In the U.S., at least 19 states have already enacted laws restricting or prohibiting gender transitions in minors. Among them: Alabama, Arkansas, Arizona, North Dakota, South Dakota, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Missouri, Montana, Oklahoma, Tennessee, Texas, Utah and West Virginia.
Some federal judges have blocked the implementation of such rules in Alabama and Arkansas. Meanwhile, many bills are still being considered by legislators in other states. One of these states is Nebraska, which stepped forward to join this list this Friday.
Nebraska's unicameral legislature passed the "Let Them Grow Act," which restricts these procedures on minors under 19 years of age and also prohibits abortion past 12 weeks. Republican Governor Jim Pillen said he plans to sign the "Let Them Grow Act." This new bill contains an emergency clause, which will make the restrictions on abortion effective the moment the governor signs it. For sex reassignment operations, the measures will become effective in October. After the act was passed in the Nebraska Senate, rallies were held by trans activists in rejection of the bill.
The main prohibitions in the laws include prison and monetary penalties for health care providers or physicians who administer puberty blockers and hormone therapies to minors, as well as penalizing those who perform sex change surgeries on children.
Below are the states that have banned sex reassignment procedures for minors.
Alabama was the third state in the country to approve a law restricting children under 19 from receiving transgender medical treatment. It also became the first to impose criminal penalties on those who fail to comply with the rule, making it a serious offense for medical professionals to provide sex reassignment care to young people or children.
Part of this legislation was challenged in a Federal Court. Therefore, the clause prohibiting puberty blockers and other hormones for minors is not currently being enforced. However, the federal judge did leave in place the ban on reassignment surgeries.
Arkansas became the first state in the nation - in April 2021 - to prevent minors from receiving medical sex change treatments (hormone therapies and surgeries). The congressmen began a legal battle when the proposal -previously approved by Congress- was vetoed by then-Governor Asa Hutchinson, who considered the text "out of order."
Subsequently, lawmakers overrode Hutchinson's veto, allowing the rule to pass. As in Alabama, this law was challenged in Federal Court in 2023, thus blocking its implementation.
However, in March of this year, current Governor Sarah Huckabee Sanders signed a bill into law that will make healthcare providers serve up to 15 years in prison if they perform a gender transition procedure on a child under 18.
In June 2023, U.S. District Judge Jay Moody issued a permanent injunction against the first 2021 law (passed by Hutchinson) and ruled that it is unconstitutional as it violates First Amendment rights:
Rather than protecting children or safeguarding medical ethics, the evidence showed that the prohibited medical care improves the mental health and well-being of patients and that, by prohibiting it, the State undermined the interests it claims to be advancing.
In March 2022, then-state Governor Doug Ducey signed a law stating that "a physician may not perform irreversible gender reassignment surgery on any person under the age of eighteen." That is, the law prohibits the performance of gender transition surgeries on minors.
Earlier this year, current Governor Katie Hobbs called the rule a "hatchet job on civil rights."
Governor Doug Burgum signed a bill into law that prevents transgender medical care for minors. The rule bans puberty blockers, hormones and sex reassignment surgery.
The measure -which was approved on an emergency basis - states that it is a crime to provide gender reassignment treatment to minors under 18 years of age and allows prosecutors to charge a healthcare provider with a felony offense (up to 10 years in prison and $20,000 in fines) for performing sex reassignment surgery on a minor.
It also allows them to charge a physician with a misdemeanor (up to 360 days in jail and $3,000 in fines) for prescribing gender-affirming drugs - such as puberty blockers - to a child.
Despite the penalties, the rule allows minors already receiving treatment before its implementation on April 19, 2023, to continue with them.
In February 2023, Governor Kristi Noem signed a law banning all so-called "gender-affirming care" for minors. This encompasses both gender reassignment surgery and chemical "treatments," including puberty blockers and hormones.
The regulation prohibits state health professionals from performing or administering gender reassignment treatments on minors. If a provider violates the law, the relevant licensing board will revoke their certificate.
Sex change surgeries and puberty blockers will be illegal for those under 18 in the state. Healthcare professionals who violate this regulation could even lose their medical license. These measures were established by a series of rules approved by Governor Ron DeSantis.
There may be exceptions, although this will depend on the opinion of the Board of Medicine and the Board of Osteopathic Medicine. Those would be for minors who had started treatment before the law came into force but not without prior parental consent. The standard also reserves a few paragraphs for adults. Those who want to expose themselves to these treatments must first be informed about their risks and irreversible consequences.