The South Carolina House of Representatives overwhelmingly passed a bill banning gender-affirming care for transgender minors on Wednesday.
The proposed H.4624 bill defines critical terms like “gender transition” and “gender transition procedures,” effectively banning surgeries, hormone therapy and puberty blockers for anyone under 18. It also restricts Medicaid coverage for surgeries for anyone under 26 and forbids public funds from directly or indirectly supporting these procedures.
H.4264, dubbed the “Help Not Harm” bill by its Republican proponents, was approved with 82-23 votes in favor. While the fiscal impact on state and local budgets is deemed negligible, potential litigation costs and notification fees for school districts raise concerns.
Before advancing the bill, lawmakers rejected two amendments. The amendment proposed by Rep. J.A. Moore would have allowed ongoing hormone treatment for minors already receiving it. Meanwhile, the amendment proposed by Rep. Marvin Pendarvis sought to remove a ban on public funding for adult gender-affirming care. Both amendments failed, and the bill advanced to the Senate.
Today, we take a stand for the protection of our children, ensuring they are not exposed to irreversible medical procedures at an age when they are most vulnerable.
Rep. Sylleste Davis
Proponents argue the bill protects children from irreversible medical decisions during a vulnerable time. However, opponents condemn the bill as unnecessary and harmful, noting the opposition from major medical groups and the concerns expressed by many South Carolinians.
“This ban will cause so much anguish, chaos and confusion for trans youth, their family members and their loved ones, all while the legality of these bans is being adjudicated in many other states. There is no reason to pass this bill, and it is imperative that the Senate now reject it,” said Rhys Chambers, a leader in the SC United for Justice & Equality.
Legislative battle for trans healthcare
Doctors and parents testified the prior week that gender-affirming treatments are vital for many transgender youths, allowing them to live happier and healthier lives. Research backs this claim, showing increased rates of stress, depression and suicide among transgender individuals forced to live as their assigned sex.
They also emphasized that surgeries are not performed on minors in South Carolina, while hormone treatments are only after careful consultation with health professionals.
However, bill co-sponsor Rep. John McCravy argued for the ban, citing “unpublished evidence” of increased self-harm from puberty blockers. He further described transgender children as “mentally disturbed youth” in need of protection from “mutilation.” Major medical associations have repeatedly debunked this rhetoric.
Rep. RJ May, the vice-chair of the state’s conservative Freedom Caucus, compared public funding for any transition surgeries to funding for “lifestyles” like drug addiction.
Democrats countered these claims, accusing Republicans of fear-mongering and attacking a marginalized group. They argued the bill would further ostracize transgender youth and limit healthcare access for adults.
“Is it really about protecting minors, or is it about attacking a group of people that you don’t agree with their lifestyle?” Rep. Marvin Pendarvis asked.
For us to sit here and have 124 legislators, none of which are medical doctors, dictate in a statute what a standard of care is, is reckless and it’s wrong.
Rep. Seth Rose
Rep. Seth Rose added, “For us to sit here and have 124 legislators, none of which are medical doctors, dictate in a statute what a standard of care is, is reckless and it’s wrong.”
After a wave of high-profile laws in 2023, Republican-led states are reviving attacks on transgender rights, proposing new restrictions on medical care for minors and, in some cases, adults. The bills extend beyond gender-affirming treatments to control pronouns, sports teams, bathrooms, even drag performances and school curriculums.
LGBTQ+ advocates fear escalating targeting and the expansion of bans to adults, while supporters cite child protection and treatment concerns. With legal challenges reaching the Supreme Court, the battle over transgender rights, especially healthcare, is still ongoing.
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