Oklahoma Bill Would Effectively End Adult Trans Care, Moves To Senate Floor

Transgender adults continue to be targeted by anti-trans legislation, showing that this was never about sports or minors.

The scope of legislative attacks on transgender people continues to expand. Four years ago, the main focus was on transgender athletes. Today, healthcare bans affecting transgender minors have been enacted in seven states, and bills targeting transgender adults are increasingly common. In Tennessee, one proposal would pressure insurers nationwide to avoid offering gender-affirming coverage to adults, while another bill in Missouri would require forcible medical detransition for trans individuals who are incarcerated. In Oklahoma, newly proposed bills seek to ban all gender-affirming care, regardless of age. Oklahoma's SB129 would effectively terminate gender-affirming care throughout the state by requiring nearly every pharmacy, clinic, doctor, and hospital to discontinue such services if they receive any government funding or disbursements, thereby excluding virtually every provider and pharmacy. The bill passed the Senate Appropriations Committee today 14-6.

The bill is only two pages long, but the provisions contained within are broad and far reaching. The most significant provision, which states that "public funds" cannot be used to provide gender-affirming care, is only three lines long. The scope of providers affected is broad, as revealed during the hearing. Providers range from grocery store pharmacies and insurance providers to doctors, entire hospital systems, and medical organizations. The definition of "paid" is also broad. For example, doctors who provide any medical care to Medicaid patients are banned from providing gender affirming care, even to patients not on Medicaid. This provision effectively eliminates gender-affirming care for transgender individuals in Oklahoma.

See the provision:

The portion of the SB129 that bans providing gender affirming care.

When defending his bill, Sen. David Bullard (R) fielded tough questions from colleagues. Sen. Julia Kirt (D) asked whether the proposed legislation would prevent doctors who accept Medicaid from providing gender-affirming care. Bullard confirmed that it would. The provisions can easily be interpreted as extending to entire hospital systems and their employees if those systems receive Medicaid funding. Sen. Roger Thompson (R) asked about the impact on grocery stores that accept WIC benefits. Bullard said they would not be affected, but Thompson requested official documentation. A careful reading of the legislation suggests that such pharmacies could be prohibited from providing medication.

In fact, there may not be a provider or pharmacy in the entire state of Oklahoma that could pass these broad provisions. Thus, gender affirming care for everyone… trans youth and adults… could be shut down in Oklahoma if this bill passes. Sen. Kirt noted just this and asked the sponsor directly, “If a trans person is obtaining care in this state, given this law, what provider can a trans person use?”

Senator Bullard dodged the answer and spoke instead about non-transition related care. The bill proceeded to pass through the committee 14-6 and will likely see the Senate floor.

Virtually every provider, hospital system, pharmacy, and medical organization receives some level of public funding, especially under the broad definitions presented in the bill. This is yet another way in which gender affirming care bans and restrictions are following the anti-abortion playbook. Instead of gestational age bans, we have bans that increasingly target older trans individuals. To get around constitutional issues, we see legislators seek to restrict the care in a dozen other different ways such as financial penalties and requirements that no clinic can operate under.

Oklahoma has been enacting increasingly discriminatory legislation aimed at the transgender community. The state was the first to propose a bill that would prohibit gender-affirming healthcare for transgender adults up to 26 years old. Although the age limit of that bill was subsequently lowered to 18, Oklahoma has pursued other measures to marginalize transgender youth and adults. These include HB2177, which prohibits insurance coverage for gender-affirming care for all ages, including private insurance, and another bill that could prevent transgender individuals and drag artists from participating in public performances, possibly banning Pride. In total, there are currently 35 bills targeting the transgender community in Oklahoma. If all of these measures were to pass, it would become increasingly challenging for transgender individuals to exist publicly in the state. The Senate will next debate the bill, which has already passed a ban on gender-affirming care for transgender minors. There is no indication that anti-trans bills will slow down in the near future.