South Carolina governor signs extreme gender-affirming care ban into law, effective immediately

South Carolina has joined most other southern states in banning gender-affirming care for transgender minors. The law also restricts Medicaid access for trans people of any age, along with forcing public schools to potentially out students.

Gov. Henry McMaster, a Republican, signed the ban, House Bill 4624, into law Tuesday. It “protects our state’s children from irreversible gender transition procedures,” he wrote on X, formerly Twitter. It goes into effect immediately, but he will have a ceremonial signing next week.

The legislation bans the administration of puberty blockers or cross-sex hormones to people under 18 for the purpose of gender transition, while allowing it for other purposes, such as the treatment of early-onset puberty. It also bans genital or nongenital surgery for gender transition for this population, although doctors do not generally recommend genital surgery for minors. “A physician who knowingly performs genital gender reassignment surgery in violation of this chapter is guilty of inflicting great bodily injury upon a child,” HB 4624 states.

The law further bans the use of public funds, including Medicaid, for gender-transition procedures for people of any age. Penalties for violation include discipline by licensing boards, and practitioners can be sued.

Another provision of the law requires public school staffers from to notify minor students’ parents or guardians if a student identifies as a gender other than the one they were assigned at birth or requests to use a pronoun or title that doesn’t align with their birth sex. However, being outed to their parents can place young trans people at serious risk of harm if the parents are not supportive.

Also, contrary to McMaster’s assertion, the effects of puberty blockers and hormone treatment are reversible. And gender-affirming care is often lifesaving for trans youth.

South Carolina is now the 25th state to ban some or all gender-affirming care for minors. Every state in the South now has a ban except for Virginia.

Civil rights groups were quick to condemn the new law. “Across the state, from the Lowcountry to the Upstate, South Carolinians are mourning the passage of H.4624, which will make it immeasurably harder for transgender youth and many adults to access the lifesaving health care that they need and deserve,” said a statement from Chase Glenn, a leader in the SC United for Justice & Equality coalition and the executive director of Alliance for Full Acceptance. “But let me be clear: This loss does not crumble a movement. Our movement supporting transgender people in South Carolina is louder and stronger than it’s ever been. We’ve marched at the State House, we’ve told our stories, and we’ve made sure our lawmakers heard from us. Now we will do everything in our power to support our community through this crisis.”

The Campaign for Southern Equality and other organizations have joined to launch the Southern Trans Youth Emergency Project, through which families can receive accurate information about the new law, help in finding out-of-state gender-affirming care providers, and emergency grants of $500 for immediate needs, including travel, medication, and other logistics.

“It has been an honor to organize alongside so many courageous trans and queer South Carolinians — and I’m proud that our community staved off this oppressive anti-trans health care legislation for more than three years,” said a statement from Ivy Hill, a leader in the SC United coalition and director of gender justice for the Campaign for Southern Equality. “Now that this attack has become law, it’s up to all of us to protect the continuity of care for as many people as we can. That’s what this project is all about: Supporting trans youth and their families and making sure they know that no law can stop the transgender community from charting our paths to a future where all of us can thrive and live authentically.”

GLAAD President and CEO Sarah Kate Ellis also released a statement denouncing the law: “H. 4624 in South Carolina is one of the most extreme attacks on transgender Americans in the country and will hurt countless families and residents while helping no one. Anti-transgender extremists claimed that their surge of attacks against basic access to health care were in the interest of protecting children, yet it’s clearer than ever that their goal is to eradicate the ability of transgender people to live and thrive in any aspect of their lives. To transgender Americans in the South and to those watching all over the country: No political maneuver can erase the fact that you exist, you belong here, and you are loved. GLAAD is committed to continuing fighting alongside our partners to undo these unconstitutional bans and to ensure an America that is safe and free for everyone.”

So did Jace Woodrum, executive director of the American Civil Liberties Union of South Carolina: “We stand in grief and solidarity with LGBTQ South Carolinians, who are increasingly under attack by our own government. We can put to rest the notion that the governor cares about limited government and personal freedom. With the stroke of a pen, he has chosen to insert the will of politicians into health care decisions, trample on the liberties of trans South Carolinians, and deny the rights of the parents of trans minors.”