Two bill packages introduced in the state House and Senate last week would ban gender-affirming care — for transgender minors only.
The proposed legislation, titled “protecting minors from chemical and surgical mutilation,” would prohibit healthcare providers from prescribing puberty blockers and hormone replacement therapy for minors who identify as a gender that does not match their birth sex. The bill shares the same name as President Donald Trump’s executive order threatening to cut federal funding from hospitals that provided gender-affirming care for patients under 19 years old.
The bills also ban surgical procedures performed for the same reason. Transgender minors undergo such surgeries at a rate of 2 in 100,000, according to a 2024 study.
Another bill in the package would require insurance providers to cover healthcare for patients who want to reverse previous gender transition procedures. And the third bill would add a violation of the first bill as grounds for investigation by the state Department of Health and Human Services.
Bill sponsors have argued that the science behind current standards of care for transgender minors is not settled yet. Emme Zanotti, senior director of movement building and political affairs at Equality Michigan said that's not true.
“This is a whole process of ethical, well-vetted standards where there's a conversation happening between a young person, their parents or their guardians, and a medical professional,” she said. And it’s none of their business, Zanotti said.
“That's not a conversation that our state legislators should necessarily be weighing in,” she said. “I don't think there's any extra chairs for them in the doctor's office.”
Many physicians provide gender-affirming care based on the World Professional Association for Transgender Health (WPATH) Standards of Care, first published in 1979. Those standards are the result of decades of peer-reviewed research and clinical experience. The latest version was published in 2022.
The Michigan bills do not apply to gender-affirming care for cisgender minors. The legislation only bans procedures that are done “when the intent is to alter the appearance or align with a perception of sex that is inconsistent with a minor’s birth sex,” according to a statement by Senate bill sponsor Thomas Albert (R-Lowell).
In February, Michigan Attorney General Dana Nessel warned Michigan healthcare providers that halting gender-affirming care for transgender minors could count as discrimination under Michigan law.
The act doesn’t criminalize gender-affirming care for transgender minors, Albert said in a press release. Instead, it creates a path for patients to sue providers for civil damages if their providers violate the act. Those are the same tactics that the Trump administration has been using, Zanotti said.
“What this is trying to do is intimidate providers from providing scientifically evidenced essential health care,” she said.
Several Michigan House Republicans introduced a similar bill in March. The May package is clearer and focuses on medical practice, said Rep. Brad Paquette (R-Niles).
“We want to make sure we have all our ducks in a row,” he said.
The bill sponsors wanted the newer legislation to be as well prepared as possible, Paquette said. They consulted with some of the same people who contributed to a recent report by the federal department of Health and Human Services.
That report also claims that the science behind gender-affirming care is still unsettled and suggests an alternative to current standards that advocates say is akin to conversion therapy.
Paquette said one of those consultants was Colin Wright, an evolutionary biologist whose criticism of gender affirming-care is at odds with most medical literature on the subject.
Numerous medical professional organizations have decried the federal report, including the American Association of Pediatrics and American Psychological Association. Neither the Michigan Psychological Association nor the Michigan State Medical Society provided statements for this story.
Albert’s team had been working on the Senate bills for months, and the federal report did not influence the introduction of the bill package, his office said in an email. Paquette said the legislation was similar to bills introduced in other states, like Ohio, and followed Trump’s executive order.
The bills aren’t actually about protecting children, Zanotti said.
“There's so many red flags in this legislation. And that's because it's not good faith public policy that's meant to protect working families in Michigan,” she said. “It's a political agenda and nothing else.”
