Utah is the first state to ban gender-affirming medical care for transgender minors this year.
Gov. Spencer Cox, a Republican, signed a bill Saturday that bars minors from receiving gender-affirming surgeries and places an indefinite moratorium on their access to puberty blockers and hormone therapy.
The bill, which passed in the Utah State Legislature last week and became effective Saturday, immediately after the governor signed it, is prospective, so minors who were diagnosed with gender dysphoria before the effective date would still be able to receive care if they meet a list of requirements.
“Legislation that impacts our most vulnerable youth requires careful consideration and deliberation. While not a perfect bill, we are grateful for Sen. Kennedy’s more nuanced and thoughtful approach to this terribly divisive issue," Cox said in a statement Saturday, referencing the bill's sponsor, Republican State Sen. Michael Kennedy. "While we understand our words will be of little comfort to those who disagree with us, we sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures.”
Last year, Cox became the second Republican governor to veto a bill that bars transgender students from playing girls’ sports.
In an emotional letter about his veto, Cox cited research about the high risk of suicide among trans youths and additional research that has found that acceptance reduces the risk of suicide.
“I don’t understand what they are going through or why they feel the way they do. But I want them to live,” he wrote. “And all the research shows that even a little acceptance and connection can reduce suicidality significantly.”
But Cox told local news station Fox 13 on Thursday, after the ban on gender-affirming care passed the House, that he did not plan to veto the bill. His office did not immediately return a request for additional comment.
State Sen. Kennedy, a family practice physician, told colleagues in a hearing this month that gender-affirming treatments “lack sufficient long-term research,” according to local radio station KUER.
“But still, our country is witnessing a radical and dangerous push for children to enter this version of health care,” he said.
State Sen. Daniel Thatcher, one of Kennedy’s Republican colleagues, disagreed and was the only Republican to speak out against a previous, though similar, version of the bill, KUER reported. He argued that though he and his colleagues might not understand gender-affirming care, “every credible medical organization on the planet says that that is the safest, best and most appropriate care to save those lives.”
Accredited medical organizations — including the American Medical Association, the American Academy of Pediatrics and the American Psychological Association — have supported such care for minors.
Thatcher added that the bill could face legal challenges because it only prohibits the care for people who are transgender, but it does not prohibit the care for children who might need it for other reasons, KUER reported. The bill provides exemptions for intersex minors, for minors who experience early puberty and for those who have “medically necessary” reasons that don’t include treatment for gender dysphoria.
A judge blocked a similar law in Arkansas last year pending the outcome of a lawsuit, during which lawyers for the American Civil Liberties Union argued that such bans on care are discriminatory, using reasoning similar to Thatcher's.
Thatcher, who is recovering from multiple strokes, was absent from the Senate vote Friday.
A crowd of protestors gathered outside the Utah Capitol on Tuesday ahead of a committee hearing on the bill, during which a number of transgender teens spoke out against it.
Bri Martin, the editor of the student newspaper at West High School, described gender-affirming care as “nothing short of life-saving,” the Salt Lake Tribune reported.
“Me and my family were saved from the arduous and painstaking task of adult transition,” Martin said. “I would like to make clear that no matter the opposition, transitioning was always the only option for me. I deserve a body to feel proud of.”
In addition to barring access to care for minors who don't already receive it, the legislation also requires the state’s Division of Professional Licensing to create a certification for those who provide hormone treatment to minors. The certification process requires “at least 40 hours of education related to transgender health care for minors from an approved organization,” and providers must obtain this before they can continue to provide such treatment.
It also directs the state’s Department of Health and Human Services to conduct a systematic review of the medical evidence regarding hormonal transgender treatments and provide recommendations to the Legislature, but it does not require the Legislature to review the indefinite moratorium on care after the review is complete.
The measure also allows minors to sue medical providers for malpractice for gender-affirming medical care if the minor “later disaffirms consent” before they turn 25.
Cathryn Oakley, the state legislative director and senior counsel for the Human Rights Campaign, a national LGBTQ advocacy group, condemned the bill last week, just before Cox signed it.
“Utah legislators capitulated to extremism and fear-mongering, and by doing so, shamelessly put the lives and well-being of young Utahans at risk — young transgender folks who are simply trying to navigate life as their authentic selves,” Oakley said, in part, in a statement Friday. “Every parent wants and deserves access to the highest quality health care for our kids.”
CORRECTION (Jan. 30, 2023, 3:10 p.m. ET): A previous version of this article misstated the effective date of the bill. It became effective Saturday, immediately after the governor signed it, not on May 3.