In May 2024, South Carolina lawmakers passed House Bill 4624, which prohibits doctors from providing gender-affirming healthcare to transgender youth as well as many transgender adults. They passed the bill despite vocal opposition from leading medical organizations, pediatricians, LGBTQ+ South Carolinians, and parents of trans youth who warned the state that the law was discriminatory, harmful, and unneeded.
By August 2024, the new law was already endangering the health of South Carolinians and forcing families of trans adolescents to consider fleeing the state so they could continue receiving prescribed treatments including puberty-delaying medications and hormones. Meanwhile, adults who were receiving gender-affirming care on Medicaid, on the state employees’ health insurance plan, and at the Medical University of South Carolina began receiving notice that their appointments were canceled and that they were no longer able to receive essential medical care.
On August 29, three adult transgender South Carolinians who had lost access to healthcare, along with two families of trans youth who were blocked from receiving care in the state, sued the state seeking a preliminary and permanent injunction on three provisions of this law:
- A prohibition on medical professionals providing gender-affirming care to South Carolinians under age 18;
- A prohibition on the use of public funds for gender-affirming care for South Carolinians regardless of age; and
- A prohibition on gender-affirming care coverage under South Carolina’s Medicaid program
The plaintiffs are represented by attorneys from the American Civil Liberties Union, ACLU of South Carolina, and Selendy Gay. Most plaintiffs filed under pseudonyms to protect their anonymity, with the exception of Sterling Misanin, a trans man who had a surgical appointment canceled at the last minute following passage of the law.
Why this case?
The ACLU of South Carolina is proud to defend the rights of trans South Carolinians, who were the target of at least 22 bills in the state legislature during the 2023-2024 legislative session. Despite making up a tiny fraction of the state population, their health, freedoms, and even their existence have come under intense attack by some of the most powerful people in state government.
This law was clearly written to discriminate. Medical care and procedures that remain available to other South Carolinians (including hormone therapy and puberty-delaying medications) are now forbidden for the treatment of gender dysphoria, a medical condition that can lead to intense distress and even suicidality when left untreated.
With the stroke of a pen, politicians have interfered in the personal healthcare decisions of trans South Carolinians and their families. This law discriminates on the basis of sex and transgender status, in clear violation of the Fourteenth Amendment’s Equal Protection Clause. The law also violates the due-process rights of parents and the anti-discrimination clauses of the Medicaid Act, Affordable Care Act, Americans with Disabilities Act, and Rehabilitation Act.
The latest
We filed the lawsuit in federal court on Aug. 29, 2024, seeking a preliminary and permanent injunction on the state’s gender-affirming care ban. The case is ongoing.
