West Virginia Bans Gender-Affirming Care for Minors, With Exceptions

West Virginia Gov. Jim Justice has signed a bill into law that bans most gender-affirming care for transgender youth, with an exception for those considered at risk for suicide or other self-harm.

Justice, a Republican, signed House Bill 2007 Wednesday. It bans the provision of puberty blockers, hormones, or gender-affirming surgery (not recommended for minors and not being performed in the state) to anyone under 18. It goes into effect in January.

An amendment added late in the legislative process by Republican Sen. Tom Takubo, a physician, allows for the exception. At least two doctors must submit “written opinions that treatment with pubertal modulating and hormonal therapy is medically necessary to treat the minor’s psychiatric symptoms and limit self-harm, or the possibility of self-harm, by the minor,” the amendment states. The minor’s parents or legal guardians must agree as well.

It stipulates that the medications must be in the lowest dosage “necessary to treat the psychiatric condition and not for purposes of gender alteration.” Puberty blockers and hormones are not to be administered to prepubescent minors, and that is not standard practice in any case.

“While providers and their lawyers are waiting to see how the new law will be implemented, some doctors expect little to change in how health care workers prescribe gender-affirming medication like hormones and puberty blockers,” reports Mountain State Spotlight, a West Virginia news service.

“Big picture, I think everybody who needs care is still going to be able to get care,” Dr. Kimberly Becher, a family physician and former health policy fellow at Marshall University, told the service.

Natalie Frazier, a Planned Parenthood worker who oversees gender-affirming care in West Virginia and neighboring states, told the Associated Press the legislation is “better than it could have been,” but it still creates “an unnecessary barrier to care that is going to end up harming people.” Some teens and families can’t afford to see multiple doctors to get approval for the treatments, she pointed out.

Virtually every young person who seeks gender-affirming care is at risk of self-harm, she added. “That’s why people are so invested in providing the care, because there is a disproportionate risk,” she said. “That’s something that any of these kids could be at risk for, and nobody’s going into this care lightly.”

Cathryn Oakley, the Human Rights Campaign’s state legislative director and senior counsel, released a statement denouncing the legislation: “Gov. Justice and the legislature are substituting their political priorities for the expert judgment of medical experts — the mainstream American medical community recommends the age-appropriate, best practice medical care that this law now prohibits. I want to be clear: these lawmakers are denying transgender and nonbinary youth care that saves lives. Gov. Justice’s actions [Wednesday] are dangerous, discriminatory, and just another example of politicians in positions of power abusing their authority to cater to extreme elements of their base — harming the children of West Virginia in the process.”

Other states that states have outlawed most or all gender-affirming care for trans minors through legislation are Alabama, Arizona, Arkansas, Georgia, Iowa, Mississippi, South Dakota Tennessee, and Utah. Florida has put a ban in place through its medical boards and is considering a bill for an even stricter measure. The Alabama and Arkansas bans are temporarily blocked by court action. Bans are pending in several other states.