CHARLOTTE, N.C. — Joining the growing list of legislation related to transgender North Carolinians, access to gender-affirming care for some transgender minors may be on the line this year.
A new proposal would prohibit the use of public health care facilities or state money for various forms of gender-affirming care for transgender minors. That includes puberty-blocking drugs, hormone-replacement therapy or gender transition surgery.
The plan by Republican lawmakers also outlines a list of public health care facilities that would be barred from such practices, including the UNC Health Care system, local health departments and facilities operated under the N.C. Department of Health and Human Services.
In response to “false information circulating on social media,” UNC Health tweeted last month that the system provides “age-appropriate, gender-affirming care to our patients and families based on national guidelines and standards of care.“ Surgeries for minors are not provided through UNC Health, the university health system said.
Lawmakers rolled out their latest plan by stripping out the contents of an unrelated bill, Senate Bill 631, and replacing it. The bill was approved by a House committee on Tuesday.
Legislation restricting gender-affirming care has become increasingly common across the country in recent years. Twenty states have passed laws limiting access to gender-affirming care as of June 6, according to the Human Rights Campaign.
NC lawmakers spar over ‘parental choice’ for gender-affirming care
Speaking on behalf of the bill, Rep. Timothy Reeder, a Pitt County Republican and physician, summarized it as a way to limit children from “potentially life-altering treatments.”
He said the bill does not seek to limit treatment for gender dysphoria, which is a feeling of distress related to one’s gender identity.
A few lawmakers disagreed with Reeder’s sentiment, including Rep. Cecil Brockman, a Guilford County Democrat who prompted a few minutes of back-and-forth questioning on the bill. Brockman said he was concerned the bill would make getting treatment for transgender children difficult for parents.
“Why are we standing in the way of parents making this decision for their children?” Brockman asked.
Reeder defended the legislation, pointing out it only limited treatments for public health care facilities.
Rep. Maria Cervania, a Wake County Democrat, agreed with Brockman’s concern regarding “parental choice.” She inquired about the “differentiating factor” between school choice, pushed heavily by NC Republicans this year, and health care choices.
The permanence of a choice to transition a minor is a primary difference between school choice and gender-affirming care, Reeder said.
“When you’re choosing your school, it’s not a permanent intervention,” Reeder said in the meeting.
A transgender 15-year-old, Rowan Bilodeau, came from Pittsboro to deliver public comment in opposition to the bill. Bilodeau recalled memories of being called slurs and being suicidal before undergoing hormone replacement therapy.
“My access to gender-affirming care saved my life. I want others to have that same opportunity,” Bilodeau said at the meeting. “I’m tired of seeing my brothers and sisters die because they are being denied their rights.”
But Prisha Mosley, also speaking to her personal experience with gender-affirming care, said it caused “severe and lasting injuries.” Mosley said she underwent hormone replacement therapy at 17 years old and a breast reduction surgery at 18 — something she regrets today.
“I am haunted by the ghosts of missing body parts and suffer from chronic pain and a host of additional medical issues and psychological and emotional anguish,” Mosley said in the meeting.
Opponents decry limits to gender-affirming care, while advocates praise it
After the committee passed the bill, around 20 audience members exited the hearing, some chanting “shame” while another protester shouted at lawmakers for not letting more members of the public speak.
More people tried to sign up to speak before the committee meeting began, but they were told there would only be one speaker in agreement and one in opposition to the bill, said Elizabeth Stroupe, a Gaston County resident.
In light of recent developments with transgender-related bills in North Carolina, Stroupe said she’s had to have “honest conversations” with her family about moving out of the state. They haven’t left yet because her spouse insisted they “stay and fight,” she said.
“Somebody needs to hold the line,” she said.
D Sellars also isn’t leaving the state yet, but if legislation becomes harsher, they said they might need to leave for their own and their 11-year-old nonbinary child’s safety. Even if they did leave, there’s a “dwindling number of states that are safe,” Sellars said.
Being nonbinary wasn’t an option until a few years ago, the 40-year-old said. They received what they considered gender-affirming care through top surgery, which removes breast tissue to resemble a more masculine chest.
Despite the joy they felt with their gender identity, Sellars fears the rising anti-transgender rhetoric being pushed in the N.C. legislature. It’s reached a point where they’re scared to go into public bathrooms because they appear more masculine-presenting, Sellars said.
“I have to be fearful that someone’s calling security to come and get me, that there’s going to be cops coming in here to come and arrest me,” they said. “And this is the bathroom I belong in.”
On her drive from Charlotte to the N.C. Legislative Building, Nicia Carla said she felt nervous and ill. But she said she knew showing up was extremely important because she was there to represent her transgender son and his experiences.
When her son came out to her at 12 years old, she said she was initially confused on what that would mean in terms of treatment. It would be three years from when he came out until he would receive hormone replacement therapy.
Carla is on a state health care plan because of her job as a theater teacher, she said, so her son may not have had the same access to gender-affirming care if it was banned. She called that “devastating.”
“They’re trying to make it sound so fringe and awful,” Carla said. “They’re just kids; let them be who they are.”
NC Values Coalition executive director Tami Fitzgerald released a statement following the meeting in support of the bill. She claimed as part of her statement that UNC and East Carolina University were “misleading the public” about their gender-affirming care treatments.
“This legislation will ensure they will no longer be able to destroy the lives and health of gender-confused children with experimental medicalized and social transitioning,” Fitzgerald said. “We urge the legislature to swiftly move this through to protect gender-confused children and their families.”
ECU Health does not offer gender surgery to transgender minors or any form of gender transition care for preteens, ECU Health spokesperson Jason Lowry said in an email. Puberty blockers are also not used, and hormone therapy is only implemented after puberty with “extensive mental health evaluations” and the consent of a parent or guardian, he added.
Other transgender-related bills in NC legislature
N.C. Republicans are looking to take advantage of their veto-proof supermajority they earned earlier this year when Mecklenburg County Rep. Trisha Cotham switched her party affiliation to Republican.
As a result, other transgender-related bills have gained traction in the legislature this session, including further restrictions on gender-affirming care as well as women’s sports.
House Bill 574 or the “Fairness in Women’s Sports Act” would ban transgender women from participating in women’s sports at the middle, high school and university levels. The bill was expected to make its way to the Senate floor Tuesday.
Another bill — House Bill 808 — would prohibit gender transition surgery procedures for minors in North Carolina. The bill garnered attention when it cleared a committee without allowing time for public comment in early May.
That bill is scheduled to be heard in the Senate health care committee at 10 a.m. ET Wednesday.
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