As 2024 Begins, Lawmakers Continue Efforts to Protect Minors From Transgender Procedures

Leaders in the Catholic Church have spoken out against the ideology of transgenderism on numerous occasions in recent years.

Elected officials in Ohio, Missouri, and South Carolina have recently proposed or passed legislation to impose stricter regulation on transgender medical policies.
Elected officials in Ohio, Missouri, and South Carolina have recently proposed or passed legislation to impose stricter regulation on transgender medical policies. (photo: Nito / Shutterstock)

After a year of major efforts to prohibit irreversible and untested transgender operations on young children, lawmakers across the U.S. are continuing the push to protect children from those procedures.

Elected officials in Ohio, Missouri, and South Carolina have recently proposed or passed legislation to impose stricter regulation on transgender medical policies, joining the nearly half of U.S. states that have implemented such legislation in recent years, including over a dozen in 2023 alone. 

The Missouri Legislature is currently considering a bill that would make permanent a four-year ban on cross-sex hormones and puberty-blocking drugs given to minors. That provision will otherwise expire in 2027, though a ban on transgender minor surgeries would remain permanent. 

Missouri Rep. Brad Hudson, who was instrumental in passing last year’s legislation, is also working on this year’s revisions to make the drug ban permanent.

Hudson told CNA that he became aware of the pervasiveness of the youth transgender issue from his work as a pastor as well as his wife’s work in a private Christian school. 

“Gender dysphoria is real,” Hudson said. “There are kids that do find themselves in a state where they’re confused about their gender. And that’s a problem.” But medical providers, he said, have been “way too quick” to prescribe and recommend untested medical procedures for such children. 

Last year’s ban, he said, “was a good bill. It was not a perfect bill.” Hudson told CNA he is working to change two aspects of the original legislation, including the four-year sunset on the drugs provision of the bill.

“I think that aspect is ridiculous,” he said. “We should’ve never put that sunset in there. We’ll put six-year sunsets on certain tax credits, but we won’t protect kids for more than four years?” 

“There was also a grandfather clause that would allow kids on these drugs to legally remain on them,” he said. “I’m trying to remove that grandfather clause as well.”

In Ohio last month, legislators successfully passed legislation prohibiting doctors from facilitating sex changes for children, overriding GOP Gov. Mike DeWine’s veto of the legislation. The law prohibits doctors from removing a child’s genitals or performing any surgeries that would sterilize the child to facilitate a sex change. It also prohibits the removal of healthy female breasts and surgeries that would alter the child’s genitals or chest to make them appear like that of the opposite sex.

State Rep. Gary Click, the sponsor of that legislation, said following its passage that it was “hard to fathom that we live in a society that would tell children that they need drugs and scalpels to live their authentic lives or that treats women as second-class citizens in their own spaces.” 

“These are horrible, harmful, and hurtful messages for Ohio’s youth, and it is remarkable that we would even need a law to affirm these commonsense policies,” Click said at the time. 

Legislators in South Carolina, meanwhile, in January moved to consider legislation stipulating that medical officials “shall not knowingly provide gender transition procedures to a person under 18 years of age.” 

The law would direct that doctors who perform “genital gender reassignment surgery” on minors would be guilty of “inflicting great bodily injury upon a child.”

State Rep. John McCravy, a sponsor of the bill, told CNA that there are “few things we do as legislators that are more important than protecting vulnerable children.” 

“One of those important legislative protections is to protect minors from so-called gender transition procedures,” he said. 

“Growing evidence shows that puberty blockers are not safe and result in irreversible, physical, and emotional damages including mood disorders, seizures, and cognitive impairment,” McCravy argued. 

The South Carolina bill ”also protects minors from the irreversible effects of sex hormones” as well as from “radical and irreversible surgeries,” he said.

“I talked to a pediatrician who told me that less than 10 years ago these procedures would have been called child abuse. Enough said.”

Youth Protections

The early state-level efforts in 2024 continue a year of major youth protection reforms from other states throughout the country. 

The state of Texas in June passed a law forbidding doctors from performing irreversible genital surgeries and mastectomies on children in order to make them appear to be the opposite sex. Doctors are also forbidden from prescribing drugs to children for that purpose. 

State Rep. Tom Oliverson, a physician, told CNA that he got involved in the legislation last year after hearing testimony from a doctor who treats transgender-identified youth. The doctor’s testimony, Oliverson said, raised “a thousand red flags” among himself and several colleagues.

“When the issue came back up this session, I had some stakeholder groups that had reached out to me,” Oliverson said. “It was already on my mind and my heart. I’d been praying about it. The groups say, ‘We really feel like we need a physician to lead the charge on this.’ I agreed to do it.”

Oliverson described the bill as “the hardest piece of legislation I’ve ever carried.” 

“I’ve passed a lot of bills,” he said. “I’m probably in the top 10% of House members over the last 10 years [for bill passage].” But the transgender legislation “became a hill that the opposition wanted to die on.”

“From my perspective, the science is so shaky on this,” he said of transgender medicine. “Just how terrible the quality of the science is that supports the use of these treatments. There are no large randomized controlled trials. All of the systematic reviews of the literature indicate that there is no benefit to these treatments in reducing the risk of suicide and actually improving the patient’s well-being.”

The doctor said that Republicans “feel very good” about the law surviving legal challenges. 

“We believe it’s entirely constitutional,” he said. “As much as I am a parent and respect parental rights, the state has a right to step in and prevent parents from doing things which are proven to be harmful.”

Alabama, meanwhile, passed its own ban on transgender minor procedures in 2022. The law, called the Vulnerable Child Compassion and Protection Act, bans sex-changing surgeries and cross-sex hormonal treatments on minors and includes criminal penalties of up to 10 years in prison for those performing or administering sex-change procedures to children.

That law survived a challenge last year when the U.S. Court of Appeals for the 11th Circuit temporarily upheld the ban. The lawsuit against the rules, brought by “a group of transgender minors” and their parents, will continue and be reviewed by the full 11th Circuit Court. A trial is set for April of this year.

In March of last year, Mississippi Gov. Tate Reeves signed legislation that prohibited medical professionals from providing “gender transition” procedures to anyone under the age of 18. The ban included both surgeries and hormone treatments.

The ACLU of Mississippi at the time claimed the law “shuts the door on best-practice medical care,” though Reeves at the time drew a hard line in the sand on what he called “a dangerous movement that’s spreading across America today.”

“No child in Mississippi will have these drugs or surgeries pushed upon them,” he said. 

Catholic Leaders Speak Out

Leaders in the Catholic Church have spoken out against the ideology of transgenderism on numerous occasions in recent years. 

Oklahoma City Archbishop Paul Coakley last year published a pastoral letter in which the prelate acknowledged “the immense pain found within this small segment of the population” who identifies as transgender. The archbishop said Catholics “must both affirm God-given sex and recognize the struggle of the person in front of us.”

The U.S. bishops, meanwhile, last year voted to revise their guidance to Catholic health care institutions on the issue of transgender surgeries and hormone treatments, emphasizing both their incompatibility with the Church’s teaching on sex as well as the dignity of the human person.

Pope Francis in March, meanwhile, called gender ideology “one of the most dangerous ideological colonizations” because it “blurs differences and the value of men and women.”

Altogether, 22 states have imposed protections for minors against transgender procedures, according to the Movement Advancement Project, a group that supports allowing youth to access transgender medical services. 

The vast majority of those laws — 19 in all — were passed in 2023, while two were passed in 2022 and one in 2021.

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