Georgia legislature passes partial ban on transgender health care for minors

Opponents of Senate Bill 140 console each other after the measure passed out of the Georgia House Public Health Committee earlier this month. (Matthew Pearson/WABE)

The Georgia Senate on Tuesday voted to ban most medical treatments that help transgender kids affirm their gender identity. Senate Bill 140 now heads to Gov. Brian Kemp’s desk for his signature on a measure that’s drawn some of the most emotional debate of the session.

The bill was approved by the Senate 31-21 on party lines, with Republicans in favor and Democrats opposed. The measure would prohibit providing hormone replacement therapy and gender-affirming surgery to minors. Doctors and health care providers who don’t comply could lose their licenses and potentially be exposed to criminal or civil liability.

Opponents of SB 140 cited the consensus of nearly every major medical and mental health association in favor of gender-affirming health care. They also cite the potential harm the ban could cause to transgender youth. And a group of over 500 medical professionals across Georgia released an open letter last week expressing their opposition to the bill.

State Sen. Kim Jackson, a Democrat and the only openly LGBTQ member of the Georgia Senate, called the situation “grossly disgusting” in comments from the Senate floor on Tuesday.

“We are using children as pawns,” she said. “We are using children to … push forward that it’s under the guise of compassion. And I do believe the sincerity of some of the members in this room, but broadly speaking, this really is about us bullying children in order to score political points. And that to me is extraordinarily disheartening.”

Supporters of the bill say it’s a “pause” on such care for people under 18 meant to “protect patients.”

“I think it does protect minors from irreversible changes when it comes to hormones and when it comes to surgery, and I think it’s the right thing to do,” said Republican state Sen. Ben Watson.

The Senate passed SB 140 on March 6 and the House passed it on March 16. But because the House amended the measure, it was sent back to the Senate for final consideration.

The bill focuses on children experiencing gender dysphoria, the clinical term for the distress someone experiences when the gender they identify as doesn’t match the one they were assigned at birth. The American Academy of Pediatrics recommends that doctors provide children with “comprehensive gender-affirming and developmentally appropriate health care.”

That typically begins with months or years of counseling and care from a team of specialized health care providers before any medical interventions to help a child align with their gender identity are prescribed. Puberty blockers, which delay puberty and are usually the next step in that process, would still be allowed under the bill.

The American Academy of Pediatrics says that gender-confirming surgery for minors is uncommon and should be considered on a case-by-case basis. Still, opponents of the bill have underlined the irreversible consequences of denying care to young people who decide with their parents and doctors that they need it.

Democratic state Sen. Elena Parent said Tuesday that Republican lawmakers were being hypocritical by removing the decision from parents on this issue but supporting parents’ decisions on other medical issues like COVID-19 and mask-wearing.

“Here we are usurping parents’ rights on one particular issue, a very private particular issue, a very private, particular medical issue,” she said.

A 2021 study by the Trevor Project found that transgender youth who received hormone therapy had lower rates of depression and suicide attempts than those who did not. Transgender children already experience higher rates of suicide and depression than other kids.

Nearly 60 people signed up for public comment when SB 140 came up in committee on March 14. As the audience spilled out of the at-capacity hearing room following a vote to advance the bill, some of those who came to testify in opposition began crying. The Republican chair of the committee was spotted hugging the crying mother of a transgender child after the panel voted to advance the measure.

Jeff Graham, executive director of Georgia Equality, said Tuesday that SB 140 “sets a dangerous precedent by putting politics over scientific fact.”

“By targeting medical professionals for doing their jobs, SB 140 threatens an already serious shortage of healthcare workers,” Graham said in a statement released after the Senate vote. “For the safety and well-being of our state, Gov. Kemp must veto this harmful legislation.”

The legislation is one of a flurry of bills being proposed in Republican-led legislatures around the country targeting transgender people.

Alabama, Arkansas, Arizona, Florida, Mississippi, South Dakota, Tennessee and Utah have all passed some form of legislation prohibiting healthcare for transgender people. The laws in Alabama and Arkansas are wrapped up in legal challenges and are now on hold. The Florida ban went into effect on March 16. Another ban is under consideration in Missouri, which their state Senate advanced on Tuesday.

Last year, Kemp signed a bill paving the way for prohibiting trans kids from playing school sports on the team that matches their gender identity.

A recent NPR analysis found that state lawmakers introduced at least 306 bills targeting trans people in the last two years – more than any previous period. Eighty-six percent of those bills focused on trans youth.

This story was updated at 1:46 p.m.