Indiana becomes 14th US state to ban sex change surgeries for children under-18

Indiana and Idaho have become the thirteenth and fourteenth states to ban puberty blockers and sex change surgery for under-18s.

Indiana Gov Eric Holcomb, a Republican, signed his state’s ban — which also included hormone therapy — into law yesterday after it passed a vote in the Legislature. 

The new law gives minors currently receiving transition care until the end of the year to stop doing so. Starting July 1, transgender youth under 18 will be prohibited from accessing hormone therapy, puberty blockers and surgeries in the state.

The move comes just a day after Idaho governor Brad Little made it a felony to offer any transgender care to minors, saying he was protecting minors from treatments that could do ‘irreversible damage’. 

They join a growing list of Republican states raising concerns over transgender care for minors, which can be irreversible. But opponents claim they violate children’s human rights.

Indiana’s Republican governor Eric Holcomb (left) said that transitions should occur as an adult, rather than as a child. Idaho’s republican governor has made it a felony to offer transgender care to minors. Both bans will come into force next year

Medical providers maintain that some of the care now prohibited by the law, including hormone blockers are ‘reversible treatments’. But supporters of the legislation argue that there is too little evidence on the long-term health consequences of the treatments.

There is no federal minimum age for providing trans youth with gender-affirming care including surgeries, hormone therapies, and pubery blockers. States have therefore set their own policies, resulting in a patchwork of laws across the US.  

Upon signing the bill on Wednesday, Holcomb said: ‘Permanent gender-changing surgeries with lifelong impacts and medically prescribed preparation for such a transition should occur as an adult, not as a minor.’

There are about 4,100 transgender children in Indiana and 2,100 in Idaho, according to the California-based Williams Institute.

Indiana’s ban is set to come into force on July 1, with youths already on treatment required to stop receiving them by the end of the year. Some of the medications affected include gonadotropin-releasing hormone (GnRH) analogues, commonly known as puberty blockers, and estrogen supplements that lower the amount of testosterone the body makes.

It also bans gender reassignment surgeries for minors, which hospital representatives in the state say they do not routinely carry out.

Medical guidelines generally do not recommend genital surgeries before a child turns 18. 

Mr Holcomb said surgeries and treatments for gender reassignment should only be offered to people as adults.

Idaho’s new law, signed by Gov Brad Little on Tuesday evening, goes into effect January 2024.

Mr Little said: ‘In signing this bill, I recognize our society plays a role in protecting minors from surgeries or treatments that can irreversibly damage their healthy bodies.

‘However, as policymakers, we 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.’ 

Gov Little’s Idaho office said it had received nearly 20,000 calls and 11,500 messages from people who were in favor of the legislation as of Tuesday evening. 

Last week the state also signed into law a bill that restricted transgender children’s access to school bathrooms. The legislation bars students from using locker rooms, changing facilities, and bathrooms that don’t match up with their sex assigned at birth. 

Gov Little recently vetoed a bill that would allow parents to sue schools and libraries for $2,500 if they contain material deemed ‘harmful to minors’ — defined as material related to homosexuality or ‘intimate sex acts’. 

Idaho and, more recently Indiana, add to at least a dozen other states that have taken steps to ban or severely curtail access to transgender healthcare services. 

In response to the Indiana law, the American Civil Liberties Union (ACLU) – a liberal legal advocacy organization that specializes in cases pertaining to reproductive healthcare, voting rights, and discrimination – has filed a legal challenge. 

The organization slammed the move as ‘devastating’ for transgender youth. 

Ken Falk, ACLU legal director for Indiana, said: ‘This law would be devastating to trans youth and their families, causing them serious injuries and forcing those who can to uproot their lives and leave the state to access the gender-affirming care they need.’

Pictured above are protesters at the Indiana senate chamber on February 2023 urging governors not to sign a law banning gender-affirming care for minors

Bud Light has come under fire this week for using trans TikTok activist Dylan Mulvaney (pictured) to promote its beers. A marketing expert said they had the wrong audience

The case was brought on behalf of four transgender youths, a doctor and a health care clinic who allege that the law violates the 14th Amendment and Medicaid requirements.

The 47-page lawsuit also asks the court to find the law unconstitutional and asks for it to block the state from enforcing the measure.

At least 12 other states have enacted partial or total bans on transgender care for minors to date. 

Utah, Arizona, South Dakota, Iowa, Tennessee, Mississippi and Florida all ban transgender care for minors.

Bans in Arkansas and Alabama have been blocked by the courts, while the one in West Virginia makes an exception allowing doctors to prescribe medical therapy if a teenager is considered at risk for self-harm or suicide. 

Georgia’s ban allows a limited exception to continue treatment for those who began receiving care prior to July 1, 2023

And in Texas, Republican Gov Greg Abbott and Attorney General Ken Paxton issued a directive in February 2022 designating most forms of transgender healthcare for youth as ‘child abuse’. This amounted to a de facto ban that has impacted as many as 29,800 transgender youth.

Major US medical organizations including the American Academy of Pediatrics, the American Psychiatric Association and the American Medical Association have thrown their weight behind gender-affirming care for youths.

President Joe Biden has also signaled support, having met with trans TikTok activist Dylan Mulvaney. At the time, he applauded her ‘days of girlhood’ video series, which he had watched. 

But the US is increasingly becoming an outlier when it comes to transgender care having imposed no federal age limit on treatments.

Britain, Sweden, the Netherlands and swathes of other European countries have taken a more cautious approach — imposing age limits for certain transgender treatments.

The editor of prestigious medical journal the BMJ has also warned that trans children in America are being rushed into sex change surgery ‘without any psychological support’.