Transgender youth will face more restrictions after veto overrides

Transgender youth will face more restrictions after veto overrides


By Rachel Crumpler

Transgender youth in North Carolina will face more restrictions accessing health care,  participating in sports and exploring gender identities at school after Republican state lawmakers overrode Democratic Gov. Roy Cooper’s veto of three bills Wednesday.

After about six weeks of inactivity, state lawmakers returned to Raleigh to take the override votes, which passed mostly along party lines in the House and the Senate, with two Democrats voting with Republicans on two out of three of the bills. 

On July 5, Democratic Gov. Roy Cooper had vetoed:

  • House Bill 574, Fairness in Women’s Sports Act, prohibits transgender female athletes from participating in sports consistent with their gender identity and limits participation to teams matching people’s biological sex at birth.
  • House Bill 808, Gender Transition/Minors, prohibits health care and mental health care professionals from providing gender-affirming care to minors, including puberty-blocking drugs, cross-sex hormones and surgeries.
  • Senate Bill 49, Parents’ Bill of Rights, requires schools to tell parents if their child asks to use a different name or pronouns at school. It also restricts instruction and discussion about gender identity, sexual activity or sexuality in kindergarten through fourth grade classrooms unless a child asks a question about it in the context of classroom activity.

“For campaign purposes only, Republicans are serving up a triple threat of political culture wars using government to invade the rights and responsibilities of parents and doctors, hurting vulnerable children and damaging our state’s reputation and economy like they did with the harmful bathroom bill,” said Cooper in a July statement announcing his vetoes.

Unlike the swift action taken by state lawmakers in May to override Cooper’s veto of the state’s abortion restrictions after only three days, legislators left people on both sides waiting for over a month for the fate of the bills to be determined while many on both sides of the aisle took vacations and went to conferences. 

shows a piece of paper with signatures on it, the word VETO with a signature under it and a larger word, OVERRIDE stamped on it.
Senate Bill 49, known as the Parents Bill of Rights, after the bill was overridden by both chambers of the legislature. Credit: Hannah Schoenbaum

Both sides, who have been active at the legislature since the legislation was introduced in April, made their final pleas in support and opposition of the legislation at afternoon news conferences.

The wait is now over. Now all that’s remaining is for advocates for transgender youth to figure out how to function in a more constrained environment. 

“These bills focus on youth and schools,” said Liz Barber, policy director at the ACLU of North Carolina, during a news conference. “They try to make being trans shameful. But they won’t stop you from being trans. They only make it harder for kids to grow up at all and make it harder to access the support.”

Restricting participation in sports

After unsuccessfully trying to pass legislation in 2021 to ban transgender students from participating in school sports, lawmakers renewed their efforts this year and have found a different result. 

In a 74-45 House vote and 27-18 Senate vote, House Bill 574, the Fairness in Women’s Sports Act, became law over the objections of Cooper. The bill goes into effect immediately and will apply to this coming school year.

a lawmaker in a suit stands at a podium in support of a restriction on trans youth participating in sport
Sen. Vickie Sawyer spoke at a news conference in support of the Fairness in Women’s Sports Act on Aug. 16. “I’m proud to be a North Carolina state senator leading this change,” she said. Credit: Rachel Crumpler

The law restricts transgender females from playing on women’s sports league teams at the middle school, high school and college levels. Sports participation will be based on biological sex at birth. The bill doesn’t affect intramural sports, something initially in the legislation.

Twenty-two other states have similar legislation banning transgender youth participation in sports.

Sen. Vickie Sawyer (R-Mooresville), a primary sponsor of the bill, has championed the legislation as “pro-woman.” She and other state lawmakers frequently cited the experience of Payton McNabb, a recently graduated volleyball player from Cherokee County’s Hiwassee Dam High School, who was injured by a ball spiked by a transgender athlete during a match last fall. They said the incident illustrates why participation rules need to change to protect female athletes from biological differences in strength to maintain the fairness of women’s sports.

McNabb came to the legislature Wednesday in support of the legislation.

a white girl stands at a podium surrounded by supporters holding signs saying "protect women's sports"
Payton McNabb, a former volleyball player from Cherokee County’s Hiwassee Dam High School, spoke at a news conference organized by NC Values Coalition on Aug. 16 outside the NC General Assembly. She shared how she was injured last fall during her senior year when a spike by a transgender athlete hit her. Credit: Rachel Crumpler

“I don’t want my sister, my cousins and any other biological females to ever go through what I went through,” she said at a news conference before the vote.

Few transgender athletes compete in sports in North Carolina. Since 2019, when the NC High School Athletic Association adopted a policy to allow transgender athletes to play on teams that align with their gender identities, Commissioner Que Tucker previously told NC Health News only 18 requests have been filed. Only two of the requests have been from trans females. 

Opponents of the bill say the legislation is unnecessary and that regulation should be left to athletic governing bodies. 

A woman speaks at a podium at a news conference on protecting transgender youth outside the legislative office
Liz Barber, policy director at the ACLU of North Carolina, spoke at a new conference organized by Equality NC on Aug. 16 outside the NC General Assembly in opposition to three bills affecting transgender youth. Credit: Rachel Crumpler

“They’re much more attuned to fairness in sports than politicians are,” Rep. Marcia Morey (D-Durham) said on the House floor. “I swam in the 1976 Olympics. I was beaten by women who were abusing performance-enhancing drugs. The government didn’t step in, the Olympic Committee did. It was the right way to do it.”

Barber, from the ACLU of North Carolina, lamented the lost sports benefits for trans youth. 

“They play sports for the same reasons — to blow off steam after a long day of sitting still, for the mental health and physical benefits of physical activity, for learning how to be on a team and work together, for learning independence, for forming lifelong relationships with older students, with coaches who could be their mentors, not just on the athletics field, but beyond.

“Today that is being taken away from trans athletes.”

Restricting gender-affirming care

In a 74-45 House vote and 27-18 Senate vote for another law immediately going into effect, the legislature passed House Bill 808. The measure bans health care and mental health care professionals from providing gender-affirming care to minors, including puberty-blocking drugs, cross-sex hormones and surgeries. Minors who began receiving care before Aug. 1 may continue treatment with their parents’ consent.

The bill also prohibits any state funds — including Medicaid funding and the state employees’ health plan — from being used for gender-affirming procedures.

Elizabeth Waugh, an Orange County mother, worries about how her nonbinary teenager could be affected by this ban. While her child is not currently receiving gender-affirming care, she knows the care is now off the table — even if it is desired.

Waugh asserted that health care decisions should be left for parents, children and their doctors, and she’s seen the difference the health care has made for some transgender youth.

“One of his best friends has just started hormone replacement therapy and finally feels like he doesn’t want to die every day,” Waugh said.

As recently as Aug. 4, the American Academy of Pediatrics reaffirmed its position that gender-affirming care should be accessible for gender diverse youth. Other major medical organizations such as the American Academy of Child and Adolescent Psychiatry, the Endocrine Society and the American Medical Association oppose gender-affirming care bans.

shows a smiling white woman with a stethoscope around her neck and rainbow pins on a lanyard. She's standing in the rotunda of the legislative building, there are people behind her who came to protest both for and against new transgender legislation.
Physician Hayley Cunningham provides gender-affirming care to adults in the Triangle. She said her colleagues who provide such care for children have been scrambling for the past few months to get treatment started for their patients ahead of the veto override. Credit: Rose Hoban

Hayley Cunningham, who provides gender-affirming care to adults at a clinic in the Triangle came to the legislature Wednesday to support continued access for minors. She said she’s seen the consequences of people not being able to access this life-saving care, such as those lost to suicide.

“I see the trauma, the aftermath that a lot of transgender people go through when they’re not allowed to have the care that they need and that they deserve,” Cunningham said.

Waiting to access gender-affirming care as an adult can be hard for folks, leading some to suicide or mental health struggles, she said. Cunningham emphasized that providing gender-affirming care is thoughtfully considered with each patient — children and adults. 

“I’ve seen many of my colleagues who do treat children kind of frantically struggling to see as many patients as possible — to treat as many people as possible, parents calling them scared out of their minds that their children won’t be able to get the care that they need,” Cunningham said.

Since the legislation was introduced in April, transgender youth and parents have shared their stories with lawmakers at many committee meetings. 

a transgender boy in a blue shirt smiles for a portrait
Sean Radek, a transgender teen, came to Raleigh from Charlotte in May to oppose legislation banning youth from accessing gender-affirming surgeries. Credit: Rachel Crumpler

Sean Radek is one such example. At the age of 16, he got gender-affirming top surgery to remove his breast tissue.

“If I had to wait two more years, I know I wouldn’t be here,” Radek told NC Health News in May. “I would have honestly taken my own life. I know it. I was at that point already where I was very much considering it because of the way I look.”

Rep. John Autry (D-Charlotte) has also shared several times on the House floor how his transgender granddaughter has benefited from gender-affirming care. He choked up when speaking against the bill Wednesday.

Nonetheless, Republicans voted to pass the bill. Rep. Hugh Blackwell (R-Valdese) asserted on the House floor that states have “long gone to extra steps to protect the interests of minors” and said this legislation is in that vein. 

Before Wednesday, 32.2% of transgender youth lived in states that have passed bans on gender-affirming care. North Carolina kids will now be added to that tally.

The Campaign for Southern Equality and Equality NC are partnering to bring the Southern Trans Youth Emergency Project to North Carolina to help families who need to travel out of state for gender-affirming care.

Restricting discussion of gender identity in schools

In a strict-party line vote in both chambers, lawmakers made Senate Bill 49, Parents’ Bill of Rights, law. The bill requires school personnel to tell parents if their child asks to use a different name or pronouns at school. It also restricts instruction and discussion about gender identity, sexual activity or sexuality in kindergarten through fourth grade classrooms unless a child asks a question about it in the context of classroom activity. The bill also adds a number of new administrative tasks to teachers’ workloads. 

Sen. Amy Galey (R-Burlington) spoke in support of the bill Wednesday night, explaining the need to keep parents informed. She said not notifying parents would be engaging in “a conspiracy to hide an essential truth about the mental health of their child.”

Critics say these types of laws can hurt LGBTQ+ students by forcibly outing them to their families, even when those families are not accepting of their identities.

Sen. Natasha Marcus (D-Davidson) said schools want more teachers and bus drivers, calendar flexibility and gun safety among other things — not more restrictions.

“They don’t want to be burdened with additional busy work, which is what Senate Bill 49 is doing, or forced to betray the trusts that students often put in them,” Marcus said. “They don’t want their curriculum micromanaged by state government, and they don’t want certain books banned just because particular parents don’t like them.” 

More restrictive environments to navigate

Many Democrats denounced the priority of taking up the veto overrides as the first order of business upon return to Raleigh, while the body has yet to pass a budget. 

“Today’s veto overrides are really just another example of finding culture wars instead of fighting for our school children, fighting for our teachers, fighting for our state employees, fighting for our citizens who don’t have basic health care coverage,” said Sen. Minority Whip Jay Chaudhuri (D- Raleigh). 

“We talk about running our state like a business, but we’re costing our taxpayers $42,000 a day because we don’t have a budget,” he said, referring to the daily cost of running the legislature while it’s in session. 

community members hold a banner reading "trans kids are loved" to demonstrate their support of transgender youth. One
At the same time NC Values Coalition held their news conference in support of legislation restricting transgender athletes from competing in sports, a group in support of trans rights voiced their opposition to increased restrictions. Elizabeth Waugh, an Orange County mother, holds the sign in the middle. Credit: Rachel Crumpler

Waugh, the Orange County mother, said these new restrictions will harm the state’s LGBTQ+ youth, placing an unnecessary burden on them.

“Families who have the resources to do so may choose to leave,” Waugh said, though she said she’s committed to staying in her home state. “Most families who have trans or nonbinary children do not have those resources, and so they will be stuck here. And they will watch their children wither. They will watch their children suffer.”

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