龙之战
States That Have Restricted Gender-Affirming Care for Trans Youth in 2023_我的网站
A | 如果说妈妈都不是天使，那么这个世界上就没有天使了。妈妈不管在什么情况下，都不会放弃自己的孩子，即使他身染重病，即使他有不完美。最近，在重庆的街头，有这样一位伟大的妈妈，她阳光开朗，但是在这样的外表下，却有着血淋淋的经历和心酸的过往。
B | 一位画画的博主，在晚上看到了这个小摊，别人都已经收工回家了，可是她还在这里简直着，而且还带着两个小孩子。
A large majority of transgender adults in the United States – 78% – say living with a gender different from the one assigned to them at birth has made them more satisfied with their lives, according to a recent survey from The Washington Post and Kaiser Family Foundation.
Among respondents, more than three-quarters had changed their type of clothing, hairstyle or grooming habits to align with their preferred gender, while 31% had used hormone treatments and 16% had undergone gender-affirming surgery or a related surgical treatment to alter their appearance.
But such options are becoming available on a more limited basis, as politicians in multiple states have attempted to restrict trans Americans’ ability to seek gender-affirming medical treatments. In some states, such as Georgia and Tennessee, bans for minors were approved in the first quarter of 2023.
What Is Gender-Affirming Care?
The Human Rights Campaign, a LGBTQ+ advocacy group, defines gender-affirming care as “age-appropriate care that is medically necessary for the well-being of many transgender and non-binary people who experience symptoms of gender dysphoria, or distress that results from having one’s gender identity not match their sex assigned at birth.” The organization notes both the American Medical Association and American Academy of Pediatrics support “age-appropriate, gender-affirming care for transgender and non-binary people.”
Conservatives often oppose the concept of gender-affirming care – which may or may not include surgical or other interventions – for various reasons, including religious beliefs and concerns about child abuse. “You don’t disfigure 10-, 12-, 13-year-old kids based on gender dysphoria,” Florida Gov. Ron DeSantis, a Republican, said at an August news conference.
Some have expressed concern about a lack of data on the possible long-term consequences of gender-affirming medical treatment for minors. A Reuters investigation, for example, found “no large-scale studies have tracked people who received gender-related medical care as children to determine how many remained satisfied with their treatment as they aged and how many eventually regretted transitioning.” Others, according to the article, have raised alarms about children who are not appropriately evaluated before receiving gender-affirming medical care.
These States Have Banned Gender-Affirming Care
Below are the states that have moved to restrict some form of gender-affirming care for minors so far in 2023, based largely on legislation tracking from the Equality Federation, an advocacy accelerator that works with a network of state-based LGBTQ+ organizations.
Some states, such as Arizona and Alabama, passed bans prior to this year and are not included on the list. Alabama’s law has since been blocked by a federal judge as it faces a challenge in court.
Dozens of bills are still being considered by lawmakers in other states, according to the federation. And officials elsewhere, including in Florida and Missouri, have bypassed state legislatures altogether.
Signed into law by new Republican Gov. Sarah Huckabee Sanders in March, Arkansas’ law will make health care providers liable for civil action for up to 15 years after a minor turns 18 if they performed a gender transition procedure on that minor – essentially making it easier to file malpractice lawsuits in these situations. On that note, experts say the law acts as a de facto ban on gender-affirming care for children because it makes it nearly impossible for providers to get malpractice insurance, according to the AP. In 2021, state lawmakers passed the nation’s first ban on gender-affirming care for minors. The move was temporarily blocked shortly after, but on June 20, 2023, a federal judge issued a permanent injunction against it, ruling the ban unconstitutional. It marked the first time such a state ban was overturned, but the more recent law signed by Sanders was still set to go into effect.
The state Department of Health’s Board of Medicine announced a new rule in March that prohibits several types of therapies and procedures for treating gender dysphoria in minors. The methods of care covered include sex reassignment surgeries and puberty-blocking therapies. Minors already being treated with the rule’s referenced therapies prior to the effective date of it were allowed to continue. Then, on May 17, DeSantis signed into law a similar gender-affirming care ban from the state legislature, which, in addition to prohibiting procedures from being performed on minors, also grants Florida courts “temporary emergency jurisdiction” over a child if they have been subjected to or “threatened” with sex-reassignment prescriptions or procedures. The law also requires transgender adults to get written consent before undergoing such procedures by using a form adopted by the Board of Medicine and Board of Osteopathic Medicine, according to Reuters. But on June 6, a district court judge in Florida issued a preliminary injunction that temporarily blocked enforcement of some parts of the law for specific plaintiffs.
Senate Bill 140 was signed into law by Georgia’s Republican Gov. Brian Kemp in late March. The legislation, pushed forward by the Republican majority in the state’s General Assembly, prohibits “certain surgical procedures for the treatment of gender dysphoria in minors from being performed in hospitals and other licensed healthcare facilities.” There are exceptions, including treatments that are deemed “medically necessary” and situations covering continued treatment for minors undergoing “irreversible hormone replacement therapies” prior to July 1, 2023. But a federal judge on Aug. 20 granted a preliminary injunction which blocked the portion of the law banning doctors from starting hormone therapy for transgender minors. The prohibition on surgical procedures was not covered by the injunction.
The state’s GOP Gov. Brad Little approved a bill that criminalizes providing gender-affirming care for youth. Signed on April 4 and going into effect in January 2024, the law makes it a felony to provide hormones, puberty blockers or other gender-affirming medical care to minors. Little said in a letter confirming the bill signing that policymakers “should take great caution whenever we consider allowing the government to interfere with loving parents and their decisions about what is best for their children.”
Republican Gov. Eric Holcomb signed into law on April 5 a bill banning all gender-affirming care for minors, after previously saying there was “some vagueness to it,” according to the AP. The governor said in a statement that “permanent gender-changing surgeries with lifelong impacts and medically prescribed preparation for such a transition should occur as an adult, not as a minor.” Parts of the law, however, were blocked by a federal judge on June 16 following a request for a preliminary injunction by the American Civil Liberties Union of Indiana. The order stops the law’s ban on puberty blockers and hormone treatments for minors from going into force on July 1, but does not impact the restriction on gender-affirming surgeries.
Iowa’s ban, signed into law on March 22, prohibits health care professionals from “knowingly” performing certain medical practices on minors if they are “for the purpose of attempting to alter the appearance of, or affirm the minor’s perception of, the minor's gender or sex, if that appearance or perception is inconsistent with the minor's sex.” Practices covered by the law include hormone therapies and surgical procedures. As with other states’ laws, there are some exceptions, including a “medically verifiable disorder of sex development.”
The state on March 29 joined others in banning gender-affirming medical care for minors when the Republican-led Kentucky General Assembly voted to override Democratic Gov. Andy Beshear’s veto, becoming the first state led by a Democrat to approve such a ban in 2023. The law notes that any health provider who violates the prohibition can have their license or certificate revoked. A federal judge on June 28 temporarily blocked the portion of the law that would have banned transgender youth from accessing puberty blockers and hormone therapy, but that same judge lifted the injunction on July 14 – allowing the restrictions to go into effect. A federal appeals court panel on July 31 allowed the state to continue enforcing the law.
With a successful override attempt of Democratic Gov. John Bel Edwards’ veto by the state’s Republican supermajority legislature, Louisiana approved a ban on gender-affirming care for minors on July 18. The law, which goes into effect on Jan. 1, 2024, covers procedures such as hormone therapies, puberty blockers and gender-reassignment surgeries. The ban’s ultimate approval came after a Republican lawmaker cast a tie-breaking vote to kill the legislation in May. But it was eventually resurrected and passed before Edwards’ veto.
Mississippi’s law – among the first to be enacted in 2023 – bans any person from knowingly providing or engaging in conduct that aids and abets the performance of gender transition procedures on a minor in the state. The ban also prohibits the use of public funds or tax deductions for such procedures. Republican Gov. Tate Reeves said when he signed the bill into law that “radical activists” are telling children they are “just a surgery away from happiness,” according to the AP.
GOP Gov. Mike Parson on June 7 signed a bill that will restrict gender-affirming health care for minors and some adults in Missouri starting in late August. The law prevents the state’s Medicaid division from covering such treatment for people of any age, and prohibits providers from prescribing puberty-blockers or cross-sex hormones to minors until Aug. 28, 2027, unless they were being treated prior to the bill’s effective date. Missouri initially banned gender-affirming care in April through an emergency regulation from state Attorney General Andrew Bailey that limited treatments for both minors and adults, the latter of which was believed to be a first in the country. But Bailey terminated the rule – which had already been on pause due to a lawsuit – on May 16, citing the state legislature’s imminent ban. A circuit judge on Aug. 25 allowed the law to take effect.
Signed into law on April 28 by Republican Gov. Greg Gianforte, Montana’s ban on gender-affirming care for minors covers both surgical procedures and medications such as puberty blockers and testosterone. As with other state laws, the prohibition has exceptions including for someone “diagnosed with a disorder of sexual development.” Any physician who performs a banned procedure can be also sued in the 25 years following it if the after-effects result in any injury, “including physical, psychological, emotional or physiological harms.” The law takes effect on Oct. 1, according to the AP. Democratic state Rep. Zooey Zephyr, a transgender woman, was exiled from the Montana House floor after she said her fellow Republican lawmakers would have “blood on their hands” if they passed the bill.
Republican Gov. Jim Pillen signed into law on May 22 a bill that prohibits gender-affirming medical care for minors, which covers people under the age of 19 in Nebraska. The law, which also bans abortions at 12 weeks of pregnancy, includes a ban on surgical procedures and limitations on “prescribed drugs related to gender alteration.” The rules for the latter are to be determined by the state’s chief medical officer – a political appointee, according to the AP. The gender-affirming care portion of the new law goes into effect on Oct. 1, 2023.
The state’s Republican-dominated legislature on Aug. 16 voted to successfully override a veto from Democratic Gov. Roy Cooper and approve a ban on gender-affirming care for minors in North Carolina. The bill’s language covers both transition surgeries and puberty-blocking drugs or cross-sex hormones. The law goes into effect immediately, but as with other state bans that have been approved, there are some exceptions to the prohibition.
Republican Gov. Doug Burgum on April 19 signed a veto-proof bill into law that criminalizes providing gender-affirming medical care to minors. The law, which went into effect immediately as an “emergency measure,” makes performing sex reassignment surgery on a minor a felony, and makes providing gender-affirming medication such as puberty blockers to minors a misdemeanor. Burgum recommended in a statement that “thoughtful debate around these complex medical policies should demonstrate compassion and understanding for all North Dakota youth and their families,” according to the AP.
GOP Gov. Kevin Stitt on May 1 signed into law a ban on gender-affirming care for minors in Oklahoma, saying he was “thrilled” to do so and “protect our kids.” The bill allows for any physician who knowingly provides gender transition procedures to be charged with a felony, but the prosecution must occur before the minor patient turns 45. The law went into effect immediately, but on May 18 the state agreed to not enforce it while opponents sought a temporary court order blocking it.
Signed into law on Feb. 13, House Bill 1080 prohibits South Dakotan health care professionals from administering various types of gender-affirming procedures on minors. If a provider violates the law, the legislation requires a professional or occupational licensing board to revoke any license or certificate held by the provider. GOP Gov. Kristi Noem strongly supported the bill before signing it, according to the AP.
Tennessee’s legislation, which was signed by Gov. Bill Lee in March but was set to go into effect on July 1, bans health care providers from performing or offering to perform a medical procedure on a minor if its purpose is to enable that minor “to identify with, or live as, a purported identity inconsistent with the immutable characteristics of the reproductive system that define the minor as male or female.” It also prohibits such procedures if the purpose is to treat “purported discomfort or distress from a discordance between the minor's sex and asserted identity.” There are exceptions, and the law establishes penalties for providers who violate it. Just days before its July 1 effective date, a federal judge on June 28 temporarily blocked the portion of the law that would have banned transgender youth from accessing puberty blockers and hormone therapy. U.S. District Judge Eli Richardson, however, did not block the law’s ban on surgical procedures. A federal appeals court on July 8 temporarily reversed Richardson’s ruling, meaning the law can take effect at least until the court conducts a full review.
GOP Gov. Greg Abbott on June 2 signed a bill banning gender-affirming care for minors in Texas. The law contains exceptions similar to other states’ efforts at restricting transition care. The Texas Supreme Court on Aug. 31 allowed the law to go into effect on Sept. 1, overruling a state district judge who had issued a temporary injunction against the ban a week prior. The law’s passage was not Texas’ first attempt at limiting gender-affirming care: Abbott in 2022 ordered the investigation of families who were receiving such care, but the order was halted by a judge in the state.
Republican Gov. Spencer Cox signed into law on Jan. 28 the first gender-affirming care ban of the year. The Utah legislature’s Senate Bill 16 restricts health providers from performing “sex characteristic surgical procedures on a minor for the purpose of effectuating a sex change” or hormonal transgender treatment on minors who weren’t diagnosed with gender dysphoria before July 1, 2023. Cox said his approval of the law was an effort at least in part to pause “these permanent and life-altering treatments for new patients until more and better research can help determine the long-term consequences,” the AP reported.
A new law signed by GOP Gov. Jim Justice on March 29 prohibits minors from being prescribed hormone therapy and puberty blockers, or from receiving gender-affirming surgery. The law, which will take effect in January 2024, contains an exception geared toward youth for whom “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.” In these cases, the minor must receive consent from their parents or guardians along with two medical providers.
。一个背在背上，另一个站在一旁，看见有客人来，老板娘十分的高兴，赶紧给顾客介绍自己家的产品，虽然是小吃，但是卖的都不贵，一个五块，一个六块。但是没想到博主上来就提出了一个要求，就是他要吃霸王餐。博主说，看见老板娘背着自己的孩子，十分的温暖，他正好是学画画的，所以想用一幅画换一顿饭。
C | 虽然不理解博主为什么这样做，但是老板娘还是麻利的就开始了手上的动作，就算是博主没有钱，她也会做一顿热腾腾的晚餐。看见博主一个女人不仅仅带着两个孩子，还在摆摊，博主十分的心疼，就问她孩子的爸爸在哪里。
D | 这么冷的天，一个正常的男人，绝对会心疼自己的老婆和孩子的。但是没想到，听到这句话，老板娘的神情落寞了下来，因为孩子的爸爸不要他了。
E | 老大在生下来就有先天性心脏病，需要花很多的钱，他的爸爸承受不住这样的压力，直接跳河了。爸爸已经放弃了孩子，她作为妈妈，不会再放弃自己的孩子，所以孩子长这么大，一直都是她在带着。心脏病比较严重，现在已经做了两次手术了，都是妈妈一个人带着去的，因为她是孩子最后的底气。孩子爸爸一去世，爷爷奶奶也不想接受这个患病的孩子，甚至把儿子的死都归咎在女人身上。尽管诉说着这样的过往，但是老板娘依旧是在笑着面对生活。
F | 现在她就是靠摆摊挣钱给孩子看病，在生活之余还会拍拍视频发到网上。在博主问到今天挣了多少钱的时候，女人苦笑的说，今天一天，就挣了22块钱。女人不仅仅有大儿子，还有老二，就是后边背着的那个。这个老二是跟现在的丈夫生的，本来两个人的感情很好，但是当她带着孩子去婆家之后，他们家里死活不同意。毕竟带着孩子的女人，就是一个拖油瓶，何况还是生病的孩子，不知道要砸进去多少钱。家人的不同意成为了两个人之间的绊脚石，尽管她又为现任丈夫生下了一个孩子，但她还是不能被婆家接受。两个人也被迫分开了，其实站在婆家人的角度来想，也不是没有道理的，毕竟大儿子需要一直做手术，这都是钱，一个活生生的人，总不能完全不管他吧？听到老板娘受了这么多的苦，博主也很心疼。尽管已经遭遇了这样的事，但是女人依旧十分的乐观，不管对谁都是笑嘻嘻的。或许只有她自己一个人在家的时候，才会体会到那种阴霾，还有那种无助和孤独，但为了孩子，她一定要振作起来，她要凭借一己之力，背起来两个孩子。老板娘说的没错，与其哭丧个脸，不如笑着面对生活！活在世上的人，谁又是一帆风顺的呢？就算是天天愁眉苦脸，也改变不了事实，她还是要努力挣够老大的医疗费，还有老二的生活费。带一个孩子已经够麻烦的了，可是她一下子就带两个，还得出去摆摊，甚至还做着互联网的工作。真不敢相信，是什么让她这个瘦弱的肩膀把这一切撑起来的，或者这就是母爱吧。唯一有安慰的就是，手术费虽然没有凑齐，但是医院考虑到她们一家人的特殊情况，可以先欠着，只要以后慢慢还就行。过完年，就要带儿子去做第三次手术了，希望这次手术一定要成功。在说到自己的时候，老板娘是笑着的，但是说到自己孩子受人白眼。老板娘的泪水就有点止不住了，眼眶也红红的，当时他奶奶把母子三人赶出家门，从这个时刻她就知道，人生，只有自己才能依靠。说到这里，女人情绪比较激动，所有人都劝她放弃孩子，但是她就偏不，她非要把儿子的手术给做了，把儿子治好才行。因为人这一辈子，就要活的有底气一点，她想要让瞧不起她的人都看看，靠自己，她也能拉扯大两个孩子。听到这里，就连博主也被感动了，说两个孩子能有这么一位妈妈，是他们的幸福。后来，博主给母子三人画了一幅画，在画上，女人的眼里有着希望的光，两个可爱的孩子，一个人在妈妈背上，另一个被妈妈搂在怀里。看起来真的很幸福，感觉在这个寒冷的冬日里，都增添了一丝的温暖。在吃完饼之后，博主说，还是要给老板娘赚点饼钱，因为她一个人，又摆摊，又带孩子，实在是不容易。博主直接给老板娘转账了5万元，因为大冬天的，一个人带着两个孩子，实在是太辛苦了。听到这里，善良的老板娘直接拒绝，说不用不用。尽管老板娘已经很穷了，但是面对陌生人来要饭吃的消息，还是赶紧动手做饭，现在面临陌生人的捐款，老板娘却连连拒绝，这才是人性的美好。博主，安慰老板娘，说没关系，他做自媒体可以挣钱。在说到第一任丈夫跳河的时候，老板娘没有哭，在自己第二次被抛弃的时候，老板娘没有哭，在自己和孩子被赶出家门的时候，老板娘心疼孩子，眼眶红了。可是现在面对陌生人的善意，老板娘终于忍不住哭了。大儿子也十分懂事的抱住了自己的妈妈，这么小的孩子，就已经很懂事了，他看向妈妈的眼神中，满满的都是心疼。
G | 看到这么懂事的孩子，或许就知道老板娘为啥宁愿不要现任丈夫，也要为孩子撑起一片天了。看见老板娘哭了，博主也是赶紧安慰，大儿子也贴心的为妈妈擦去了眼角的泪水。博主说，希望在孩子康复的路上，能够有他的一份力，在母亲哭的时候，儿子的眼神满满的都是心疼。小朋友也十分懂礼貌，走到博主跟前鞠了一躬说了谢谢。或许他从小就一直在遭人冷眼，从小就看见自己的妈妈被人欺负，偶然遇见这么好的叔叔，心里的感激之情无以言表。孩子现在最恨的就是，为什么自己不能突然长大，因为只有长大了才能保护自己的妈妈。看着女人拿纸巾擦眼泪的时候，实在是心疼死了。妈妈在年轻的时候也是一个漂亮的小姑娘，喜欢打扮，喜欢拍照，喜欢吃好吃的，喜欢去旅游。可是一旦成长为了母亲，心里就有一种责任感，这是她的孩子。孩子生病又怎么样？别人都抛弃孩子又怎么样？她作为孩子的妈妈，永远给孩子留着温暖的怀抱，就算是去工地扛钢筋，做一些体力活。
H | 或者是去开吊车，做一些危险的活，也要把两个孩子抚养成人。孩子，成为了妈妈唯一的珍宝，是妈妈最宝贵的东西。尽管自己面对了那么多世间的冷漠，可还是愿意用自己的温暖去帮助别人。
I | 会在别人对自己施以援手的时候崩溃大哭。
J | 还有博主，一个陌生人，为了一个陌生的孩子，直接转账了5万元。可是自己的手机屏幕已经裂开了，他也不愿意换，这不是大爱，什么是大爱？孩子也非常懂事，不仅妈妈是天使，就连孩子也是天使。希望孩子能够好好长大，平安健康，然后好好的保护妈妈，以后再也不让妈妈受委屈。让那些人都看看，尽管自己有心脏病，也能平安长大。信息来源。
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