Utah Care Ban For Trans Youth Takes Effect Immediately, Gov. Cox Signs

Utah becomes the first state in 2023 to ban gender affirming care for trans youth. It takes effect immediately. Utah is the only state with such a law being enforced. Governor Cox has signed the bill.

In a rare Saturday signing session, Governor Cox signed a gender affirming care ban for transgender youth. The bill, which rocketed through the senate and the house and featured heated debate in both, bans all trans youth not already diagnosed with gender dysphoria from receiving gender affirming care. It also features a complex web of statutes meant to make gender affirming care impossible to provide, such as a statute that lets anyone go back in time and “disaffirm consent” up to the age of 25 years old. Collectively, these statutes will effectively end gender affirming care for transgender youth in the state of Utah.

There was some hope within the transgender community that Gov. Cox would veto the bill. In 2022, he famously vetoed a transgender sports ban with a heartfelt statement worrying about transgender suicides: “Rarely has so much fear and anger been directed at so few. I don’t understand what they are going through or why they feel the way they do. But I want them to live.”

That hope faded when he immediately signed the anti-trans healthcare ban. It is somewhat perplexing that he thought that sports were a step too far and that taking action against transgender people in sports would lead to suicides, and yet he could not see the threat this bill posed to that same community. In fact, anti-trans healthcare bans have dramatically harmed the mental health of trans youth in recent months, according to a poll by the Trevor Project. Meanwhile, studies repeatedly show a massive improvement in suicide rates once gender affirming care is allowed to commence, such as the study in the prestigious journal Pediatrics which showed that such care lowered trans youth suicidality by 73%.

Governor Cox released a signing statement which seemed to ignore all of that:

Utah Gov. Spencer J. Cox @GovCox

Today we signed SB 16, Transgender Medical Treatment and Procedures.

This is not a compassionate statement that respects the wellbeing of transgender people in Utah. This is the opposite of his previous statement in the sports ban veto of 2022 where he said “I want them to live.” Instead, this is Gov. Cox bowing to pressure from his fellow Republicans to discount the medical expertise that was presented in front of the committees in which this was heard. Instead of going with credentialed doctors and the testimony of medical organizations representing hundreds of thousands of physicians, he has decided to follow the fear-mongering put forward by those who wish to end gender affirming care entirely.

There is a strong chance that this bill will be blocked in court - all other states with bans have seen their bans meet such a fate. Currently, there are only two states that have passed total bans on gender affirming care that apply to hormone therapy and puberty blockers: Alabama and Arkansas. Two states have targeted gender affirming care through executive actions - Texas by investigating families of trans kids for child abuse and Florida through state control of the Board of Medicine. Two other states, Arizona and Tennessee, have limited bans that don’t have heavy applicability and focus on surgeries. Collectively though, none of these states are actively banning gender affirming care at this moment and various efforts to in those states are held up in court, not yet in effect, or made ineffectual by the wording of the law.

However, because the gender affirming care ban in Utah had an immediate start date when the Governor signed the bill, the law is now in effect. Because Gov. Cox did this on a Saturday before any veto campaign could be mounted and before families could make preparations, many such families will be left with no options and no way to obtain their diagnoses before the law comes into effect. It is inexplicable that he rushed to sign this bill given his previous positions on other anti-trans bills, and he was instantly decried for doing so.

“This fake compassion is the product of the kind of concern trolling that we see in the pages of the New York Times and the Atlantic and elsewhere. Don't say you're concerned while cutting people off from medical care,” the ACLU’s Chase Strangio said in a tweet responding to the signing of the bill.

Utah has other anti-trans bills working their way through the legislature. SB100 would forcibly out transgender kids to their parents in some circumstances. SB93 would ban transgender birth certificate changes for trans youth. Both have passed the senate and are working their way through the house. In other states, 18 healthcare bans are working their way through legislatures, some with cutoff ages all the way up to 26 years old.

The modern anti-trans panic that the GOP is spearheading has taken root in several red states. The bans on gender affirming care will deteriorate the mental and physical health of the trans youth in the states they are passed. Because of this action by Utah, their risk category for legislation now moves into the “worst states for anti-trans legislation” category on my anti-trans legislative risk map (update pending). This makes them the first state to move up into that category since the creation of the map. This law will harm the trans youth of Utah and given that the state is the only one with such a law immediately in effect, it seems like a justifiable categorization. It is my sincere hope that I do not have to do the same for any other state in the near future.