Bills targeting transgender medical care continue to move through the Legislature

Yahoo

02-04-2025

Opponents of legislation that would place restrictions on transgender Georgians gathered across from the state Capitol in January. Ross Williams/Georgia Recorder
As the 2025 legislative session comes to a close, transgender Georgians continue to be relentlessly targeted by state legislators, including with Senate Bill 30, Senate Bill 39, and Senate Bill 185, all of which would restrict access to evidence-based medical care. Despite opposition from medical, mental health, and legal experts, the Georgia Senate passed these bills, handing them off to the House for consideration.
SB 39, a vaguely worded and wide-ranging bill, inserts lawmakers directly into the patient provider relationship. It would prevent access to any health care deemed 'transition related' for more than half a million state employees and their dependents who rely on the State Health Benefit Plan, as well as others who receive care that is state funded. The breadth of its impact regarding state associated funding is unclear, and perhaps that is the point, allowing its sweeping prohibition to be as widely applicable as possible. Likewise, what qualifies as 'transition-related' care is similarly unclear, risking the restriction of funds for a wide range of medical care. At a House Health Committee hearing on March 26, when questioned about whether SB 39 would prevent access to mental health care, Sen. Blake Tillery, the bill's sponsor, stated 'If not aligned with one's sex at birth, then I think yes.'
To push through the myriad of anti-transgender legislation prior to the end of the session, SB 39 has adopted language from SB 185, a bill that specifically prohibits gender-affirming care for transgender adults who are incarcerated in Georgia, including medications that were previously prescribed by their medical provider. To protect the health of transgender individuals, we must prevent these bills becoming law.
As medical and mental health providers, we believe all patients deserve access to high quality, evidence-based medical care. For many transgender people, gender-affirming care is essential and lifesaving. Numerous studies demonstrate the indisputable benefits of gender-affirming care for transgender patients, including reduced symptoms of anxiety and depression, less psychological distress, lower risk of suicidal thoughts, and better interpersonal relationships. Every major medical and psychological association in the U.S., including the American Medical Association, the Endocrine Society, the American Psychiatric Association and the American Psychological Association, among others, recognize the evidence basis supporting the medical and psychological necessity of gender-affirming care. These bills inappropriately insert legislators into medical decision making, infringing on the rights and well-being of transgender patients.
Taking away individuals' access to gender-affirming therapies while in prison constitutes cruel and unusual punishment and increases the likelihood of abuse and detrimental health consequences. Abrupt cessation or forced weaning of medically necessary, ongoing treatment is a health risk. Physical effects of hormone withdrawal are accompanied by psychological distress, which may manifest as anxiety, depression, and suicidality. These bills risk the forced detransition of individuals who may have consistently taken gender-affirming hormone therapy for years. This physically and psychologically damaging experience is unnecessary and profoundly harmful.
Transgender people often endure significant discrimination, economic insecurity and, in some cases, homelessness. These vulnerabilities make it more likely that transgender individuals will face criminalization and incarceration. Within the criminal legal system, transgender people experience further marginalization and discrimination. It is common for transgender individuals to be dangerously and illegally placed in prison facilities misaligned with their gender, increasing risk of harassment and violence. They are also less likely to receive necessary services, including personal care items and essential medical care. At least one in three transgender people in prisons and jails have reported being sexually assaulted. The danger is much greater for transgender females, with almost 50% reporting harassment, physical violence, or sexual assault while incarcerated. These statistics are likely an underestimate as some prison staff facilitate and perpetuate violence towards transgender individuals, making it dangerous to report abuse. Often, the only 'protection' offered is solitary confinement, which exacerbates stigma and may result in serious mental health consequences.
The U.S. Department of Justice has determined that Georgia's prisons fail to reasonably protect incarcerated people from harm, violating their constitutional rights. SB 185 would prohibit the state from funding medically necessary gender-affirming therapies, including hormone therapy, for transgender people who are incarcerated. All people who are incarcerated in Georgia have a right to medically necessary care, not only those deemed deserving by state politicians. Multiple lawsuits brought against the Georgia Department of Corrections as well as departments in several other states have resulted in courts ruling that transgender individuals who are incarcerated have a right to access gender-affirming care. Prior discrimination lawsuits involving transgender people in Georgia have cost taxpayers more than $4 million since 2015, including cases brought by transgender people who were unable to access medical care while incarcerated. SB 39 and SB 185 run counter to established precedent and medical expertise. This would not only worsen the health of transgender individuals in Georgia but also continue a track record of costly litigation paid for with taxpayer dollars.
The bills are dangerous and discriminatory and create new problems for the state while addressing none. By dismissing medical expertise and interfering with the patient-physician relationship, the Georgia Legislature once again seeks to make Georgians' health decisions for them. Lawmakers should devote their time and the state's resources to improving healthcare gaps currently impacting millions in our state. This legislation targets the rights and wellbeing of transgender people, who are made vulnerable by widespread societal stigmatization. Under the guise of fiscal responsibility, this paternalistic legislation seeks to politicize medical care at the expense of a marginalized patient population. It is incumbent upon all Georgians who respect a patient's right to make their own medical decisions with their physician and oppose state sanctioned discrimination against minoritized groups, to contact our state legislators and urge them to oppose any legislative efforts to harm transgender Georgians.
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