Content warning: discussion of transphobia in healthcare

Earlier this month, Tennessee Governor Bill Lee signed Senate Bill 1 (SB 1) into state law, legally prohibiting transgender minors from seeking gender-related healthcare after July 1 of this year. As defined by the Tennessee government, the bill outlaws any “course of treatment that involves hormone treatment for gender dysphoric or gender incongruent prepubertal minors.” This includes medications used to delay puberty, hormone replacement therapy (HRT), and surgery performed to alleviate gender dysphoria. 

The bill’s sponsors proposed that two groups be exempt once it goes into effect: intersex youth (people born with a combination of male and female sex characteristics) and minors who have already begun medically transitioning. Once the decision goes into effect in July, the latter population will have until next March, seven months after the enactment, to discontinue their current medical care. 

“It helps the minor children who otherwise might be subjected to surgical procedures that remove body parts or being prescribed medications that make permanent changes to a child’s body,” says state Senator Jack Johnson, a sponsor of SB 1, in an interview with Fox News.

The legislation passed through the state House with 77 ayes and 16 nays.

Opponents of SB 1 liken the bill to the state’s complete ban on abortion passed in August of last month. 

“For the legislature to take away the ability of patients to receive this care and doctors to provide this care is really unprecedented in anything except the abortion context,” says Kathryn Sinback of the American Civil Liberties Union of Tennessee. 

Lindsay Templeton, Enloe senior and co-president of the school’s Genders and Sexualities Alliance says, “It’s just a different type of puberty a lot of the time. You would never know who is going through it and who’s not half of the time.”

So, how does this approval affect North Carolinians?

Tennessee is one of four states that have passed restrictions on gender-related healthcare for minors in 2023. With it being so close to Raleigh’s home state, transgender rights activists say there is a chance of influence over state lines. North Carolina’s House Bill 43 (HB43), restricting the same kinds of healthcare services for minors, is currently advancing through the state House of Representatives. If passed, the bill would impose a $1,000 penalty on healthcare providers and revocation of their medical licenses. Tennessee’s recent bill proposes a fine of $25,000. 

The Duke Child and Adolescent Gender Care Clinic in Durham is one of the few gender clinics in the South open to minors. Many patients make long road trips across state borders and encounter six-month long waitlists to receive the care offered. In the past decade, British gender-related healthcare providers have seen a 4000% increase in demand for their services (Rayner).

The shutdown of Tennessee’s singular gender clinic at Vanderbilt University Medical Center (VUMC) would cause transgender Tennesseans to seek their care elsewhere, mainly in neighboring states. This even larger influx of necessity would make wait times longer and reduce clinics like Duke Health’s availability. VUMC has already put a pause on gender-related surgeries since last October after backlash from opposed state lawmakers. 

“Families of trans kids who can move might see North Carolina as a refuge state… we’re already a booming population, our healthcare system is already not great, so we’re definitely going to see the effects of other states banning trans healthcare but we’re also going to see it if we pass our own anti-trans healthcare [bills],” says Templeton.  

NC House Bill 43 was introduced in early February but has not progressed since then. If passed, it would be implemented on October 1, 2023. 

Works Cited

Mion, Landon. “Tennessee Senate Approves Measure Banning Gender Transition Treatment for Transgender Youth.” Fox News, 15 Feb. 2023, www.foxnews.com/politics/tennessee-senate-approves-measure-banning-gender-transition-treatment-transgender-youth 

Timms, Mariah, and Laura Kusisto. “Tennessee Governor Signs Bill Restricting Transgender Healthcare for Minors.” WSJ, 3 Mar. 2023, www.wsj.com/articles/tennessee-governor-signs-bill-restricting-transgender-healthcare-for-minors-9e178c33 

Rayner, By Gordon. “Minister Orders Inquiry Into 4,000 per Cent Rise in Children Wanting to Change Sex.” The Telegraph, 16 Sept. 2018, www.telegraph.co.uk/politics/2018/09/16/minister-orders-inquiry-4000-per-cent-rise-children-wanting