U.S. Facing Growing Extremism in Denying Care to Transgender People: Report

People walking along a path with a blended-in trans pride flag
People walking along a path with a blended-in trans pride flag

In a report released earlier this month, Movement Advancement Project (MAP) highlights the growing number, scope, and severity of bills that aim to prevent transgender individuals from receiving gender-affirming care.

MAP’s “LGBTQ Policy Spotlight: Bans on Medical Care for Transgender People” is the most comprehensive analysis of the efforts to limit or ban medical care for transgender youth and adults, according to the organization.

On Friday, Montana became the nation’s first state to restrict gender-affirming medical care.

MAP examined more than 250 bills introduced over the last several years that threaten the rights of transgender patients to receive medical care. In addition, several anti-LGBTQ+ bills have been passed in the past year, and these measures are part of a more comprehensive climate of record-breaking anti-LGBTQ+ activities.

MAP reports that state legislators have introduced over 650 bills aimed at attacking LGBTQ+ people this year, including more than 125 bills limiting the rights of transgender people to receive health care.

The report highlights the extreme measures taken by these bills.

In addition to expanding the ban on care for minors to include adults, there is an increasing prevalence of felony criminal charges and child abuse allegations against doctors, parents, and educators, along with the elimination of insurance coverage for gender-affirming care written into these measures.

In the years before 2021, no state prohibited medical care for transgender youth, but today almost 20 states have banned at least some forms of health care, and others are actively seeking such bans. In Missouri, for example, almost one out of five transgender youth and adults do not have access to the best medical care.

“These bills are part of a much broader, coordinated effort to prevent transgender people from being our authentic selves,” writes Logan Casey, a senior policy researcher at MAP. “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.”

More than half of the states still do not provide explicit protections against discrimination for transgender individuals under their health insurance laws. There are at least nine states that expressly prohibit Medicaid coverage for medically necessary health care for transgender individuals, and two more that prohibit coverage for minors.

In addition, the fact that more than one in five transgender individuals live in poverty further limits their ability to obtain medical care.

During 2020-2023, the number of bills allowing individuals to sue physicians who provide medical care to transgender individuals more than quadrupled, illustrating how these bans are increasingly privatized, similar to the tactics used against abortions.

The report concludes that opponents of transgender equality seek to undermine the medically necessary health care prescribed by physicians who follow best practices recognized by major medical organizations, such as the American Medical Association and the American Academy of Pediatrics.

“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,” MAP Executive Director Ineke Mushovic stated.

“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,” Muschovic added.