Editor’s note: This is the first in an ongoing series about key issues that states have advanced in 2021.

The cultural phenomenon of transgenderism is growing at an astonishing rate. The number of gender reassignment clinics in the United States has increased from one in 2007 to 50 today. In her book, Irreversible Damage, Abigail Shrier reports that most Western countries have seen a 1,000-5,000 percent increase in teenage females seeking treatment from gender clinics and psychologists—many of whom recommend that these girls socially and physically transition through hormones and sometimes surgery. This is aimed at treating what is known as gender dysphoria, defined by the American Psychological Association as “psychological distress that results from incongruence between one’s sex assigned at birth and one’s gender identity.”

One’s sex is never “assigned at birth”; it is always objective and observable by the time of birth. Propagating an ideology of fluid sexuality undermines a scientific understanding of human anatomy and damages children’s lives. The staggering growth of transgender ideology increasingly pressures children to undergo life-altering procedures with puberty-blocking drugs, cross-sex hormones, and irreversible surgeries. These unscientific, destructive gender transition procedures should not be allowed to interrupt the development of children and irreversibly alter their bodies.

States have been taking bold steps to protect vulnerable minors from being harmed by the unscientific idea that people can be “born in the wrong body.” To date, a total of 20 states have introduced gender transition bans in 2021. On April 6, Arkansas became the first state in the nation to ban the use of puberty blockers, cross-sex hormones, and gender reassignment surgeries for the purpose of gender transition on individuals under 18 when the legislature enacted House Bill 1570, the Save Adolescents from Experimentation (SAFE) Act, over the governor’s veto.

The Arkansas SAFE Act can be considered the “gold standard” for gender transition procedure bans. Arkansas HB 1570 has four key provisions:

  1. It protects minors from puberty blockers, cross-sex hormones, and gender transition surgeries (with a professional penalty).
  2. It bans the use of public funds and/or insurance coverage mandates for such procedures on minors.
  3. It includes an exception for the treatment of minors with a diagnosis of a physiological intersex disorder.
  4. It provides legal remedies for minors who have been permanently disfigured and/or sterilized by such procedures.

In addition to Arkansas, four states introduced fairly strong bills this year: Kentucky (HB 336), Mississippi (SB 2171), Iowa (HF 193), and North Carolina (S 514). Each of these bills contains a prohibition and professional penalty (Iowa’s bill includes a civil penalty as well), an exception for minors with a physiological intersex disorder, and legal remedies for minors harmed by such procedures. However, they do not prohibit medical insurance from covering such procedures for minors or put any restrictions on public funds being used for such purposes.

Two other states, Georgia (HB 401) and Indiana (HB 1505, SB 224), also introduced bills with all but the insurance/public funding ban. Yet, these bills impose criminal as opposed to professional penalties, which may make them more difficult to pass. Tennessee’s bills (SB 657 and HB 578), which also contain criminal penalties, are diluted because they allow minors who have entered puberty to be subjected to such procedures, provided they have parental consent and the written consent of two doctors and a psychiatrist. Family Research Council does not support allowing for medical experimentation on minors before they are old enough to make adult decisions.

Twelve states this year have introduced protections for minors that contain criminal penalties but lack legal remedies and/or exceptions for children with physiological intersex disorders (in addition to lacking provisions addressing insurance and public funds). They are:

  • Alabama (SB 10, HB 1, no private right of action)
  • Arizona (SB 1511, lacks key definitions, no private right of action)
  • Florida (HB 935, no private right of action)
  • Kansas (SB 214, HB 2210, no private right of action)
  • Louisiana (HB 575, no private right of action)
  • Missouri (SB 442, lacks key definitions, no exception for intersex disorders, no private right of action)
  • Montana (HB 113, lacks key definitions, no exception for intersex disorders)
  • Oklahoma (SB 583, SB 676, no private right of action, no exception for intersex disorders)
  • South Carolina (HB 4047, no private right of action)
  • Texas (HB 2693, HB 1399, SB 1311, lacks key definitions, no private right of action)
  • Utah (HB 92, no private right of action)
  • West Virginia (HB 2171, no private right of action)

Bills like these have been the most common for gender transition bans since 2017. They would need to add a prohibition on insurance coverage and/or public funding, an exception for minors with intersex disorders, and stronger legal remedies, in addition to trading their criminal penalties for professional penalties.

Two states, Missouri and Montana, introduced very weak bills in 2021. Missouri HB 33 includes a prohibition and professional penalty but no other provisions. Montana HB 427, despite including each key provision besides one addressing insurance and public funds, only prohibits gender reassignment surgery, not the use of cross-sex hormones or puberty blockers. Since the latter is what is most often used on minors, this makes the bill much weaker.

Eight additional states introduced bills from 2017 to 2020. The strongest of these was Minnesota HF 4694, which included each of the key provisions, including a ban on insurance coverage. However, it imposed a civil penalty instead of a professional penalty, had slightly weaker definitions, and lacked findings, among other drawbacks. The next strongest of these bills was Ohio HB 513, which lacked an insurance coverage/public funding ban and imposed criminal penalties. Four of these states—Illinois (HB 3515, 2019), Idaho (H 465, 2019), South Carolina (4716, 2020), and South Dakota (HB 1057, 2020)—lacked most key provisions. Additionally, Idaho’s bill contained criminal penalties and South Dakota’s bill contained a civil penalty, as opposed to a professional penalty. New Hampshire’s bill (HB 1532, 2018) was especially weak, prohibiting gender reassignment surgery for minors but containing no other provisions.

Over the past four years, one thing has been made clear—states want to protect their minors from life-altering procedures such as puberty-blocking drugs, cross-sex hormones, and irreversible surgeries. They have come to grips with the reality that “gender transition” is an experiment. No intervention can change a person’s genetic composition, and the best studies have demonstrated no reduction in the number of completed suicides among those who have transitioned. We have also seen states proposing stronger, more successful bills each year. Arkansas’ SAFE Act made it the first state to pass potent protections for minors. Arkansas HB 1570 is a watermark and standard that states are sure to follow, making a safer United States for future generations.