RALEIGH, N.C. (AP) — The family of a transgender boy in North Carolina is suing state health officials to block implementation gender-affirming care restrictions which they say will force their son into a traumatic, misgendered puberty.
A federal lawsuit filed Wednesday in U.S. District Court alleges that the new state law violates the Equal Protection Clause of the 14th Amendment by denying transgender youth access to treatment and undermining parents’ rights to make medical decisions for their children .
The North Carolina lawsuit closely follows the pattern of other successful legal challenges gender-affirming bans on childcare that swept Republican-controlled states this year.
At least 22 states have passed laws restricting or banning customary treatment of transgender minors, and legal challenges have produced mixed results. But court victories occur in states like Arkansas, which has a federal judge a state ban lifted as unconstitutional, outlined what Lambda Legal attorney Omar Gonzalez-Pagan sees as a successful strategy for transgender North Carolinians.
Transgender youth in the Tar Heel State immediately lost access to gender-affirming medical treatments on August 16 when Republicans won a supermajority in the General Assembly a veto overridden of the ban by the Democratic governor. State law now prohibits medical professionals from providing hormone therapy, puberty blockers and gender reassignment surgery to people under 18, with few exceptions.
Under the new law, minors who began treatment before August 1 can continue to receive that treatment if their doctors consider it medically necessary and their parents agree. However, providers say it remains unclear whether they will face retaliation for switching an underage patient from puberty blockers to cross-sex hormones because the law does not specify whether that would constitute a different course of treatment.
Representatives from Lambda Legal and the National Health Law Program say they also plan to file a motion for an injunction to block enforcement of the law while the court challenge is ongoing. Other plaintiffs include a North Carolina family doctor who cares for transgender patients and several local and national LGBTQ+ advocacy organizations. The family of the 9-year-old transgender boy is listed under a pseudonym to protect their privacy, lawyers said.
The complaint alleges that the law discriminates against transgender patients because it does not provide a blanket ban on hormone therapy and other treatments, but only prohibits them if they are performed “for the purpose of ‘gender transition.'”
“There is no treatment for transgender patients in North Carolina that is not also offered to the rest of the patients in their care, and yet the exact same treatment would be perfectly legal for all other patients,” said Alex Sheldon. Executive director of GLMA: Health Professionals Advancing LGBTQ Equality, an organization involved in the lawsuit.
The Republican General Assembly leaders’ offices did not immediately respond to emails seeking comment. Telephone messages were left for North Carolina Medical Board CEO Thomas Mansfield, who is named as a defendant in the lawsuit for his role in overseeing the licensing of medical professionals in the state.
North Carolina law also prohibits the use of state funds to support the provision of gender-affirming care. Exempt from this ban is the North Carolina State Health Plan for Government Employees and their Families, which falls under a Court order to cover these procedures while a Federal Court of Appeal considers a related case.
Medical professionals like Dr. Riley Smith, the doctor who is a plaintiff in the lawsuit filed Wednesday, would have her licenses revoked if she violates the law. Families of minor patients who receive the banned treatments would also have the right to sue the doctors who perform the procedures.
Smith said the law limits its ability to follow evidence-based protocols at the expense of its most vulnerable patients.
The American Academy of Pediatrics, the American Medical Association and the Endocrine Society consider gender-affirming care to be safe and medically necessary. While transgender minors very rarely receive surgical procedures, they are often prescribed medications to delay puberty and sometimes begin taking hormones before they reach adulthood.
Supporting young patients through gender-inclusive treatments is “the most incredible, challenging, beautiful, heartbreaking and heartwarming part of my job,” Smith said. “When I say that gender-inclusive care can be life-saving, it is no exaggeration. And the politicians who voted for this law have no idea what it means to take away that concern.”