Analyzing the Latest Gender-Affirming Care Restrictions in State Laws

Unfortunately, the political undermining continued. Arkansas Governor Sarah Huckabee recently signed Act 274 into law on March 13, 2023, the latest tactic to restrict gender-affirming care (Ark. Code Ann. §§ 16-114-401 to -403). In “An Act Concerning Medical Malpractice and Gender Transition in Minors; to Create the Protecting Minors from Medical Malpractice Act of 2023; and for Other Purposes,” Governor Huckabee amended the state medical malpractice act to permit civil suits against the healthcare provider if any harm—physical, psychological, emotional, or physiologic—arises from the gender-affirming care. The claim can be brought within 15 years of the minor turning 18 years old. This makes it exceedingly difficult to obtain malpractice insurance for the provider, which serves to restrict gender-affirming care and stigmatize this population.

Tennessee’s bill is no different. Laws are aimed to protect citizens. Tennessee’s bill does the opposite, effectively increasing the likelihood of childhood mortality. Gender-affirming interventions have repeatedly been shown to make short-term and long-term improvements in mental health (JAMA Netw Open. 2022;5:e220978). Restricting care reverses this progress. These laws fuel misinformation, distrust of science and the politicization of medicine, and serve as another gateway for constraining patient autonomy.

Dr. Fadel is a PGY-5 with the department of otolaryngology at the University of Pittsburgh School of Medicine. Dr. Troublefield is a clinical instructor of otolaryngology at Brown University in Providence, R.I., and chair of legislative affairs for the AAO-HNS Board of Governors Executive Committee.