Iowa’s governor signs law banning gender-affirming care for minors

Iowa’s Republican Gov. Kim Reynolds signed into law Wednesday a ban on gender-affirming care for minors, joining a growing cadre of red states looking to restrict access to the treatments for trans youth in America.

SF 538 bans health care professionals from giving medical treatment “for the purpose of attempting to alter the appearance of, or affirm the minor’s perception of, the minor’s gender or sex, if that appearance or perception is inconsistent with the minor’s sex [at birth].” The legislation went to effect immediately after the governor’s signing.

Health professionals found to violate the law will be subject to discipline from the appropriate licensing board and can face lawsuits.

The bill’s sponsor, Republican state Rep. Steven Holt, said during floor debate earlier this month that the bill was intended to stop treatment that he considered too “experimental” to be allowed.

“I believe that the medical efficacy of these treatments is not proven,” Holt said.

Major medical associations agree that gender-affirming care is clinically appropriate for children and adults with gender dysphoria, a psychological distress that may result when a person’s gender identity and sex assigned at birth do not align, according to the American Psychiatric Association.

Though the care is highly individualized, some children may decide to use reversible puberty suppression therapy. This part of the process may also include hormone therapy that can lead to gender-affirming physical change. Surgical interventions, however, are not typically done on children and many health care providers do not offer them to minors.

Democrats in Iowa’s state House accused supporters of the ban of hypocrisy for not giving parents a choice of whether to allow gender-affirming care for their own children.

“I was under the impression that this session was going to be all about parents rights,” said Democratic state Rep. Jennifer Konfrst. “So I guess the way I’m going to read this bill is that parents know best until the government does.”

Some Republicans expressed their displeasure with the idea during debate. “I was raised not to judge other people, and we do a lot of judging of people in this building,” Republican state Rep. Chad Ingels said. “If this bill was very narrowly focused on surgery, I might have a different opinion, because that’s a big deal, but this is very broad.”

The bill ultimately passed the state House by a vote of 58-39. It had earlier passed the state Senate by a 2-to-1 margin.

On Wednesday, Reynolds also signed Iowa’s version of what opponents have called “bathroom bills,” prohibiting transgender people from using school restrooms that do not correspond to their sex assigned at birth. Any Iowa citizen who believes a school is in violation could file a complaint with the attorney general.

Iowa’s gender-affirming care ban puts it in line with Tennessee, which this month enacted a ban on all forms of gender-affirming care for minors. Mississippi, Utah and South Dakota passed their own bans earlier this year. Alabama, Arizona and Arkansas also enacted bans on gender-affirming care in recent years, though the laws in Alabama and Arkansas have been temporarily blocked by federal courts.

Other potential bans are likely on their way, with Missouri’s Republican attorney general announcing Monday he would seek to implement an emergency regulation restricting gender-affirming care. Kentucky’s Republican-led legislature passed its ban earlier this month while boasting a majority that could overturn the likely veto of its Democratic governor. That bill would also allow educators to refuse to refer to transgender students by their preferred pronouns and would not allow schools to discuss sexual orientation or gender identity with students of any age. And a bill that would ban certain types of gender-affirming care for minors is headed for Georgia Republican Gov. Brian Kemp’s desk after passing the state Senate this week.

CORRECTION: This story has been updated to reflect Missouri’s attorney general announced Monday he would seek to implement the emergency regulation.