3 SC bills would restrict transgender care after MUSC halts hormonal therapy for kids

A group of conservative South Carolina legislators is furthering its push to next year ban transgender therapy and reassignment surgeries for young people, a renewed effort that mirrors similar legislative efforts targeting transgender youth in other states.

Lawmakers have filed three bills ahead of the 2023 session, which starts Jan. 10, that would make it illegal to provide medication or surgery for people under 21 to transition to another gender. One bill, filed by a member of the hard-right S.C. House Freedom Caucus, would ban hormonal treatment for anyone under 18.

Democrats say the efforts are a waste of time to address an issue they argue is not a problem in the state.

This week, the S.C. House Freedom Caucus claimed victory after the Medical University of South Carolina confirmed it no longer was providing pediatric hormonal therapy.

“Officials from MUSC have informed us that they will no longer be providing morally and ethically repugnant ‘gender affirming care’ that results in irreparable harm for minors,” said Greenville Rep. Adam Morgan, who chairs the freedom caucus.

The conservative band of legislators filed a Freedom of Information Act request to get records about the hospital’s pediatric endocrinology unit, claiming the hospital was engaged in “child abuse” for providing hormonal therapy at the clinic.

MUSC says it stopped providing transgender hormonal care six months ago, after lawmakers attached a measure to the state budget banning the hospital from providing gender transition care for anyone under the age of 16. The hospital also said it’s never provided therapy to kids ages younger than 10.

“MUSC has taken steps to operate in compliance with the Appropriations Act since it went into effect in July 2022,” MUSC said in a statement.

Lawmakers target transgender care

The three bills filed by House and Senate Republican legislators are part of a months-long State House effort targeting the transgender community.

Earlier this year, lawmakers passed a ban on transgender girls participating in women’s sports on the middle school, high school and college level. The bill was passed over testimony that only four transgender athletes had been approved to participate in high school sports since 2016 and one was a transgender female.

State lawmakers also added a measure to the 2022-23 state budget barring MUSC from spending state money to provide gender transition care for anyone under the age of 16.

In the Senate, Republican Sens. Brian Adams, of Berkeley, and Josh Kimbrell, of Spartanburg, have filed a bill to ban reassignment surgery or medication to block puberty for minors. State Sen. Danny Verdin, a Laurens Republican who chairs the chamber’s Medical Affairs Committee, meanwhile, filed a proposal to ban transition surgery for anyone under 21, with a handful of medical exceptions, and ban taxpayer dollars paying for any surgery.

And, in response to an MUSC student study presented in 2021, which looked at how often families requested transgender hormonal therapy at MUSC’s pediatric endocrine clinic, state Rep. Stewart Jones filed legislation to make it illegal in the state to perform sex reassignment operations or provide puberty blockers to children under the age of 18.

“We can’t allow this to happen again,” Jones said. “We have a moral, ethical and legislative duty to protect children from leftist doctors and pharmaceutical companies who use our kids as guinea pigs for profit and to promote their radical agenda.”

Lawmakers’ efforts may have support from the state’s top Republican.

“Well, that’s the topic of great interest these days,” Gov. Henry McMaster said when asked about the proposals, adding he has yet to see the legislation. “I think the Freedom Caucus is headed in the right direction. I think we have to be very careful about life-changing, irreversible things that may be based on changing circumstances. I think we have to know more or have to be very careful.”

South Carolina Democrats, who were unable to prevent the transgender women’s sports bill from passing this year, despite the bill previously failing twice in a Republican-led committee, say they’re not pleased with the proposals.

“It’s amazing to me how it seems that a lot these groups talk about freedom, ... are the same ones trying to limit people’s personal freedoms. It makes no sense to me. It’s very ironic,” said Florence Rep. Roger Kirby, who was recently elected House assistant minority leader. “I don’t pretend to be a physician. I typically err on the side of allowing the medical community to make decisions that are best for their patients, without interference.”

House Minority Leader Todd Rutherford, of Richland County, called his colleague’s legislation a waste of time.

“At the end of the day, I’m not sure how much of a problem it is in South Carolina anyway, and why they’re going to waste taxpayer’s time focusing on these issues is simply beyond me,” Rutherford said. “Maybe one of them had a bad experience.”

Rutherford said he worries the debate could hurt the state’s ability to attract businesses.

“The biggest thing is moving South Carolina forward and making sure that the business industry likes what they see when they consider South Carolina, and we’re going to fight against anything that gets in the way of that,” Rutherford said of Democrats’ strategy of addressing these bills.

Ivy Hill, the community health program director for the Campaign for Southern Equality, also called the legislation frustrating.

Hill said hormone blockers can be reversed, as it only pauses puberty from taking place, giving time for a transgender person to decide what is best for themselves. Some doctors even require a letter from a therapist before even starting blockers or replacement therapy, Hill said.

“I think therapy is always good for every person,” Hill said. “I also think this is life-saving care for folks. The less barriers that are there, the better.”

MUSC study sparked Freedom Caucus FOIA

The 20-member conservative S.C. House Freedom Caucus began questioning the hospital about the pediatric gender-affirming care after an MUSC research study that reported the increase of families asking for gender-affirming care gained public attention.

The students’ data analysis looked at patient care over a decade through 2020. The authors reported some evidence of improved outcomes for those who were connected to medical and support services, MUSC said.

The caucus pointed to the part of the study that indicated children potentially as young as age 4 were receiving puberty blockers or hormone therapy. However, MUSC said in a statement that 4-year-old children never received hormonal therapy to align or change their gender identity, as it’s not appropriate for anyone before puberty.

“This is not appropriate medical practice in pediatric endocrinology,” the hospital said.

The hospital said in the study that the average age for a first visit for gender care for children was between ages 13-14.

When MUSC responded to the caucus’ FOIA request, the hospital said it no longer provided hormonal care to children.

Furthermore, the hospital said it has never provided gender affirming surgery. Its pediatric endocrine clinic had provided transgender hormonal therapy, but only with parental or guardian permission, MUSC said. That clinic also provides care for diabetes and Turner syndrome, which leads to developmental problems in females, such as short height, failure of the ovaries to develop and heart defects because of a missing X chromosome.

The clinic sees about 120 children a year for gender-related issues. Some come to the clinic themselves or have been referred to MUSC by primary care or mental health providers, or parents. MUSC also provides behavioral health, nutritional support and social services for those patients.

The House Freedom Caucus also took issue with part of an email included in the hospital’s response, claiming MUSC was encouraged to circumvent public records law.

The email in question was to a group of mostly non-MUSC employees asked to use a personal email address for an MUSC staffer when corresponding about transgender issues.

“State institutions like MUSC can’t be allowed to keep hiding their taxpayer-funded activities from the public,” said state Rep. Josiah Magnuson, R-Spartanburg.

MUSC spokeswoman Heather Woolwine said the email was sent by a non-MUSC staffer to group of people who included Chase Glenn, MUSC’s director of LGBTQ+ Health Services. The group, which included behavioral health counselors who don’t work for MUSC, were discussing safety concerns around transgender issues.

The discussion did not deal with MUSC business, Woolwine said.

“MUSC does not condone the use of personal email for state business,” Woolwine said. “We never have condoned that, it’s not part of our protocol and we encourage all of our factory, students, staff (and) employees to follow the letter of the law.”