State Watch

South Carolina gender-affirming care ban sent to governor’s desk

South Carolina lawmakers gave final approval Thursday to legislation banning gender-affirming care for minors, sending the measure to Republican Gov. Henry McMaster, who is expected to sign it into law.

South Carolina’s House Bill 4624 prohibits health care providers from administering puberty blockers, hormone therapy and surgeries to transgender minors, though youths receiving care prior to Aug. 1 will be allowed a “tapering off period.” Care must cease entirely by Jan. 31.

The measure also prohibits public funding from being used “directly or indirectly” for gender-affirming care, which some LGBTQ advocates have said will prevent transgender adults in South Carolina from using programs such as Medicaid to help cover the cost of treatment.

The 4th U.S. Circuit Court of Appeals, which includes South Carolina, ruled in April that state health care plans and government-funded insurance programs cannot exclude coverage for gender-affirming medical care.

If the measure is signed by McMaster, South Carolina will join 24 other states — more than half of which are in the South — to limit access to gender-affirming care for minors. 


McMaster in January called the bill “a good idea,” though some changes have been made since then. State senators this month added a requirement that public schools inform a student’s parents if they request to use a different name or pronouns that are inconsistent with their sex assigned at birth.

“If they wanna make those decisions later when they’re adults then that’s a different story,” McMaster told WPDE-TV in Florence in January, referring to gender-affirming medical care, “but we must prevent our young people from making irreversible errors.”

Gender-affirming health care for transgender adults and minors is considered safe and medically necessary by every major medical organization, though not every trans person chooses to medically transition or has access to care. Groups including the American Medical Association and American Academy of Pediatrics have denounced state and federal laws that penalize seekers or providers of transition-related care.

“South Carolina legislators abused their power today by substituting their judgment for that of parents, medical professionals, mental health care professionals and other experts,” Cathryn Oakley, senior director of legal policy for the Human Rights Campaign, a national LGBTQ advocacy group, said in a statement Thursday. “This is a major violation of South Carolinians’ liberty.” 

The Campaign for Southern Equality, another LGBTQ rights organization, said Thursday that it would expand a program for transgender youths whose access to gender-affirming care is disrupted by government policies to South Carolina. The program, the Southern Trans Youth Emergency Project, provides families with information and financial aid to ensure continuity of care. 

“We are sending so much love, support and solidarity and want trans people in SC to know that you are loved, affirmed, and seen – and that there is an entire community ready to fight against these oppressive laws,” the group said Thursday on the social platform X.