RALEIGH, N.C. (WGHP) — The North Carolina senate has filed two bills dealing with transgender youth in North Carolina.

Filed on Wednesday, Senate Bill 639, aka the “Youth Health Protection Act” would make gender-affirming care illegal for minors, and the “Fairness in Women’s Sports Act,” Senate Bill 631 and also filed in the House as House Bill 574, would exclude transgender children from playing on sports teams that match their gender identity.

These bills mirror bills that have been filed in dozens of legislatures across the country, including a case in West Virginia that garnered a Supreme Court ruling on Thursday.

Amid a legal battle over whether or not transgender athletes can compete on female sports teams at school, a West Virginia appeals court placed an injunction that allowed a transgender girl to compete on female teams at her middle school. The state asked the Supreme Court to lift the injunction, and the Supreme Court denied the request. This means the girl can continue to compete on female school teams pending a final ruling in the case.

The North Carolina bills were filed on the same day that Mecklenburg County Representative Tricia Cotham announced she was switching from the Democratic Party to the Republican Party, giving the North Carolina House of Representatives a veto-proof majority.

SB 631

SB 631 regulates participating in school sports, with a litany of sponsors, but the primary sponsors are Kevin Corbin (R-District 50), Joyce Krawiec (R-District 31), and Vickie Sawyer (R-District 37).

It dictates that any public, private or charter schools that are part of the State High School Athletic Association would only be able to designate teams as male, female or co-ed, and a student could only participate in the team that matches the sex listed on their birth certificate.

The former head basketball coach for the UNC-Chapel Hill women’s basketball team joined lawmakers at a press conference on Wednesday, stating she’s “not against transgenders” but that it’s “not a level playing field” and “could take away scholarship money.”

This bill only applies to K-12 athletics. College athletics are governed by a completely separate set of rules and regulations through the NCAA, which already has guidance in place for transgender athletes.

Right now, the North Carolina High School Athletic Association allows student-athletes to play based on their gender identity. The agency’s website outlines a process for student eligibility, that includes providing documentation from a healthcare professional and a list of treatments and medications a student takes.

The way the bill is currently written would block girls from playing on football teams.

SB 631 by FOX8 on Scribd

SB 639

Primarily sponsored by Senators Ralph Hise (R-District 41), Buck Newton (R-District 4) and Norman Sanderson (R-District 1), SB 639 or the “Youth Health Protection Act” seeks to make it illegal to offer gender-affirming care to anyone under the age of 18. Additionally, it bans any state-provided health insurance from covering gender-affirmation treatments.

This includes treatments like puberty blockers, which are prescribed to delay the onset of puberty in children experiencing gender dysphoria, as well as hormone therapy and gender-affirming surgery. The bill calls puberty blockers “experimental” and “not-FDA approved.” The Associated Press notes that using puberty blockers for transgender children is, while not technically what the FDA designated the treatment for, considered a common “off-label” use for them, “which is an accepted and permitted practice” in medicine.

It also has a provision that makes it illegal to not tell a parent or guardian if a child expresses any feelings of gender dysphoria, a provision that has appeared in similar bills and received criticism for the potential of “outing” transgender or other LGBTQ+ children to unsupportive or abusive parents.

Children born “with external biological sex characteristics that are irresolvably ambiguous, such as a minor born having 46 XX chromosomes with virilization, 46 XY chromosomes” may still receive surgical care if it is a “good-faith medical decision of a parent or guardian.” These conditions fall under the umbrella of being “intersex.” Estimates say that around 1-2 in 100 people in America are born intersex.

“This is actually a national push by the far right who are trying to play doctor and actually get involved in families’ lives,” said Scott. “People pushing these bills think there won’t be any repercussions. But, North Carolinians don’t want this. They want their legislators working on real problems like potholes and taxes.” 

Gender affirming care

While this bill would ban all gender-affirming care for minors, it is worth noting that surgery for transgender minors is not common practice and that gender-affirming care that is practiced with minors is largely reversible. Additionally, the American Academy of Pediatrics supports providing health care to transgender children.

A table on the American Academy of Pediatrics website explains the steps that go into gender affirmation and the reversibility of each step, as well as the rough age range.

For young children, gender affirmation is simply a social transition; calling a child by a new name and different pronouns and allowing them to dress the way they’d like to, growing out or cutting their hair are common markers of social transition.

At the onset of puberty, a pre-teen or young teen might be prescribed puberty-blocking drugs. These drugs have been used for non-transgender children since the early 1980s, most often to treat precocious puberty in children. These are entirely reversible.

Hormone therapy is reserved for adolescents onward and is partially reversible depending on the length of time they’re used.

Surgical options are typically reserved for adults. Older teens might be given gender-affirming surgery on a case-by-case basis, but this is not a medical norm.

The American Academy of Pediatrics states that every child’s experience with gender affirmation will be unique and should be overseen by medical professionals as well as counselors.

Despite the fact that irreversible surgery is by and large reserved for adults, multiple states have banned or proposed banning it for minors across the country.

Trans issues in North Carolina

North Carolina was hit with serious economic fallout after the passing of 2016’s HB 2, or “The Bathroom Bill,” which required that people use bathrooms based on their biological sex rather than their gender identity and made it illegal for municipalities to pass their own non-discrimination ordinances. Several tournaments, businesses and performers protested the law, pulling events out of the state, and news organizations at the time reported it could cost North Carolina over $3 billion.

The bathroom portion of the bill was repealed, but the limitation on non-discrimination ordinances remained on the books until it expired at the end of 2021 when several cities across the state then took up non-discrimination ordinances.

2021 was the deadliest year on record for transgender and gender non-conforming people with the Human Rights Campaign documenting at least 59 people killed. Three of them were North Carolinians. 2022 saw at least 38 people killed, and 2023 has already seen 7 transgender or gender non-confirming people killed, including a Wilmington woman whose body was found on the bank of the Savannah River in January.