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NH Republicans revive effort to ban some gender-affirming surgeries for trans youth

A group of protesters with handwritten signs stand outside a state office building. The messages on the signs include "Protect trans kids," "Don't ban medically necessary care" and "Doctors yes! Politicians no!"
Paul Cuno-Booth
A crowd gathered outside the Legislative Office Building in Concord on Tuesday, Oct. 31, to protest a bill limiting access to some gender-affirming surgeries for minors.

After putting the policy on hold earlier this year, Republican lawmakers are proposing a narrower version of a bill that would restrict access to gender-affirming care for transgender youth in New Hampshire.

The original version of House Bill 619 would have banned any type of gender transition-related medical care for people under 18, including puberty blockers and hormone therapy. That bill was retained in committee.

State representatives are now considering an amendment that would ban only gender-affirming genital surgeries, sometimes called bottom surgeries, for minors.

For young people, gender-affirming care can encompass a range of treatments, including therapy, drugs that delay puberty and, sometimes, cross-sex hormones.

Gender-affirming surgeries, particularly bottom surgeries, are exceedingly rare for people under 18. A recent study found that across the country, just 405 people aged 18 or younger had bottom surgery between 2016 and 2019. (As that figure includes 18-year-olds, it’s unclear how many were in fact minors.)

Dartmouth Health, which has the state’s only pediatric gender clinic, does not perform gender-affirming surgeries on minors as a rule, Courtney Tanner, the director of government relations for the health system, told lawmakers. However, she said there may be rare exceptions where doctors conclude it’s a “medical necessity.”

“There's a principle here that we don't want to legislate medicine,” she said. “These are complex subject matters that are really between a patient and a provider.”

The country’s major medical associations all support access to gender-affirming care for youth. The American Medical Association, American Academy of Pediatrics and other professional groups say that care is evidence-based and medically necessary for people experiencing gender dysphoria – and often critical for the mental health of trans youth.

Tuesday’s hearing drew a crowd of protesters, who characterized the attempted ban as part of a larger push to restrict the rights of trans youth.

“It sends a harmful message that you don't know who you are, and you don't get to make your own decisions with your parents and your doctors about your own body,” said Linds Jakows, the founder of the LGBTQ+ advocacy group 603 Equality.

Rep. Erica Layon, a Republican from Derry who co-authored the amendment, said it’s not about targeting transgender youth, but protecting their health.

“We do not seek to invalidate your experience,” she said. “This effort is to prioritize your lifelong health and well-being by pumping the brakes on the rapid adoption of this medical care.”

The proposed amendment would also revise some of the language in New Hampshire’s ban on conversion therapy, the discredited practice of trying to change someone’s sexual orientation or gender identity.

Layon said the intent is to clarify that therapists can work with adolescents as they explore or question their gender identity. But representatives of the New Hampshire Psychological Association and the New Hampshire chapter of the National Association of Social Workers said that concern is unfounded and there’s no reason to revisit the current law.

The House Health, Human Services and Elderly Affairs committee is expected to vote on the amendment at an upcoming meeting.

Eleanor McDonough was one of about two dozen people who protested ahead of the hearing. She said she recently moved to New Hampshire from Florida to escape an “anti-trans climate” in that state.

“I think it's very surprising to me,” McDonough said. “New Hampshire, a state that's known for personal freedom, the Live Free or Die state, talking about, you know, removing people's medical freedom.”

Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at
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