures continued access to treatment and alleviates concerns regarding the limitations imposed by laws in other states. Some healthcare providers have already noticed an increase in prospective patients from states where options for gender-affirming care have been restricted.
“Frequently, we will talk about gender-affirming care as life-saving health care. And we’re not saying that to be dramatic,” says Dr. Angela Kade Goepferd, chief education officer and medical director of the Gender Health program at Children’s Minnesota. Kade Goepferd says kids who can’t access care “are at significantly higher risk of worse mental health outcomes, including suicidality.“
Republicans in the state legislature have opposed extending legal protections to families traveling for gender care services.
“The bill makes Minnesota a sanctuary state for so-called gender-affirming care, while simultaneously infringing on the fundamental right of parenting,” said state Rep. Peggy Scott, a Republican, last month.
Bella Mendez, 8, stands with her mother during a Trans Day of Visibility rally at the Minnesota State Capitol building on March 31, 2023.
Maryland: Broadening Medicaid coverage
The Maryland Trans Equity Act, which came into effect on January 1, 2024, represents a significant step forward in expanding access to gender-affirming treatments for individuals covered by the state’s Medicaid plan. This act aligns Medicaid coverage with what is offered by private insurers, ensuring that transgender individuals have access to essential treatments. These treatments can include procedures such as hair modifications, facial or neck alterations, and voice therapy.
By providing coverage for gender-affirming care, the Maryland Trans Equity Act aims to address disparities in healthcare access and promote equality for transgender individuals. It is estimated that around 25 additional individuals will be able to access gender-affirming treatments through the Medicaid program as a result of this act.
Research has consistently shown the positive impact of gender-affirming care on the mental health and well-being of transgender individuals. Studies published in the Journal of the American Medical Association and other reputable sources have demonstrated that access to gender-affirming care can help reduce rates of anxiety, depression, and other adverse psychological outcomes. By expanding coverage for these treatments, Maryland aims to support the overall health and well-being of its transgender population.
The Maryland Trans Equity Act represents a significant advancement in promoting inclusivity and equality in healthcare, ensuring that transgender individuals have access to the necessary treatments that can positively impact their lives.
Colorado: Expanded legal protections
Last week, Democratic Governor Jared Polis signed a bill into law in Colorado to provide legal protections and ensure access to reproductive healthcare and gender-affirming care for people from other states. The law aims to create a safe haven for individuals seeking services such as abortion, puberty blockers, and gender-affirming care without fear of prosecution.
Under this law, Colorado will not participate in out-of-state investigations targeting providers or recipients of abortion or gender-affirming care. This includes ignoring search warrants, arrests, subpoenas, summons, or extraditions to another state, as long as the activity took place in Colorado and there is no indication of a violation of Colorado law.
Democratic State Representative Meg Froelich, one of the main sponsors of the legislation, emphasized that the laws of other states seeking to punish providers of reproductive healthcare or gender-affirming care do not apply in Colorado.
The effort to make Colorado a safe haven for transgender individuals was initially proposed by Colorado’s only transgender state lawmaker, Democratic Representative Brianna Titone, last year. However, Democrats decided to address the issue in the current legislative session.
The bill faced extensive hearings and debates, but Republicans did not have enough votes to defeat it. Supporters of the legislation argue that it extends legal protections and expands insurance coverage to ensure access to essential healthcare services. However, there were concerns from some individuals, such as Cynthia Halversion from Colorado Springs, who testified against the bill, expressing worries about potential risks and illegitimate practices.
Overall, the new law in Colorado aims to safeguard the rights and access to reproductive healthcare and gender-affirming care for individuals from other states, while providing legal protections to providers offering these services.
Michigan: Growing the state’s Civil Rights Act
Michigan has taken steps to protect individuals based on “sexual orientation” and “gender identity” under the state’s civil rights law, known as the Elliott-Larsen Civil Rights Act. This expansion was signed into law by Democratic Governor Gretchen Whitmer last month.
The Elliott-Larsen Civil Rights Act initially provided protection against discrimination based on categories such as religion, race, color, national origin, age, sex, height, weight, familial status, or marital status. With the recent amendment, the law now includes “sexual orientation” and “gender identity” as additional protected classes.
While Michigan has not explicitly addressed the protection of gender-affirming care in its statutes, the inclusion of “gender identity” as a protected class under the civil rights law is seen as a step toward recognizing and safeguarding the rights of transgender and gender non-conforming individuals.
By expanding the protected classes, Michigan aims to provide legal protections and prohibit discrimination based on sexual orientation and gender identity in various areas, such as employment, housing, public accommodations, and public services. This move reflects efforts to promote equality and ensure that individuals are not subjected to discrimination or unfair treatment based on their sexual orientation or gender identity.
“I am so proud to be here and I am excited to put our state on the right side of history,” Whitmer said as she prepared to put her signature to the bill. That move capped nearly four decades of efforts to add LGBTQ protections to state law.
The changes were adopted by the legislature’s Democratic majorities over the objections of Republicans and the Michigan Catholic Conference.
“While I fully support this original intent of the Elliott-Larsen Act and understand the importance of protecting individuals from discrimination, I also believe that it is crucial to respect the religious beliefs of small business owners and employers,” said Republican state Rep. Rachelle Smit.
But former Rep. Mel Larsen, a Republican who the original law is partially named for, says gay rights were always intended to be part of the protections.
Dana Ferguson is Minnesota Public Radio’s politics reporter, Bente Birkeland is Colorado Public Radio’s public affairs reporter, Scott Maucione is WYPR’s health reporter, Rick Pluta is Michigan Public Radio’s managing editor and state Capitol bureau chief, Colin Jackson is Michigan Public Radio’s capitol bureau reporter and Acacia Squires is NPR’s States Team editor.
fleeredstates.blog 
You must be logged in to post a comment.