Arizona governor signs bill outlawing gender-affirming care for transgender youth and approves anti-trans sports ban

By Devan Cole, CNN

Republican Gov. Doug Ducey of Arizona on Wednesday signed two bills into law targeting transgender youth in the state, including one that restricts access to gender-affirming health care for minors.

Ducey’s approval of the health care ban, as well as a law prohibiting transgender athletes from competing on women’s and girls’ sports teams at some schools in the state, comes as GOP-led states are pushing laws that opponents say further marginalize members of the transgender community. Oklahoma’s Republican governor approved a similar sports ban earlier Wednesday.

“A physician may not provide irreversible gender reassignment surgery to any individual who is under eighteen years of age,” reads the text of SB 1138, the health care ban. The bill makes some exceptions, including in the case of someone born intersex.

Arizona is the latest state to enact such a measure. Last year, Republican lawmakers in Arkansas overrode a veto from their governor to put their own health care ban on the books, and Tennessee has passed a similar ban.

“SB 1138 delays any irreversible gender reassignment surgery until the age of 18,” the governor wrote in a letter announcing his decision to sign the legislation. “The reason is simple, and common sense — this is a decision that will dramatically affect the rest of an individual’s life, including the ability of that individual to become a biological parent later in life.”

The two measures are part of a larger movement by conservative lawmakers to impose restrictions on the lives of transgender youth in the US. LGBTQ advocates have strongly opposed such bans, arguing they further marginalize a vulnerable community and could cause serious harm to a group that suffers from uniquely high rates of suicide.

Advocates tore into Ducey for signing the pair of bills into law, noting in their criticism that his signatures came a day before the observance of International Transgender Day of Visibility. The day aims to celebrate the achievements of transgender rights activists and to increase awareness of ongoing challenges transgender and gender-nonconforming people ​face.

“Today alone, on the eve of Transgender Day of Visibility, three anti-trans bills were signed into law across the country,” said Sam Ames, director of advocacy and government affairs at the Trevor Project, a nonprofit that works to prevent suicide among LGBTQ youth.

“This onslaught is not an accident; it is overwhelming by design and in direct response to progress in the fight for trans rights. But the Trevor Project will continue supporting our young people while we continue the fight against these policies,” Ames added in a statement.

Advocates have already vowed to challenge Arizona’s health care ban in court, with the American Civil Liberties Union saying in a tweet: “The government can’t violate our rights without a fight. We … will see you in court.”

The group sued Arkansas over its ban last year, and in July, a federal judge temporarily blocked the state from enforcing the law.

Fifth sports ban this year

The sports ban in Arizona, meanwhile, applies to teams “sponsored by a public school or a private school whose students or teams compete against a public school.” The law says that athletic teams or sports “designated for ‘females,’ ‘women’ or ‘girls’ may not be open to students of the male sex” across the state.

“Every young Arizona athlete should have the opportunity to participate in extracurricular activities that give them a sense of belonging and allow them to grow and thrive,” Ducey said in his letter Wednesday, adding that the bill would ensure “that the girls and young women who have dedicated themselves to their sport do not miss out on hard-earned opportunities including their titles, standings and scholarships due to unfair competition.”

The law makes Arizona the fifth state to enact an anti-transgender sports ban this year. The debate over the inclusion of transgender athletes, particularly women and girls, has become a political flashpoint, especially among conservatives.

Advocates of such measures have argued that transgender women and girls have physical advantages ​over cisgender women and girls in sports. But a 2017 report in the journal Sports Medicine that reviewed several related studies found “no direct or consistent research” that suggests transgender people have an athletic advantage over their cisgender peers, and critics say such legislation adds to the discrimination that transgender people face, particularly transgender youth.

While the Arizona law mentions “biological sex,” it doesn’t define what that means. Similar bills in other states have stipulated that “biological sex” is defined as the sex marked on a student’s original birth certificate.

While sex is a category that refers broadly to physiology, a person’s gender is an innate sense of identity. The factors that go into determining the sex listed on a birth certificate may include anatomy, genetics and hormones, and there is broad natural variation in each of these categories. For this reason, critics have said the language of “biological sex,” as used in the sports ban legislation, is overly simplistic and misleading.

So far this year, GOP governors in Oklahoma, Iowa and South Dakota have enacted similar sports bans. Last week, Republican governors in Indiana and Utah vetoed transgender sports bans in their states, saying the measures were unnecessary. Lawmakers in Utah, however, later overrode their governor’s veto to enact the measure. In 2021, Alabama, Arkansas, Florida, Mississippi, Montana, Tennessee, Texas and West Virginia enacted similar sports bans.

Opponents of such bans have had limited legal success in fighting the measures. Last year, a federal judge temporarily blocked West Virginia’s enforcement of its ban after advocates for the athletes sued the state, with the judge saying he had “been provided with scant evidence that this law addresses any problem at all, let alone an important problem.” And in 2020, a federal judge blocked Idaho’s enforcement of its sports ban.

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CNN’s Paul LeBlanc and Paradise Afshar contributed to this report.