The U.S. State of South Carolina is facing widespread criticism for passing a ban on gender-affirming care for trans young people, along with imposing “extreme” restrictions on healthcare for transgender adults.

On Tuesday, 21 May, South Carolina’s governor, Henry McMaster, signed bill H4624 into law. The bill prohibits all gender-affirming care, including puberty blockers, hormone therapy, and surgery, for individuals under 18.

The legislation also restricts access to gender-affirming care for trans adults by limiting which public healthcare and insurance providers can cover the cost of such care. The law took effect immediately, making South Carolina one of many states that have restricted gender-affirming care for trans individuals since 2021.


According to the Human Rights Campaign (HRC), 39% of trans youth aged 13 to 17 reside in the 25 states, including Texas, Florida, and Ohio, that have banned gender-affirming care.

Sarah Kate Ellis, president and chief executive of LGBTQ+ organisation GLAAD, called the restrictions extreme, stating that politicians aim to “eradicate” transgender people’s ability to thrive.

“H4624 in South Carolina is one of the most extreme attacks on transgender Americans in the country and will harm countless families and residents while helping no one,” she said.

“Anti-transgender extremists claimed that their surge of attacks against basic access to healthcare were in the interest of protecting children, yet it’s clearer than ever that their goal is to eradicate the ability of transgender people to live and thrive in any aspect of their lives.”

“To transgender Americans in the South and to those watching all over the country, no political manoeuvre can erase the fact that you exist, you belong here, and you are loved,” she added.

South Carolina’s new legislation passed despite trans children, their families, and medical experts testifying against the bill in January. The parents of a 15-year-old girl highlighted that her mental health had improved significantly since she gained access to gender-affirming care.

A survey last year found that a majority of Americans (57 per cent) support trans adults having access to gender-affirming healthcare. Additionally, most respondents (63 per cent of 18 to 34-year-olds, 73 per cent of 35 to 64-year-olds, and 83 per cent of those aged 65 and older) believe U.S. politicians lack sufficient knowledge about gender-affirming care for trans young people to make fair policies.

The HRC noted that Oklahoma, Texas, and South Carolina have considered banning care for trans adults up to the age of 26.