Several states this legislative session have introduced bills aimed at curtailing access to transgender surgery and puberty-blocking drugs for minors, as well as restricting biological males from competing in girls’ high school sports.

South Dakota’s House of Representatives last week passed a bill that would ban sex-reassignment surgery and puberty-blocking medication for minors, a measure which enjoys the support of the South Dakota Catholic Conference. The measure is expected to advance, as both the state House and the Senate hold Republican supermajorities.

In Florida, a similar measure is encountering opposition in the state’s House. The bill, aiming to outlaw transgender surgery and hormone therapy for minors, has stalled in the House Health Quality Subcommittee, the Miami Herald reported Monday.

Senate Bill 1864 and its companion, House Bill 1365, would make it a felony for doctors to provide minors with hormone therapy, or to perform sex reassignment surgery, with a potential maximum penalty of a $10,000 fine or 15 years in prison, the Herald reports.

A sub-committee workshop on Monday featured hours of debate and testimony for and against the bill.

“It’s the wild west...there’s no real guidelines, laws, no real valid diagnoses given to a child before they go down the path of changing their gender,” sponsor State Rep. Anthony Sabatini (R-Howey-in-the-Hills) said in reference to Florida’s current laws governing transgender surgery for minors.

“This bill makes sure that a young person waits until they are 18 years old before they make an irrevocable decision to change into the opposite sex.”

Democrats on the House committee opposed the bill, arguing that if transgender youth have access to puberty blockers, their chances of depression and suicide decline.

The Florida speaker will be the one to decide whether the bill will move to the next committee to be voted on, a lawmaker told the Herald.

Lawmakers in Kentucky also have introduced a bill to criminalize transgender surgery performed on minors. House Bill 321, filed by State Rep. Savannah Maddox (R-Dry Ridge) would prohibit medical professionals from performing surgeries or prescribing medications to a minor with the intent to alter the sex the child was assigned at birth, the Lexington Herald-Leader reports.

Kentucky is also considering a measure aimed at restricting girls’ high school sports to biological females.

Kentucky Senate Bill 114, known as the “Save Women’s Sports Act,” would close any sport or activity designated as a “girls” sport to male students. It also would restrict locker rooms to members of the dedicated sex, coaches and staff, and emergency responders.

The sex of the student would be determined either by what is listed on their birth certificate, or by an examination by a medical professional.

According to the legislation, the state board of education and the Kentucky High School Athletic Association would not be allowed to entertain a complaint, open an investigation, or take any other adverse action against a school for maintaining separate interscholastic or intramural athletic teams, activities, or sports for students of the female sex.

Lawmakers in Massachusetts have introduced similar bills aimed at restricting lawfully sex-segregated spaces to members of the associated biological sex.

Lawmakers in Tennessee passed such a measure in 2019 clarifying what constitutes a "public place" in the law prohibiting indecent exposure and includes restrooms, locker rooms, dressing rooms and showers, The Tennesseean reports.

In other states, such as Illinois, Oklahoma and South Carolina, bills are under consideration that provide for the loss of a doctor’s medical license if they perform transgender surgery on a minor.

A bill under consideration in Missouri, HB 1721, would revoke a doctor’s medical license if they administer gender-reassignment treatment, and parents who consent to such treatment would be reported to child-welfare officials for child abuse, the AP reports.

Proposed laws restricting transgender surgery and drugs for minors in several states come in the wake of an October 2019 decision by a federal judge to strike down an Obama-era requirement that doctors perform gender-transition surgeries upon request.

The regulation stemmed from Section 1557 of the Affordable Care Act, which prohibits discrimination in health care on the basis of race, color, national origin, sex, age, or disability. HHS interpreted “sex discrimination” under this rule to include gender identity, thus mandating the provision of gender-transition surgeries.

In response to the rule, an alliance of more than 19,000 health care professionals, nine states, and several religious organizations combined in two lawsuits against the mandate, saying that it unlawfully required doctors who objected to the procedures to violate their religious beliefs or the Hippocratic Oath to do no harm to the patient.