South Carolina governor signs ban on gender-affirming medical care for minors

Sam Wolfe/Reuters/File

South Carolina Governor Henry McMaster speaks in Conway, South Carolina on February 10, 2024.


South Carolina's Republican governor signed a law Tuesday banning gender-affirming medical care for minors in the state.

Governor Henry McMaster announced the signing of H 4624 in a statement on social mediathe measure “protects the children of our state from irreversible gender reassignment procedures and prohibits the use of public funds for them.”

With the law, South Carolina joins more than 20 other states in restricting gender-affirming care for transgender minors. The measure passed earlier this month by a vote of 28-8 in the state Senate and 67-26 in the state House of Representatives.

The law comes into effect immediately and prohibits doctors from providing gender reassignment medical care to minors, such as hormone treatments, puberty blockers or surgical procedures – although surgical procedures are rarely carried out on children.

Major medical associations agree that such care is appropriate for gender dysphoria, the psychological distress that can arise when a person's gender identity and the sex assigned at birth do not match.

Under the provisions of the new law, doctors may temporarily continue to administer hormone treatments and puberty blockers to minors to whom these treatments were prescribed before August 1, 2024, if the doctor determines and documents that immediate discontinuation of treatment would harm the minor. The provider “may establish a period of time during which the person’s use of the drug or hormone is systematically reduced,” which must end by January 31, 2025.

South Carolina health care professionals who provide such care to minors outside of these limits are subject to their licensing board's “disciplinary penalty” and may face civil charges. A doctor who performs surgery could be charged under the state law with inflicting great bodily harm on a child and, if convicted, face up to 20 years in prison.

The law also requires school officials to notify a minor's parents or guardians if their child has told school staff that his or her gender does not match the gender assigned at birth or if they request to use different pronouns.

“We can bury the idea that the governor cares about limited government and personal freedom,” Jace Woodrum, executive director of the American Civil Liberties Union of South Carolina, said in a statement Tuesday.

“With the stroke of a pen, he has chosen to incorporate the will of politicians into health care decisions, trample on the freedoms of trans South Carolinians, and deny the rights of the parents of trans minors,” Woodrum added.

The Human Rights Campaign released a statement calling the law “a serious violation of the freedoms of South Carolinians.”

The measure “threatens to plunge the transgender community into a deeper health crisis, leave Virginia as the only Southern state without a ban, worsen nightmarish travel times and deny transgender youth across the South access to health care,” said Brandon Wolf, the state's resident the group's press secretary said in the statement.

South Carolina is just the latest state to restrict the care of transgender minors, with about half of all states adding similar laws to their books in recent years.

As laws expand across the country, legal challenges to health restrictions are also increasing. The challenges led to conflicting rulings from federal judges and district courts, increasing pressure on the U.S. Supreme Court to weigh in on the sensitive issue.

Anna Harden

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