Feds target NC law against gender transition surgeries for minors as unconstitutional

U.S. Attorney Sandra Hairston of North Carolina's Middle District. (Image from justice.gov)

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  • The federal government has filed a court document arguing that North Carolina's new ban on gender transition surgeries for minors violates the US Constitution.
  • US Attorney Sandra Hairston and three officials from the federal Justice Department's Civil Rights Division filed a "statement of interest of the United States of America" in the federal lawsuit Voe v. Mansfield.
  • The law enacted over Gov. Roy Cooper's veto in August makes it unlawful "for a medical professional to perform a surgical gender transition procedure on a minor or to prescribe, provide, or dispense puberty-blocking drugs or cross-sex hormones to a minor.”

The federal government believes North Carolina’s new law banning gender transition surgeries for minors violates the US Constitution. Federal officials offered that opinion in a court document filed Friday.

A federal lawsuit, Voe. v. Mansfield, challenges provisions of House Bill 808. Lawmakers enacted the measure over Gov. Roy Cooper’s veto on Aug. 16.

“The North Carolina General Assembly recently enacted a statute that prohibits the provision of, and use of state funds to pay for, medically necessary care to young people because of their sex and because they are transgender,” according to the court filing.

The 27-page document, described as a “statement of interest of the United States of America,” comes from US Attorney Sandra Hairston of North Carolina’s Middle District, along with three officials connected to the Federal Coordination and Compliance Section of the US Justice Department’s Civil Rights Division.

“As a result [of HB 808], medical professionals in North Carolina are prohibited from administering medically necessary care for transgender minors diagnosed with gender Dysphoria — even where the minors’ parents or guardians have consented to such care — while leaving non-transgender minors free to receive the same procedures and treatments,” the court filing continued. “Similarly, medically necessary care for transgender minors diagnosed with gender dysphoria is excluded from coverage under any publicly funded health insurance or health coverage plan.”

The statement of interest is designed “to advise the Court of its view that, by denying transgender minors — and only transgender minors — access to medically necessary and appropriate care and health coverage, H.B. 808 violates the Equal Protection Clause of the Fourteenth Amendment. Accordingly, Plaintiffs are likely to succeed on the merits of their equal protection claim.”

“The United States has a strong interest in protecting both individual and civil rights, including the rights of transgender persons,” according to the document. It cites a Biden administration executive order from January 2021. The order “recognizes the right of all people to be ‘treated with respect and dignity,’ ‘to access healthcare … without being subjected to sex discrimination,’ and to ‘receive equal treatment under the law, no matter their gender identity or sexual orientation.’”

The legislation states “It shall be unlawful for a medical professional to perform a surgical gender transition procedure on a minor or to prescribe, provide, or dispense puberty-blocking drugs or cross-sex hormones to a minor.”

Those currently receiving treatment will be grandfathered in, though. HB 808 states that medical professionals “shall not be prohibited from continuing or completing a course of treatment for a minor that includes a surgical gender transition procedure, or the administration of puberty-blocking drugs or cross-sex hormones” that commenced prior to Aug. 1, 2023, as long as the parents, children, and medical professional all deem it to be in the child’s best interest.

The new law also creates penalties for medical professionals in violation, including the revoking of their medical license and being opened up to civil suits from patients. In addition, HB 808 bans any use of state funds for minor sex-change treatments.

In the Senate, the veto override vote went directly along party lines, with no Democrat voting to override and no Republican voting to sustain. In the House, however, Democrats Rep. Garland Pierce of Scotland County and Michael Wray of Northampton County voted with Republicans to override.

“In some of the most liberal parts of the country, children are allowed to permanently alter their bodies with off-label drugs for the purpose of changing their sex,” said state Sen. Joyce Krawiec, R-Forsyth, in a press release after the override. “While Republicans are protecting minors from such absurd open-door policies, Democrats are siding with the furthest left of their base and putting politics ahead of documented medical risks and consequences. We need to take a cautious approach and limit access to these life-altering medical procedures, and today’s vote to override Gov. Cooper’s veto does just that.”

House Speaker Tim Moore, R-Cleveland, released a press statement on all the overrides, saying, “While Governor Cooper has tried to stand between parents and their kids, today the NC House will continue to affirm parent’s rights, protect female athletes, and advocate for the health and safety of our children.”

The controversy over youth sex-change operations and hormone treatments, often called “gender-affirming care,” has exploded onto the scene in recent years. Gender dysphoria, the sense that one’s biological sex and one’s gender identity do not match, went from being a rare condition in mostly males to a much more common condition in mostly females.

In Europe, after a time heading in the same fairly open direction to youth sex changes as the United States, they’ve had second thoughts.

The United Kingdom shut down its main youth gender center, the Tavistock Clinic, after it was determined youth were “at considerable risk” because of the clinic’s “unquestioning affirmative approach” to transitioning. They also found that while autistic people made up around 1% of society at large, they made up around 1/3 of patients at the clinic. Similar results have been found at other clinics, leading critics to wonder if social difficulties experienced by autistic people make them more at risk for gender confusion.

Sweden, Finland, and Norway, once considered the most pioneering in pro-LGBTQ+ laws, are also now backtracking, largely banning the treatments for minors after a review of the data, as North Carolina just did.