Louisiana's legislature utilized its Republican supermajority Tuesday to enact a ban on gender-affirming care for most minors, overriding its Democratic governor who had vetoed the bill.
The law will take effect January 1, 2024.
Gov. John Bel Edwards, who vetoed House Bill 648 last month, responded to the successful override by pointing out that the first time he was overridden on a separate measure, the courts threw out the bill he opposed.
"Today, I was overridden for the second time, on my veto of a bill that needlessly harms a very small population of vulnerable children, their families, and their health care professionals," he said in a statement. "I expect the courts to throw out this unconstitutional bill, as well."
The state House and Senate voted 76-23 and 28-11, succeeding in blocking Edwards' move with the two-thirds majority in each chamber needed to overpower the governor.
The law will bar those under 18 in Louisiana from receiving gender-affirming surgeries, puberty blocking medications and hormone treatments, and punishes health care professionals that provide them with the revocation of their license for a minimum of two years.
Doctors who began providing such drug or hormone therapy to a minor before January 1, 2024, are allowed to continue providing care through December 1, 2024, if they determine that "immediately terminating the minor's use of the drug or hormone would cause harm to the minor."
Gender-affirming care spans a range of evidence-based treatments and approaches that benefit transgender and nonbinary people. The types of care vary by the age and goals of the recipient, and are considered the standard of care by many mainstream medical associations.
Though the care is highly individualized, some children and parents may decide to use reversible puberty suppression therapy. This part of the process may also include hormone therapy that can lead to gender-affirming physical change. Surgical procedures prohibited under the measure, however, are not typically done on children and many health care providers do not offer them to minors.
No such surgeries were performed on Louisiana minors enrolled in Medicaid from 2017 to 2021, according to a report from the state Department of Health, which found that few minors, between 21 and 57 each year, received chemical treatment during the same time period.
Proponents of the legislation have expressed concern over long-term outcomes of the treatments. But major medical associations say that gender-affirming care is clinically appropriate for children and adults with gender dysphoria -- a psychological distress that may result when a person's gender identity and sex assigned at birth do not align, according to the American Psychiatric Association.
Republicans gained strong enough majorities in the state's House and Senate to override vetoes from the governor after Louisiana's longest-serving legislator switched in March from the Democratic Party to the Republican Party.
But not all Republicans have supported HB 648. The bill was temporarily stalled in a state Senate committee last month, with the panel's GOP chairman casting a tie-breaking vote against the legislation.
"I've always in my heart of hearts, believed that a decision should be made by a patient and a physician," state Sen. Fred Mills said, explaining his vote.
It was moved out of his committee and into another where it was passed.
The American Civil Liberties Union of Louisiana condemned the legislature's override, saying in a statement that lawmakers who voted to override have chosen to sacrifice the health and safety of Louisiana's transgender children and undermine the rights of their parents.
"This is extreme government overreach and a direct threat to the civil liberties and constitutional rights of all Louisianans. We condemn today's override of HB648, and we will never stop fighting to protect the rights of transgender youth and their families," the statement added.
Laws restricting the procedures for minors have spread across the country, with 17 states besides Louisiana so far this year placing their own laws on the books -- though the legality of such bans is under intense scrutiny as federal judges last month temporary blocked laws in Tennessee, Indiana and Kentucky, while a 2021 law in Arkansas was struck down outright and deemed unconstitutional.
Democratic governors have pushed back on Republican-led efforts to restrict the treatments with varying degrees of success -- Kansas Gov. Laura Kelly successfully blocked a ban while state lawmakers overrode Kentucky Gov. Andy Beshear's veto.