New Jersey will become a "safe haven" for gender-affirming health care under an executive order signed Tuesday by Gov. Phil Murphy.
The order seeks to ensure transgender and non-binary people have access to gender-affirming care at a time when many states have restricted or banned such health care services for members of the LGBTQIA+ community.
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The executive order directs all state departments and agencies to protect all people, including health care providers and out-of-state patients, against repercussions resulting from gender-affirming health care. The state will not extradite out-of-state patients who seek legal health care in New Jersey or cooperate with interstate investigations into them.
The order also protects health care providers. Some health care facilities that provide gender-affirming care have been subject to bomb threats due to false claims made on social media about surgical procedures done on infants.
"Across the nation, we are witnessing attacks led by certain states that seek to undermine the equality, dignity and safety of the LGBTQIA+ community, especially transgender and non-binary youth," Murphy said. "As leaders, our greatest responsibility is ensuring that every person we represent, regardless of their gender identity or gender expression, is entitled to respect, fairness and freedom. We will continue to uphold these principles in New Jersey and support every person's right to live freely and authentically by making our state a safe haven for those seeking or providing gender-affirming care."
Last Friday, to commemorate Transgender Day of Visibility, New Jersey launched an online portal with resources for transgender residents – like how to change one's name and gender on a state ID. It also provide information on legal protections, civil rights and supports for youth and families.
New Jersey has an estimated 30,000 transgender and non-binary residents, according to the Williams Institute at UCLA. Pennsylvania has about 43,000.
The executive order covers any care that addresses a transgender or non-binary person's physical, mental or social health needs and is designed to affirm one's gender identity. These health care services include mental health or psychiatric care, surgery, hormone replacement therapy, nonsurgical treatments and mental or behavioral services meant to support and affirm an individual's gender identity.
According to a December 2021 study published in the Journal of Adolescent Health, about half of transgender or non-binary youth ages 13 to 24 reported that they were not receiving gender-affirming hormone therapy but would like to. Transgender youth who receive hormone therapy have been found to have a lower risk of suicide and mental health issues.
Researchers at the University of Washington found that transgender and non-binary youth who received gender-affirming care, like hormone therapy and puberty blockers, were 60% less likely to develop depression and 73% less likely to contemplate or attempt suicide.
Many efforts to restrict or ban gender-affirming health care focuses on invasive procedures like surgery. But a Reuters investigation with Komodo Health Inc. found that though the frequency of such procedures has risen slightly in recent years, mastectomies are uncommon for minors. They typically are performed on older adolescents who have shown a persistent gender identity.
Top surgeries and genital surgeries are typically not performed until people are 18 or older, according to Columbia University's Department of Psychiatry.
The American Civil Liberties Union, which maps legislation targeting transgender health care, notes that there have been 451 anti-trans bills introduced during the current legislative session.
The Human Rights Campaign, which also maps anti-LGBTQIA legislation across the country, notes that 13 state legislatures have passed bans or restrictions on gender-affirming health care. They include Texas, Alabama, Arkansas, Florida, Missouri, Georgia, Tennessee, Kentucky, West Virginia, Iowa, South Dakota, Arizona and Utah.
Court injunctions in Texas, Alabama and Arkansas may prevent Republican-led state legislatures from outlawing gender-affirming care. Florida, in particular, has been met with criticism over its law, including from Murphy.
"When transgender youth are under attack across the country, (Murphy's order) gives me hope," said Rebekah Bruesehoff, a transgender youth activist. "I have always been grateful to live in New Jersey, but I am especially proud now to see my state take action that will protect and support not only me but my friends in states across the country. Transgender kids and teens like me just want to live our lives and be ourselves."
Sen. Ed Durr, a Republican serving New Jersey's Third District, introduced a bill in September that would ban minors from receiving puberty blockers, hormone therapy and gender-affirming surgical procedures. The bill, which does not apply to emancipated minors or those who are intersex, has stalled in New Jersey's Democratic-controlled legislature.
In Pennsylvania, Rep. Paul Schemel, a Republican from Franklin County, introduced a bill in December that would extend the statute of limitations for those who had gender-affirming surgery as minors to file civil lawsuits. The legislation was referred to the House Judiciary Committee in March.