Louisiana Legislature overturns veto of ban on transgender youth health care 

Protestors hold signs, including one that says
Protestors assemble on the steps of the Louisiana State Capitol on July 18, 2023, to oppose the state legislature’s attempt to override gubernatorial vetoes of anti-LGBTQ+ legislation. Photo by Wes Muller

This story was first reported by Louisiana Illuminator and republished with permission.

In a rare occurrence, the Louisiana Legislature has overridden a veto from Gov. John Bel Edwards, allowing a ban on gender-affirming health care for transgender youth to become law.

House Bill 648 by Rep. Gabe Firment, R-Pollock, was overridden in the House on a 75-23 vote and in the Senate on a 28-11 vote. The bill will ban gender-affirming health care for all transgender youth.

Democratic Reps. Roy Daryl Adams of Jackson, Robby Carter of Amite, Chad Brown of Plaquemines, Mack Cormier of Belle Chasse, C. Travis Johnson of Vidalia, Dustin Miller of Opelousas and Sens. Katrina Jackson of Monroe and Greg Tarver of Shreveport, voted with Republicans to override the veto.

Firment’s legislation is likely to be the subject of a lawsuit. Similar laws have been blocked by federal judges in Alabama, Arkansas, Florida and Indiana. In Tennessee and Kentucky, courts have blocked the bans, but another judge lifted the stay in Kentucky and an appeals court in Tennessee has lifted a district court’s enforcement block.

In a statement, Edwards, a Democrat, slammed the legislature for canceling out his veto.

“The first time I was overridden, on the Congressional district map, I said the bill was illegal and I expected the courts would throw it out. The courts have done so,” Edwards said. “Today, I was overridden for the second time, on my veto of a bill that needlessly harms a very small population of vulnerable children, their families and their health care professionals. I expect the courts to throw out this unconstitutional bill, as well.”

Rep. Jason Hughes, D-New Orleans, took to the House floor to speak against Firment’s proposal, emphasizing his Christian faith led him to oppose the bill. He read Edwards’ six page veto message detailing problems with the measure and slammed the idea it is about parental rights.

“What this bill does it states that parents don’t know what’s in the best interest of the children,” Hughes said. “It also takes away parental rights to work with a physician to make important health care decisions for children experiencing gender crisis that could quite literally saving their lives,” Hughes said, pointing out that youth who receive gender-affirming care have better mental health outcomes.

Quest Riggs, a New Orleans native who came to the Capitol to protest three anti-LGBTQ+ bills, said the Republican Party is trying to take away the rights of parents to make medical decisions for their own children

“Here in this building they have completely taken the wrong side of history,” Riggs said. “They’re trying to create a Louisiana that is modeled under a theocratic image.”

Senator Fred Mills speaks in opposition to the gender affirming care bill Tuesday, July 18, 2023, during the veto override session at the State Capitol in Baton Rouge, La. (Matthew Perschall for Louisiana Illuminator)

In the Senate, Sen. Fred Mills, R-Parks, who helped kill Firment’s bill before it was later revived in an unusual procedural move, gave an impassioned speech asking his colleagues to sustain Edwards’ veto.

Mills said legislators have a roadmap for what will happen next with the bill in other states where federal courts have blocked them. Judges have ruled the bills are unconstitutional, and Mills argued Louisiana’s ban faces a similar fate.

Vetoes upheld for ‘Don’t Say Gay,’ pronoun bills

The legislature failed to overturn vetoes of two other anti-LGBTQ+ bills.

House Bill 466, by Rep. Dodie Horton, R-Haughton, would have prohibited discussion of gender identity and sexual orientation in public schools. House Bill 81, by Rep. Raymond Crews, R-Bossier City, would have forbidden school employees from using transgender students’ preferred names or pronouns unless they had parental approval.

Veto overrides need a two-thirds vote in both chambers. The Horton and Crews bills failed to reach that threshold in the House and didn’t advance to the Senate.

Several Republicans, including governor candidate Rep. Richard Nelson of Mandeville, joined Democrats in opposing the bills. Others were Reps. Stephanie Hilferty of New Orleans and Barbara Frieberg of Baton Rouge.

House Speaker Pro Tempore Tanner Magee, R-Houma, joined Hilferty, Freiberg and Nelson in voting against Crews’ bill.

Misinformation drives Firment bill

Alexander Andreson, who works at an elementary school, was very happy the vetoes of the bills dealing with K-12 students were sustained.

“On [the gender-affirming care ban], the fact is that we’re not gonna give up and we’re gonna have to go to the courts with it,” Anderson said.

Supporters of Firment’s bill have raised concerns about minors receiving irreversible gender-affirming surgeries and that children are being left sterile, claims that are both factually questionable.

Rep. Gabe Firment speaks to members of the Louisiana House of Representatives Tuesday, July 18, 2023, during the veto override session at the State Capitol in Baton Rouge.
Rep. Gabe Firment speaks to members of the Louisiana House of Representatives Tuesday, July 18, 2023, during the veto override session at the State Capitol in Baton Rouge. (Matthew Perschall for Louisiana Illuminator)

In reality, gender-affirming procedures, such as top surgery, which adds or removes breast tissue, or bottom surgery, which constructs a vagina or penis are not recommended for minors, according to Dr. Kathryn Lowe, a pediatrician who represents the American Academy of Pediatrics Section on LGBT health and wellness.

The American Academy of Pediatrics and many other major medical associations support gender-affirming care for transgender youth.

Gender-affirming care is a catch-all term for medical treatments given to people to align their physical bodies with their identified gender. Gender-affirming care is used by transgender people, who identify as a gender different from their sex assigned at birth, as well as cisgender people, who identify as their assigned sex.

Treatments are individualized to the patient. Some young patients will be prescribed fully reversible puberty blockers, giving the patient time to consider their options.

Later, a patient may be given hormone treatments that can help young people go through puberty in a way that allows their body to change in ways that align with their gender identity. These treatments are partially reversible.

Firment has raised concerns about the harm of puberty blockers, but medical providers consider them safe and have used them for decades to treat children who enter puberty too early. Firment’s own bill makes exceptions for these children, as well as for intersex youth, to continue to receive these treatments.

Firment’s bill requires any transgender youth currently receiving gender-affirming health care be taken off the course of treatment by the end of 2024. Providers who specialize in gender-affirming treatments say there is no length of time that would make discontinuing care safe, pointing to the risk of suicide.

Studies approximate 80% of transgender youth have considered suicide, and 40% report at least one suicide attempt. Research also indicates gender-affirming health care leads to improved mental health outcomes.

Horton’s bill is similar to a Florida law critics refer to as a “Don’t Say Gay” bill. Her proposal is much broader and would have applied to grades K-12, where Florida’s law covers up to the third grade.

Horton’s legislation would have applied to any school employee or volunteer, and it covers discussions in the classroom and during extracurricular activity, meaning it would effectively outlaw Gay Straight Alliance clubs.

While proponents of Crews’ proposal argue the bill prioritizes parental rights, teachers with religious or moral objections could opt to override parental consent to use a student’s given name, also called a deadname, as well as pronouns associated with their sex assigned at birth. Referencing a person by pronouns other than how they identify themselves is referred to as misgendering.

The Crews bill provided no recourse for educators with a religious or moral objection to deadnaming or misgendering their students.

Parental rights in question

At the core of Crews’ proposal is his belief that parents have the right to know whether their kids are transgender.

“I don’t think it’s ever good for the parents to not to know what’s going on in school, and it ensures the rights of parents as primary caregivers to know what’s occurring in their children’s lives,” Crews said when his bill came up in the Senate Education Committee in June.

Advocates have raised concerns about what happens when parents find out — and don’t approve — when their children identify as transgender.

A survey from the Trevor Project found that 38% of transgender women, 39% of transgender men and 35% of nonbinary youth experienced homelessness as a result of parental rejection.

The override makes Edwards the first governor in modern Louisiana history to have more than one veto overturned, surpassing Buddy Roemer and Edwin Edwards.

Veto sessions are rare in Louisiana. Just three have occurred in approximately the past 50 years — all of them in John Bel Edwards’ second term as his relationship with the Republican-controlled legislature became more tense. Lawmakers handled the Roemer and Edwin Edwards vetoes during regular legislative sessions.

Reporter Wes Muller contributed to this article.