How H.4624 Impacts Transgender South Carolinians of All Ages – from Youth to Adults

Throughout 2024 we've talked a lot about how H. 4624 will harm trans youth in South Carolina, but last week, a Senate Committee hearing made clear that Far Right lawmakers’ actions could harm transgender adults, too. The committee passed a disturbing amendment that banned Medicaid from covering transgender-related care for transgender people of ANY age – and they reinserted an amendment forcing school staff to “out” transgender youth to their parents. Somehow, they took a terrible bill and made it even worse.

H.4624 in its current form will restrict access to gender-affirming care – or make it prohibitively expensive – for many adults in South Carolina, too.

Let’s recap how H. 4624 can impact adults:

❌ No one *of any age* who is insured through the state’s Medicaid program will be able to pay for gender-affirming care using that funding (the bill’s original language – which was already bad enough – banned Medicaid coverage of trans-related healthcare for people under 26);

❌ The bill prohibits ANY public funding from being used “directly or indirectly” for gender-affirming care. This is not limited to a specific age – so people insured through the state healthcare plan may be forced to newly shoulder the burden of medical expenses, and providers who receive public funding may be intimidated away from offering gender-affirming care to people of ANY age. 

❌ The bill defines “sex” as sex assigned at birth and “gender” as male or female for the purposes of this bill – which could be a troubling precursor to the wave of broader trans-exclusionary “sex definition” bills we’ve seen advancing in other states. 

And this is on top of the egregious impacts on transgender youth:

❌ The bill bans best-practice healthcare for transgender youth under the age of 18 – including puberty blockers, hormone therapy, and surgery are banned for transgender youth under the age of 18. 

❌ The bill allows for a “tapering off period” for transgender youth that were already taking puberty blockers or hormones before August 1, 2024. These youth would, by the letter of the law, be allowed to continue receiving puberty blockers or hormones from a provider in South Carolina until January 31, 2025 – but in other states where similar laws have passed (including Missouri, Louisiana, and Tennessee), providers have ceased care for all patients immediately, which poses a serious danger to the health of young trans people. 

❌ The bill requires that nurses, counselors, teachers, principals, and other school officials tell a student’s parent or guardian if the student has a gender identity or expression that is not the same as their sex assigned at birth. While many parents are supportive, forced outing provisions ignore the risk danger to young people if abusive family members learn this information, and also drives young people away from trusted adults with whom they may feel more comfortable discussing sensitive subjects.  

And the awful impacts on providers of gender-affirming care:

❌ Medical providers who provide gender-affirming care to youth would have their actions be “considered unprofessional conduct” and could lose their licenses to practice medicine.

❌ The bill allows patients to “assert an actual or threatened violation … as a claim or defense in a judicial or administrative proceeding and obtain compensatory damages, injunctive relief, declaratory relief, or any other appropriate relief.” The bill allows minors to bring claims for up to 21 years. This alone would intimidate providers of gender-affirming care from supporting youth.

Let’s be clear: Gender-affirming care is FUNDAMENTAL, best-practice healthcare. It shouldn’t be restricted by the government in any way – and insurance plans should be required to cover it. Medical providers should not be threatened out of the state for doing their job and providing compassionate care.

H.4624 would catapult South Carolina into the totally wrong direction, making this life-saving care impossible for young people to access in-state and much harder for many adults to access – especially those who are already part of marginalized communities.

This bill is a drastic government overreach being pushed forward by extreme politicians against the will of the people. South Carolinians broadly oppose discriminatory against LGBTQ+ people, and support LGBTQ+ equality – this shameful bill has NO place in our state. 

Please join us in taking action against H.4624. Click here to rush a message to your Senator today.