New Georgia legislation places limits on gender-affirming healthcare for minors

By Stephanie Srakocic | Fact-checked by Jessica Wrubel
Published April 3, 2023

Key Takeaways

  • Senate bill 140 in Georgia criminalizes physicians providing specific forms of gender-affirming care to minors. The bill goes into effect this summer.

  • Physicians have spoken out about the impact of the bill.

Recently Georgia Governor Brian Kemp signed Senate Bill 140.[] The bill restricts the gender-affirming care available to transgender minors in the state. Georgia is one of a handful of states that have passed similar legislation in the past year.

In Georgia and other states where these measures have passed, proponents argue that the new restrictions protect minors from irreversible changes to their bodies. Opponents state that these restrictions are not only actively harmful to minors but also go against parental rights and standard medical recommendations. 

What does Georgia Senate Bill 140 say?

Georgia Senate Bill 140 was proposed by Republican Senator Carden Summers. The bill criminalizes physicians providing specific forms of gender-affirming care to people under 18 in the state.

This includes all forms of surgery and any hormone therapy treatment. Puberty blockers are still permitted. Violations of this law could lead to a medical practitioner losing their license. 

The legislation does allow minors who already taking hormone therapy to continue. Additionally, it includes exceptions for minors who were born with conditions that require hormonal treatment, such as intersex conditions. Although the American Medical Association supports hormone therapy as a treatment for gender dysphoria, Georgia Bill 140 does not. 

The American Medical Association’s position

In 2021, the American Medical Association stated in response to a proposed restriction on care for transgender minors in Arkansas. The statement affirmed the Association’s support for gender-affirmative care and read, in part:[]

“Decisions about medical care belong within the sanctity of the patient-physician relationship. As with all medical interventions, physicians are guided by their ethical duty to act in the best interest of their patients and must tailor recommendations about specific interventions and the timing of those interventions to each patient’s unique circumstances. Such decisions must be sensitive to the child’s clinical situation, nurture the child’s short and long-term development, and balance the need to preserve the child’s opportunity to make important life choices autonomously in the future. We believe it is inappropriate and harmful for any state to legislatively dictate that certain transition-related services are never appropriate and limit the range of options physicians and families may consider when making decisions for pediatric patients.”

 Response to the bill

In a tweet, Governor Kemp said the new law would “ensure we protect the health and wellbeing of Georgia’s children. However, many people, including members of the transgender and broader LGBTQ community, parents of transgender youth, representatives of advocacy and public policy groups, and medical professionals, fear that Senate Bill 140 will have the opposite effect. Critics of the bill point to studies, statistics, and stories showing that appropriate medical care for gender dysphoria is not just affirming; it’s often life-saving for youth.

For advocates, including Søren Estvold, MD, MPH, a family medicine physician, and board member of the Equality Clinic, part of Augusta Health, in Georgia, this bill is a setback for care in the state. 

“This bill does not protect minors, but increases their gender dysphoria, increases their depression, and increases their suicidality. It is unfortunate that transgender medicine specialists were not consulted for this legislation,” says Dr. Estvold. 

For organizations such as the ACLU, the bill’s feared overreach goes beyond medical misunderstanding and interferes with personal and family rights. According to these opponents, medical decisions about minors should be left to the child, parents, and doctor.

They argue that the state has no place in making these choices for parents or telling doctors how to care for their patients. “This bill [hurts] children and families. It’s disturbing how quickly the governor acts to sign bills that take away people’s rights,” said Andrea Young, Executive Director of the ACLU of Georgia, in a statement about Senate Bill 140.[] 

What’s next

Senate Bill 140 goes into effect on July 1. The ACLU of Georgia has promised to take legal action to fight the legislation. According to the Human Rights Campaign (HRC), there are 100 similar bills being discussed across the country.

Some bills being discussed could restrict care for people as old as 26. Georgia Senate Bill 140 joins previously passed legislation in Alabama, Arkansas, Florida, Mississippi, Texas, Tennessee, Utah, and South Dakota. According to data compiled by the Williams Institute, part of the UCLA School of Law, the restrictions affect nearly 78,000 transgender youths in these states.[] 

What this means for you

Legislation such as Georgia’s puts physicians in a difficult position, but you can still affirm and respect the gender identity of your patients. In Georgia, puberty blockers will still be an option, so that might be a conversation to have with younger patients and their parents. Beyond puberty blockers, you can affirm your patient’s gender and help them feel heard and seen in your office with best practices, such as:

  • Asking for and using their preferred pronouns

  • Asking for and using their preferred name

  • Asking if they’d like a recommendation for a gender therapist in your area

  • Having educational materials available in your office for patients and parent

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