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North Carolina Republicans propose ban on gender-affirming care for young adults up to age 21

NC HB2 billboard
A billboard mocking North Carolina's regressive policies.Photo: Equality House

Republicans in North Carolina have introduced perhaps the most sweeping anti-transgender bill yet, which would ban gender-affirming health care for anyone under the age of 21 while also banning the state and local governments from taking any action against conversion therapists and forcing state employees to out trans youth to their parents.

Just as Arkansas’s legislature overrode the governor’s veto to ban gender-affirming care for trans people under 18, North Carolina Republicans are trying to out-do Arkansas and ban the life-saving care for minors and young adults.

Related: Republican wants to stop feds from letting trans youth get health care behind parents’ backs

S.B. 514 would create fines for health care professionals who “facilitate the minor’s desire to present or appear in a manner that is inconsistent with the minor’s sex” and threaten their licenses to practice medicine if they provide gender-affirming care for transgender youth.

The bill defines sex as “based on sex organs, chromosomes, and endogenous hormone profiles” and lists procedures that can’t be provided if they’re for gender affirmation, including puberty blockers, which have been shown to drastically reduce suicidal thoughts for trans people who want them and get them but are not useful after puberty has occurred.

The North Carolina bill has an exemption for doctors who want to perform the listed procedures on intersex minors to make them appear male or female.

The bill says that the state and local governments cannot “take any adverse action” against anyone who provides therapy that is “consistent with conscience or religious belief,” effectively preventing local governments from banning conversion therapy.

Under S.B. 514, any state employee who knows someone under 21 who “has exhibited symptoms of gender dysphoria, gender nonconformity, or otherwise demonstrates a desire to be treated in a manner incongruent with the [their] sex” would have to tell the person’s parents, which could put transgender and gender non-conforming people up to age 20 in danger by outing them.

This part of the bill has the title “Protection of parental rights,” even though most of the bill is about banning parents from making decisions about their children’s health.

The bill was introduced by state Senators Ralph Hise, Warren Daniel, and Norman Sanderson, all Republicans. They are not responding to local media’s requests for comment. The bill has seven co-sponsors.

S.B. 514 is not expected to pass. While Republicans control both the state house and senate, Senate leader Phil Berger (R) has not even said whether he supports the bill yet. And North Carolina Gov. Roy Cooper (D) campaigned on his opposition to the anti-trans bathroom bill H.B. 2, so he is unlikely to sign this bill into law.

Moreover, the Biden administration has already said that discrimination against LGBTQ people is illegal under federal law in an executive order signed the day President Joe Biden took office. Organizations like the ACLU have already said that they will sue if bills like this one pass and they could win because federal law preempts state laws.

“Transgender youth have the best chance to thrive when they are supported and affirmed, not singled out and denied critical care that is backed by virtually every leading health authority,” the Campaign for Southern Equality’s Rev. Jasmine Beach-Ferrara said in a statement.

“A person’s gender identity shouldn’t limit their ability to access health care or be treated with dignity and respect.”

The bill comes just a week after North Carolina Democrats introduced four bills to protect LGBTQ rights, including a conversion therapy ban, a bill to expand discrimination protections to LGBTQ people, a ban on the gay/trans panic defenses, and a bill to overturn H.B. 2.