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Gov. Bill Lee signs bill that bans some gender-affirming care for minors into law

SB 0001 was introduced by Senator Jack Johnson (R - Franklin).

NASHVILLE, Tenn. — UPDATE (March 2): An anti-transgender bill banning some gender-affirming care for minors, such as puberty blockers or surgery, was signed into law on March 2 by Governor Bill Lee. It was previously amended to remove language that would have considered some gender-affirming care child abuse.

Senator Jeff Yarbro (D -Nashville) said that there were some medical conditions that would involve puberty blockers or medications that do not relate to transgender identities, and those would continue to be allowed.

"What this law actually does is outlaw the people and the purposes that are in people's heads," he said. "When this bill makes it illegal for people to think or behave in a certain way, that's when everyone in this chamber should give pause ... It's regulating what they believe, and what they believe about the most personal thing in the world."

He also said he was concerned the bill would signal to parents of transgender children that they were bad parents, for supporting their children. Senator Heidi Campbell (D-Nashville) said the bill also appeared in other states with the same language, indicating it was not written by Tennessee constituents.

She also said that some transgender adults claimed gender-affirming care treated their depression in ways other types of care couldn't. Supporters of the bill claimed they were worried transgender youth would regret undergoing the treatment.

The American Civil Liberties Union Of Tennessee and Lambda Legal said they would bring immediate legal action against the bill if it became law. They said it would ban the only evidence-based care for gender dysphoria for transgender people under 18 years old.

They released a statement about the law. It is below.

“We will not allow this dangerous law to stand. Certain politicians and Governor 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. 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.”

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An anti-transgender bill that would effectively ban gender-affirming healthcare for people under 18 years old in Tennessee passed a Senate committee on Wednesday and a House subcommittee on Tuesday.

The bill, SB 0001, is now headed to the House Health Committee. It was introduced by Senator Jack Johnson (R - Franklin), who also introduced a bill that would effectively ban drag shows across the state which passed committees on Tuesday.

During the Senate Health and Welfare Committee, he claimed that some kinds of gender-affirming care could cause a person to be effectively sterilized, or cause depression. The committee meeting lasted around an hour.

"This bill, I feel, was born out of fearmongering — out of false rhetoric that we are doing sex-change operations on our children," said Dr. Allison Stiles, a physician from Memphis, who testified during the meeting. "Now Tennessee is outlawing all transgender care. The hate has grown, and we now have a bill that could get parents arrested for taking their gender-dysphoric child to the physician, and their physicians for taking care of them."

In Oct. 2022, Vanderbilt University Medical Center said they were pausing gender-affirming surgeries for minors after pressure from lawmakers.

"Just to throw in a little science here, I know you love science, there are four independent aspects to our sexuality. Our genetics — which could be XX, XO, XY, XXY, XYY — there is our outward appearance, our gender identity, and our sexual preference," said Stiles. "The XX and XY fetus are identical, actually, until six weeks of gestation."

VUMC said they provided around five gender-affirming surgeries to minors every year since 2018. All were over 16 years old and had parental consent, and none received genital procedures, they said.

"I wish you could understand what these kids go through, what it's like to be forced to live in the wrong body ... They call their birth names, their dead names," said Stiles. "This care is medical care."

She said there are several steps involved in gender-affirming care, such as informed consent, vetting, counseling and primary care. These steps are taken before puberty blockers, hormone therapy, or surgery. She also said genital surgery is also already outlawed for minors and said gender-affirming could prevent suicide among teens.

She also said that a person's gender identity is usually stable by four years old, and said part of treating gender dysphoria is ensuring there would be nothing else affecting the stability of a person's identity. 

The bill aims to ban gender-affirming medical procedures from being performed on minors if they are "inconsistent with the minor's sex" or if the procedure is to treat "purported discomfort or distress from a discordance between the minor's sex and asserted identity." This includes procedures involving surgery and prescription drugs.

It also specifically does not consider gender dysphoria a disease.

"The bill would clarify that performing these medical procedures can constitute abuse," Johnson said. "The bill would treat these procedures as our law treats other attempts to wound, injure or disable a child."

The bill passed Senate Health and Welfare Committee passed the bill with an 8-1 vote and it was referred to the Senate Judiciary Committee, which will hear it on Feb. 7.

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