N.C.’s new anti-trans laws sow confusion around gender-affirming care

Amanda and Josh, parents of an almost 13-year-old transgender boy, spent the summer talking to policymakers about the devastating impact that a trio of anti-trans bills in the state legislature could have on families like theirs in North Carolina and beyond. Gov. Roy Cooper (D) vetoed the bills in July, but the couple knew that wasn’t the end. So they kept talking to anyone who would listen.

“We’ve been overwhelmed trying to help and get the word out,” said Amanda, who asked that her last name not be used out of concern for her family’s safety.

On Wednesday, North Carolina’s Republican supermajority voted to override the governor and enact the bills, which affect what names or pronouns teachers use for trans students, what team sports trans girls can play in middle and high school, and whether trans children can get gender-affirming care. The laws took effect immediately.

“We’ve known this was coming since the early stages when it was being voted in the House and the Senate, but still, once everything passed I was shocked and heartbroken,” Amanda said.

Many advocacy groups and families of trans youth have been preparing for this moment, having seen a wave of similar bills enacted across the South. But the new restrictions on gender-affirming care, in particular, have created uncertainty over what care will still be allowed within state borders.

North Carolina in 2016 was the first to pass a bill barring transgender people from using bathrooms consistent with their gender identity, provoking national outrage. The law was repealed a year later. Since then, states across the country have passed scores of anti-trans bills, some of which are facing legal challenges. By the time North Carolina joined the more than 20 states that have enacted limits on gender-affirming care, advocacy groups had begun connecting families of trans kids with providers out of state and the resources to get them there. But many parents are not sure how certain aspects of North Carolina’s new restrictions will work.

The state now bars medical professionals from providing hormone therapy, puberty-blocking drugs and surgical gender-transition procedures to anyone under 18, with limited exceptions. Medical professionals found to be violating the law will lose their medical licenses.

The day the legislature voted to override the governor’s veto, Republican state Sen. Joyce Krawiec, one of the sponsors of the restrictions, said in a statement to CNN, “We need to take a cautious approach and limit access to these life-altering medical procedures, and today’s vote to override Gov. Cooper’s veto does just that.”

Most of the confusion over the new restrictions stems from an attempt to grandfather in those who are already receiving care. Anyone under 18 who needs to start care after Aug. 1 will not be able to do so in North Carolina. They will have to travel out of state for care, unless doctors deem it medically necessary and parents consent. In that case, “Any course of treatment that was initiated prior to August 1, 2023, could be continued or completed.”