HB1 Passes, Effectively Banning Gender-Affirming Care for Youth

The Tennessee General Assembly passed a bill Thursday that puts doctors at risk of losing their license for providing gender-affirming care to minors. The legislation is also making parents of trans youth question their future in the state. 

House and Senate Bill 1, which effectively bans gender-affirming care for transgender youth, is on its way to Gov. Bill Lee’s desk after passing in the House 77 to 16 on Thursday. It passed in the Senate earlier this month. The American Civil Liberties Union of Tennessee is planning to take legal action to stop the legislation, which penalizes medical providers who offer hormone therapy, puberty blockers and gender-affirming surgeries for minors in the state. 

ACLU of Tennessee staff attorney Lucas Cameron-Vaughn says the bill violates the constitutional rights of adolescents, parents and their medical providers. 

“Parents have a fundamental right to direct the upbringing of their children,” Cameron-Vaughn says. “It's been recognized for many years by the U.S. Supreme Court. This law would intrude upon that right. It would also discriminate against young people for being transgender, violate their equal protection and due process rights and it would violate the rights of doctors to take care of their patients.”

Tennessee is one of 11 states that has proposed a law limiting gender-affirming care for trans youth, but two states, Alabama and Arkansas, are ahead of Tennessee in the process. In 2021, Arkansas passed a similar law, and the ACLU sued. The case is ongoing. In 2022, Alabama was the first to make providing gender-affirming medical treatment a felony in the state. The U.S. Department of Justice promptly challenged the law, and eventually a judge ruled to allow hormones and puberty blockers, but not surgeries. State Rep. John Ray Clemmons (D-Nashville) unsuccessfully pushed for a similar policy on the House floor Thursday.  

Senate Majority Leader and bill sponsor Jack Johnson (R-Franklin) was among the legislators who stood in front of a crowd at an anti-trans rally in October and pledged to file what would become HB1. The rally was led by conservative media figure Matt Walsh, who posted a social media thread accusing the Vanderbilt Pediatric Transgender Clinic of malpractice and prompted a firestorm of attention. Walsh also testified for the bill in the legislature. 

Vanderbilt University Medical Center’s Pediatric Transgender Clinic released a statement that month explaining that an average of five patients per year, all 16 or older, received surgeries, and none received genital surgeries. Even so, Vanderbilt put a pause on the surgeries in October. The pause is still in effect, a spokesperson confirmed to the Scene Thursday.  

The legislation provides a path for parents to sue if the care happened without their consent and for people who received gender-affirming care as minors to sue their medical providers as adults. Even if the family involved is satisfied with their child’s care, the state attorney general can sue.  

“Physicians have the harm of having to choose between breaking the law or providing appropriate care in line with medical consensus,” says Cameron-Vaughn. 

HB1/SB1 does not explicitly threaten gender-affirming care for adults, but it is evidence of a worrisome trend, Cameron-Vaughn says. There are a number of bills moving through the legislature that target the LGBTQ community, including one criminalizing public drag performances, which also passed Thursday.

The ACLU is poised to buy time by suing before HB1/SB1 goes into effect in July, but families of transgender kids are on a timeline too — when their child will hit puberty. 

One mother of an adolescent trans son is considering closing down her small business and moving away due to the legislation.

“I feel like I've done my part as a Tennessean for the last eight years that I've resided in the state by running a successful business that supports people in their community, and I've found a lot of great success and a lot of amazing friendships and community and solidarity in this city,” she says. “I'm just hoping that the courts are able to stop it and that somehow people will come to their senses and realize what dangerous legislation this is.”

Another mother whose name we also withheld has a kindergarten-age child who is trans and is worried about access to gender-affirming care as her child grows. She has lived in Tennessee her entire life and is concerned for families who may not have the means to leave.   

“​​We love our community and we're super invested and we are really supported and loved and valued by our immediate community, but we're positioned in a state where it's kind of up in the air,” she says. “It's a question mark, and if we can't give our child the life that she deserves, then we will find that somewhere else.”