Transgender surgery ban advances in North Carolina House

Dozens of transgender North Carolinians and their supporters spoke out against state lawmakers Tuesday as a House committee advanced legislation banning gender-affirming surgeries for minors without allowing members of the public to testify.

The audience erupted in chants of “Let us speak” and “Blood on your hands” as the Republican-controlled House Health Committee passed a proposal prohibiting healthcare providers from performing surgeries on minors to remove or alter features typical of the patient's sex assigned at birth. If the bill becomes law, North Carolina physicians would also be unable to refer a minor to another provider to receive such procedures.

While doctors sometimes provide medications for puberty blockers or cross-sex hormones to young patients who are experiencing gender dysphoria, they rarely perform irreversible procedures such as genital surgery or mastectomies on minors.

The bill, which was filed last month but not taken up by the chamber until two days before a parliamentary deadline, also bans using state funds to support gender transition procedures that are surgical for people younger than 18. It's among a flood of bills the General Assembly is fast-tracking this week with little to no time for public comment. Bills that are unrelated to taxes, spending or elections that haven’t passed one chamber by Thursday are unlikely to be considered for the rest of the biennial session.

Rep. Hugh Blackwell, a Burke County Republican and a primary sponsor of the bill, said children and teenagers need to be protected from nonemergency surgeries until they are old enough to make those decisions themselves.

“In North Carolina, you cannot get a tattoo at all, even with your parents' consent. You can't get a body piercing other than for earrings without parent consent," he said. "But we allow these surgical procedures that, in many instances maybe are irreversible and life-changing, for children who have not arrived at 18 years of age.”

Testimonies from Blackwell and another sponsor filled the allotted time to debate the bill, angering residents who traveled from across the state to share their stories. For Kirstin Cassell, a therapist and mother of a trans teenager in Greensboro, the experience was “devastating and heartbreaking.”

Cassell, 44, criticized the bill sponsors for “grandstanding” in front of those most impacted by the policy and said that parents and doctors, rather than lawmakers, should be able to make informed healthcare decisions for their kids.

“When someone isn't able to live in their body in a way that feels comfortable, you experience anxiety, you experience depression,” she said. “And having to live under transphobia for a long time — that's complex trauma.”

Rae Bandy, a transgender 22-year-old who lives in Raleigh, said they did not have access to gender-affirming treatments while growing up in Texas and seriously considered suicide because they were unable to physically transition. Bandy said they had intended to tell lawmakers about their experience being hospitalized for depression to warn them that their legislation could endanger the lives of trans youth.

“I just could not stop crying,” they said after the committee meeting. “I was a trans kid who is now a trans adult, and I made it by the skin of my teeth because I was able to get gender-affirming care when I needed it.”

The proposal must pass through another committee before it reaches the House floor for a vote. In both legislative chambers, Republicans hold a veto-proof supermajority.

At least 16 states have now enacted similar laws restricting or banning gender-affirming procedures for minors. Federal judges have blocked enforcement of laws in Alabama and Arkansas, and nearly two dozen other states are considering bills this year to restrict or ban transgender surgeries or hormone treatments.

Three states — Florida, Missouri and Texas — have banned or restricted the treatments via regulation or administrative order, but Missouri is the only state that also limits adults' access to treatments. A judge has blocked Missouri’s restrictions through May 15.