政策聚焦：禁止跨性别者接受医疗服务（英）

LGBTQPOLICYSPOTLIGHT:BANSONMEDICALCAREFORTRANSGENDERPEOPLE WA MTND OR IDSD WY NVNE UT MN WI MI IA ILINOH NH VTME NYMA RI PACT NJ CACO AZ NM AK KSMO OK AR TX LA KY TN MSAL WVVADE MD NCDC SC GA FL HI Statecurrentlybansorrestrictsbestpracticemedicalcareforatleastsometransgenderpeople(19states) Statehasconsideredabilltobanorrestrictbestpracticemedicalcareforatleastsometransgenderpeople(since2017)(20states) Statehasnobillorlawbanningbestpracticemedicalcarefortransgenderpeople(11states+D.C.) Note:Thismapshowslegislativeeffortstobanorrestrictmedicalcarefortransgenderpeoplesince2017(lightred).Thismapalsoshowsanycurrentbanorrestriction,includingthosethatpre-date2017,onmedicallynecessarycarefortransgenderpeople,whetherthroughyouth-specificbans,privateinsurance,orstateMedicaidprograms(darkred). Source:MAP’sEqualityMapsandbilltracking.DataasofApril15,2023. AuthorsAPRIL2023 2 DavidBohnettFoundation DavidDechman&MichelMercureGillFoundation EsmondHarmsworth Evelyn&WalterHaas,Jr.FundJimHormel JohnsonFamilyFoundationLaughingGullFoundationWestonMilliken InekeMushovicThePaletteFundMonaPittenger RonaldW.NaitoMDFoundationMacKenzieScott TedSnowdonFoundationTzedekSocialJusticeFundVanAmeringenFoundationWildGeeseFoundation MAPisverygratefultothefollowingmajorfunders,whosegeneroussupportmakesitpossibleforustodoourwork: Thisreportwasauthoredby: MovementAdvancementProject MAP’smissionistoprovideindependentandrigorousresearch,insight,andcommunicationsthathelpspeedequalityandopportunityforallpeople.MAPworkstoensurethatallpeoplehaveafairchancetopursuehealthandhappiness,earnaliving,takecareoftheonestheylove,besafeintheircommunities,andparticipateinciviclife.Formoreinformation,visitwww.mapresearch.org. ContactInformation MovementAdvancementProject 190515thStreet#1097 Boulder,CO803061-844-MAP-8800 www.mapresearch.org CorinneGreen,EqualityFederation MichelleM.Johns,NORCattheUniversityofChicagoSaraMar,Whitman-WalkerInstitute VivianTopping,EqualityFederationTheWilliamsInstitute,UCLA Acknowledgments Recommendedcitation:MovementAdvancementProject.April2023.LGBTQPolicySpotlight:BansonMedicalCareforTransgenderPeople.www.mapresearch.org/2023-medical-care-bans-report 3 TABLEOFCONTENTS EXECUTIVESUMMARYi INTRODUCTION1 THEIRGOAL:ERADICATETRANSGENDERPEOPLE1 CURRENTPOLICYLANDSCAPE:TRANSGENDERPEOPLE’SACCESSTOMEDICALCARE2 RECENTEXPLOSIONOFBILLSTHATWOULDBANMEDICALLYNECESSARYCARE FORTRANSGENDERPEOPLE7 OVERTIME,TRANSGENDERHEALTHCAREBANSAREGROWINGINSCOPEANDEXTREMISM10 GrowingApplicationtoTransgenderAdults10 GrowingBansonState-FundedHealthCare12 RestrictionsorWaiversforPrivateInsurers12 ShiftingPunishments,IncludingGrowingPowerforStates’AttorneysGeneral13 ExpandingTargetsFromDoctorstoParents,Teachers,andMore14 DefiningSex,WithPotentiallyFar-ReachingImplications14 AllowingNon-ConsensualSurgeriesonIntersexChildren15 ForcedOutingofTransgenderChildren16 OtherProvisions17 THEIMPACTSOFEFFORTSTOBANMEDICALCAREFORTRANSGENDERPEOPLE19 HarmtoTransgenderPeople&TheirFamilies19 HarmtoMedicalProviders&TheBroaderCommunity20 CONCLUSION22 ENDNOTES23 Duetothenatureofongoingstatelegislativesessions,someofthenumberscitedinthisreportwillnecessarilychange.Inthisreport,billanalysisdatareflectbillsintroducedthroughApril1,2023;lawsonthebooksarecurrentasofApril15,2023.ThevariousLGBTQEqualityMapsreferencedinthereport,andothers,willcontinuetobeupdatedinrealtimeaspolicieschange.Thosemapsareavailableatmapresearch.org. EXECUTIVESUMMARY i Inlessthanthreemonths,2023hasalreadysetnewrecordsforanti-LGBTQ,andespeciallyanti-transgender,legislationintheUnitedStates.Inparticular,2023hasbroughtdevastatingandunprecedentedattacksontransgenderpeopleandtheirabilitytolivesafelyandfreely.Thisisnowheremoreevidentthanintheescalatingeffortstorestrict,ban,andevencriminalizetransgenderpeople’saccesstomedicallynecessarycare,sometimesalsocalled“gender-affirmingcare.” Whilemostofthepublicfocushasbeenonrecenteffortstobanmedicalcarefortransgenderyouth,thisreportshowshowtheseattacksarepartofamuchlargerefforttobanmedicalcareforalltransgenderpeople.Infact,justdaysbeforethisreport’spublication,Missouribecamethefirststatetoeffectivelybangender-affirmingcareforalltransgenderpeople,regardlessofage. Thefindingsdemonstratehowrecentbillstobanorrestrictmedicalcarefortransgenderpeoplearegrowinginnumber,growinginscope,andgrowingmoreandmoreextremetoharmmorepeoplethaneverbefore.Thisshowsthattheultimategoalsofthesebills,andoftheextremistsandpoliticianspushingthem,aretomakeitimpossiblefortransgenderpeopletotransition,tobetheirauthenticselves,andeventoexist. CurrentPolicyLandscape:TransgenderPeople’sAccesstoMedicalCare Historically,ithasbeennotoriouslydifficultfortransgenderpeopletoaccessgender-affirmingcare.Transgenderpeoplefaceextraordinarilyhighratesofemploymentdiscrimination,blockingtheiraccesstohealthinsuranceandeconomicsecurity.Eventhosewithhealthinsurancehavefaceddecadesofobstaclessuchasdiscriminationinhealthcaresettings,ascarcityofcompetent,affirmingmedicalproviders,andinsurancecompaniesroutinelydenyingcoverag