Tennessee governor signs ban on gender-affirming care for minors

Washington CNN  — 

Tennessee Gov. Bill Lee on Thursday signed a law that prohibits gender-affirming care for minors, the latest state to do so as part of a wider Republican-pushed effort nationwide.

Senate Bill 0001 prohibits health care providers “from performing on a minor or administering to a minor a medical procedure if the performance or administration of the procedure is for the purpose of enabling a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex.”

It specifies that minors who receive care cannot be held liable but lawsuits could be brought up against a minor’s parents “if the parent of the minor consented to the conduct that constituted the violation on behalf of the minor.”

The newly signed law also grants the attorney general the authority to fine health care professionals who provide the care with a civil penalty of $25,000 per violation.

The law – enacted on the same day that Lee signed a bill restricting drag show performances in the state – will go into effect on July 1. Gender-affirming care that began prior to July 1 is not considered a violation “provided that the treating physician must make a written certification that ending the medical procedure would be harmful to the minor,” though access to such care must conclude by March 31, 2024.

LGBTQ advocates and many physicians regard the treatment as medically necessary, evidence-based care that uses a multidisciplinary approach to help a person transition from their assigned gender – the one the person was designated at birth – to their affirmed gender, the gender by which one wants to be known.

But Tennessee’s legislation – similar in its aim to more than 80 such bills nationwide seeking to restrict access to the treatment, according to data compiled by the American Civil Liberties Union and shared with CNN – expresses concern over long-term outcomes and questions whether minors are capable of making such consequential decisions.

Major medical associations agree that gender-affirming care is clinically appropriate for children and adults with gender dysphoria, which, according to the American Psychiatric Association, is psychological distress that may result when a person’s gender identity and sex assigned at birth do not align.

Though the care is highly individualized, some children may decide to use reversible puberty suppression therapy. This part of the process may also include hormone therapy that can lead to gender-affirming physical change. Surgical interventions, however, are not typically done on children and many health care providers do not offer them to minors.

In pushing the health care bans, Republicans have argued that decisions around such care should be made after an individual becomes an adult, though lawmakers in some states have sought to push bans as far back as the age of 26.

“The state has a compelling interest to protect children from experimental and unproven medical procedures,” Tennessee state Sen. Jack Johnson, a Republican, told CNN. “We want children suffering from gender dysphoria to get the important mental health treatment they need, but it’s not appropriate to subject children to irreversible procedures with lifelong health complications.”

Tennessee’s law comes in the wake of similar restrictions in other Republican-controlled states.

Earlier this week, Mississippi enacted a similar ban, joining Utah and South Dakota, which passed their own bans earlier this year. Arkansas enacted a ban in 2021, and Alabama put one on its books last year. Arizona also enacted restrictions on gender-affirming care in 2022, though its ban was less sweeping than the others.

Blasting Lee’s signing, the ACLU on Thursday said Tennessee’s law takes a critical and sensitive decision away from families of transgender youth and promised to mount a legal challenge in court.

“We will not allow this dangerous law to stand,” the ACLU, its Tennessee chapter and Lambda Legal said in a statement. “Certain politicians and Gov. Lee have made no secret of their intent to discriminate against youth who are transgender or their willful ignorance about the life-saving health care they seek to ban. Instead, they’ve chosen fearmongering, misrepresentations, intimidation, and extremist politics over the rights of families and the lives of transgender youth in Tennessee.

The statement continued, “We are dedicated to overturning this unconstitutional law and are confident the state will find itself completely incapable of defending it in court. We want transgender youth to know they are not alone and this fight is not over.”

CNN’s Devan Cole contributed to this report.