These States are Trying to Block Access to Gender-Affirming care. Here are Some Real Problems They Could Be Solving.

Lately, Republican lawmakers have been singularly focused on attacking the rights of trans minors. Their latest (and cruelest) obsession has been to criminalize gender-affirming healthcare for trans youth, despite the fact that timeliness is vital in receiving such care. But all it takes is for just one of these proposals to prove salient, and it spreads like wildfire, as state after state proposes identical bills with copycat language. Now, at least a third of the nation’s transgender youth are at risk of having their access to life-saving care revoked. 

But the fact that this is a choice is important to remember—these public servants have limited time and resources, and it matters what they choose to spend those on. While these politicians seem to think that restricting the rights of trans youth is a politically savvy move during an election year, these efforts also expose their chosen priorities. Their constituents, after all, have bigger problems than what medicine someone else’s child is prescribed.

So what are the real problems these states could be focusing on instead of laws banning gender-affirming care—laws which the American Medical Association, American Academy of Pediatrics, and American Psychiatric Association all oppose? For starters, recovery from the COVID pandemic should be on the top of everyone’s list. But here are a few examples so glaring that it’s a wonder these legislators have time for anything else.

Alabama

Proposed anti-trans healthcare legislation

SB 5 – Criminalizes the provision of gender-affirming treatment to anyone under 19 carrying a sentence of up to 10 years, mandates the outing of trans children to parents.

Issues state lawmakers could be solving

• Alabama has the 5th highest firearm mortality rate in the nation
• Alabama’s poverty rate ranks 7th highest in the nation
• Alabama’s prevalence of food insecurity has rated above the national average
• The average reading level for 4th grade students has scored below the national average

Arizona

Proposed anti-trans healthcare legislation

SB 1045 – Criminalizes the provision of gender-affirming treatment to anyone under 18 carrying a sentence of up to 3 years

Issues state lawmakers could be solving

• Public school funding was ranked lowest in the nation, adjusted for cost of living
• Arizona has the 5th highest incarceration rate in the nation
• Arizona has the 6th highest rate of violent crime in the nation
• Arizona has an high average household income-to-debt ratio (1.7)
• Teacher salaries fall between $30-53,000, compared to the median state household income of $62,000

Arkansas

Proposed anti-trans healthcare legislation

HB 1570 – Bans the provision of gender-affirming treatment to anyone under 18, allowing for doctors to be sued and/or have their licenses revoked. Note: this bill was vetoed by the state governor, which was subsequently overruled by the state legislator.

Issues state lawmakers could be solving

• Arkansas has the 4th highest rate of incarceration in the nation
• Arkansas has the 5th highest violent crime rate in the nation
• Arkansas’s poverty rate ranks 6th highest in the nation
• Arkansas has 12,902 bridges rated structurally deficient. 193 dams are considered to have high hazard potential. Driving on poor roads costs drivers an average of $671 per year.

Florida

Proposed anti-trans healthcare legislation

HB 935 – Criminalizes the provision of gender-affirming treatment to anyone under 18, misdemeanor charges

Issues state lawmakers could be solving

• The disastrous collapse of the Champlain Towers condominium (which killed 98 people) was the result of owners skirting building codes and avoiding expensive maintenance. In the aftermath, Governor DeSantis downplayed state responsibility in ensuring the safety of other buildings.
• Parts of southern Florida are expected to lose coastline (including large swaths of residential areas) to rising sea levels over the ensuing decades.
• Florida has the 3rd highest percentage of homeless residents in the nation
• Florida has an high average household income-to-debt ratio (1.75)
• Public school funding was ranked 7th lowest in the nation, adjusted for cost of living

Kentucky

Proposed anti-trans healthcare legislation

HB 253 / SB 84 – Bans the provision of gender-affirming treatment to anyone under 18, allowing for doctors to be subject to disciplinary practices

Issues state lawmakers could be solving

• Kentucky has the 2nd highest fatal drug overdose rate in the nation
• Kentucky coal miners in the Appalachian mountains have been found to have higher rates of cancer and birth defects than in the rest of the state
• Kentucky’s poverty rate ranks 5th highest in the nation
• Kentucky’s prevalence of food insecurity has rated above the national average

Louisiana

Proposed anti-trans healthcare legislation

HB 570 – Bans the provision of gender-affirming treatment to anyone under 18, allowing for doctors to be subject to disciplinary practices, mandates the outing of gender-noncoforming minors to parents

Issues state lawmakers could be solving

• Louisiana has the highest rate of incarceration in the nation
• Louisiana has the 2nd highest firearm mortality rate in the nation
• Louisiana has the 2nd highest rate of poverty in the nation
• Louisiana’s prevalence of food insecurity has rated above the national average
• The average reading level for 4th grade students has scored below the national average

Missouri

Proposed anti-trans healthcare legislation

HB 2649 – Bans the provision of gender-affirming treatment to anyone under 18, allowing for doctors to be sued and/or have their licenses revoked.

Issues state lawmakers could be solving

• In 2018, 62% of voters approved an amendment prohibiting gerrymandering. The Republican majority of lawmakers have yet to enact a redistricting plan in accordance with the will of voters.
• 837 bridges in Missouri have been rated poor quality under the Federal Highway Administration criteria.
• Missouri has the 4th highest firearm mortality rate in the nation
• Teacher salaries fall between $30-53,000, compared to the state median household income of $57,000

North Carolina

Proposed anti-trans healthcare legislation

SB 514 – Bans hormone treatment and puberty blockers for anyone under 21, revokes license and fines up to $1000 per instance, requires state employees to out gender nonconforming children to parents

Issues state lawmakers could be solving

• Public school funding was ranked 5th lowest in the nation, adjusted for cost of living
  • In 1997, five lower income school districts successfully sued the state for providing inadequate funding in Leandro v. North Carolina. Over twenty years later, a court-ordered report by WestEd found that much reform is still needed to bring the state in accordance with the ruling.
• Teacher salaries fall between $30-53,000, compared to the median state income of $57,000
• North Carolina has 1,460 bridges and over 3,116 miles of highway in poor condition. Driving on poor roads costs drivers an average of $500 per year.

Oklahoma

Proposed anti-trans healthcare legislation

SB 676 – Makes the provision of gender-affirming medical care for anyone under 21 a felony, with a prison sentence of at least 3 years and a fine of $20,000

Issues state lawmakers could be solving

• Oklahoma has the 2nd highest incarceration rate in the nation
  • A Reuters investigation also uncovered that between 2009 and 2019, Oklahoma had a disproportionately high jail mortality rate
• Despite a successful teacher’s strike in 2018, Oklahoma teachers earn between $30-53,000, compared to the median state household income of $54,000 
• The average reading level for 4th grade students has scored below the national average
• Oklahoma’s prevalence of food insecurity has rated above the national average
• 10.2% of bridges in Oklahoma were rated structurally deficient

Tennessee

Proposed anti-trans healthcare legislation

HB 2835 – Bans the provision of gender-affirming treatment to anyone under 18, allowing for doctors to be subject to professional disciplinary action and $1,000 fine per instance

Issues state lawmakers could be solving

• Tennessee schools have a shortage of nurses and counselors. Ratios have been estimated as 1 nurse for every 3,000 students and 1 counselor for every 500 students.
• Tennessee has the 4th highest violent crime rate in the nation
• Tennessee has the 5th highest rate of drug overdoses in the nation
• Tennessee’s prevalence of food insecurity has rated above the national average

Texas

Proposed anti-trans healthcare legislation

Governor Greg Abbott has issued a directive to the state’s child welfare agency to investigate parents who affirm their child’s gender as child abusers, which has been temporarily suspended by court

Issues state lawmakers could be solving

• Texas’s electric grid famously proved to be a disaster during a deadly winter storm last February. It still needs repair, and the advance of climate change means storms like these will only get worse.
• The EPA has identified the Houston area as a high producer of pollution
• Texas has the 4th highest percentage of homeless residents in the nation
• 4th grade reading level scored below the national average
• Texas has the 6th highest rate of incarceration 

Sources

School funding by state via The Education Law Center

Mean teacher salaries by state via US Bureau of Labor Statistics

Median household income by state via National Center for Education Statistics

Infrastructure report card by state via American Society of Civil Engineers

Incarceration rates by state via US Bureau of Justice Statistics

4th grade reading level by state via National Assessment of Educational Progress

Food insecurity by state via US Department of Agriculture (USDA)

Firearm mortality rate by state via CDC

Violent crime rate by state via FBI

Poverty rate by state via US Census Bureau

Median household debt-to-income ratio via The Federal Reserve

Drug overdose deaths by state via CDC

Homelessness percentages by state via US Interagency Council on Homelessness