A transgender man from Charleston and other transgender families in South Carolina filed a federal lawsuit in an important legal battle to overturn a state law that restricts access to healthcare that affirms gender identity. The ACLU of South Carolina and Selendy Gay have joined forces to launch a lawsuit challenging certain provisions of House Bill 4624. These provisions forbid doctors from providing gender-affirming care to minors and also forbid the use of public and Medicaid funds for such care.
The lead plaintiff in the case, Sterling Misanin, a 32-year-old transgender man from Charleston, had his scheduled transition surgery at the Medical University of South Carolina (MUSC) abruptly canceled following the passage of the law. Misanin, who has lived in Charleston for several years, expressed his deep disappointment and frustration over the state’s interference in his healthcare.
“I feel so lucky and fortunate to be supported and affirmed by so many wonderful people who accept me for who I am,” Misanin said in a statement. “In Charleston, I have a wonderful community who make me feel safe and seen. But the actions by MUSC have caused me significant harm, and I am devastated that my state has interfered in my access to life-saving health care. I am an adult, and I know myself better than my state does, and I cannot stay silent about the very real harms that this law inflicts on transgender people like me.”
The law, which Governor Henry McMaster signed earlier this year, primarily targets gender-affirming care for children by outlawing the prescription of puberty inhibitors, hormone therapy, and gender-affirming surgeries for those who are younger than 18. However, the law also contains provisions that have far-reaching consequences for transgender adults, particularly those reliant on public or Medicaid funds for their healthcare. The law explicitly prohibits the use of state funds “directly or indirectly” for gender transition procedures, a clause that has led to the cessation of all gender-affirming care at MUSC.
RELATED: South Carolina Bans Gender-Affirming Care for Transgender Minors
The lawsuit argues that South Carolina’s law violates the constitutional rights of transgender individuals, specifically their rights to equal protection under the law. The plaintiffs, represented by the ACLU and Selendy Gay, are seeking to block the enforcement of three key aspects of the law: the prohibition on gender-affirming care for minors, the restriction on the use of state funds for such care, and the ban on using Medicaid funds for these services.
David Bell, a Charleston parent of a 15-year-old transgender daughter, has been one of the most outspoken opponents of the law. Bell participated in legislative hearings, passionately advocating for his daughter and others like her who rely on gender-affirming care for their mental and physical well-being.
“I wish it never had to come to the point of a lawsuit,” Bell said. “I wish that our legislators in South Carolina were required to legislate by the facts, scientific data, and the recommendations of professional organizations that are experts in this field. But those were ignored, and now we’re left with a law that is not only harmful but also unconstitutional.”
The law’s passage and the subsequent legal challenge reflect the broader national trend of states enacting legislation that restricts access to gender-affirming care, particularly for minors. South Carolina is now the 25th state to implement such restrictions. These laws have been met with fierce opposition from LGBTQ+ advocacy groups, medical professionals, and affected families, who argue that they endanger the lives and well-being of transgender individuals.
Critics of HB 4624, such as Kelli Parker, Director of Communications for the Women’s Rights and Empowerment Network, argue that the law is rooted in discrimination and a fundamental misunderstanding of transgender healthcare.
“Rather than prioritizing the real issues facing South Carolinians, our lawmakers shamefully chose to promote hate, fear, and discrimination under the guise of ‘protecting kids,’” Parker said. “Laws that block essential healthcare violate human rights and are a major setback for equality.”
The lawsuit against South Carolina’s HB 4624 is particularly significant given recent federal court rulings on similar issues. The U.S. 11th Circuit Court of Appeals recently upheld Alabama’s law restricting gender transition care for minors. However, the 4th Circuit Court of Appeals, which has jurisdiction over South Carolina, has issued rulings that bolster the plaintiffs’ case. In April, the 4th Circuit upheld decisions preventing North Carolina and West Virginia from blocking gender-affirming care for individuals on state healthcare plans and Medicaid, respectively.
Jace Woodrum, Executive Director of the ACLU of South Carolina, expressed confidence that the federal courts would recognize the unconstitutionality of South Carolina’s law.
“The ban on medically necessary healthcare for transgender people in our state is not only mean-spirited and harmful, it’s unconstitutional,” Woodrum told the SC Daily Gazette. “We believe that the courts will see this law for what it is: a violation of the fundamental rights of transgender individuals to access the care they need.”
The stakes are high for Misanin and the other plaintiffs in the case. For Misanin, the law’s impact is deeply personal, affecting his ability to access critical healthcare services that are vital to his well-being. His experience underscores the broader struggle faced by transgender individuals in South Carolina and across the nation, as they contend with laws that seek to limit their rights and access to care.
Governor McMaster, in defending the law, has stated that it is intended to protect young people from “irreversible” medical procedures and to ensure that decisions about gender transition are made with the utmost care. However, opponents of the law argue that it disregards the medical consensus on the importance of gender-affirming care and ignores the voices of those most affected by such legislation.
As the legal battle unfolds, the plaintiffs and their supporters remain hopeful that the federal courts will rule in their favor, striking down the provisions of HB 4624 that they believe are not only harmful but also unconstitutional. For transgender individuals in South Carolina, the outcome of this case will have profound implications for their access to healthcare and their ability to live authentically.
The lawsuit is expected to draw national attention, as it addresses a critical issue at the intersection of healthcare, civil rights, and the ongoing struggle for LGBTQ+ equality in the United States. As the legal proceedings move forward, the voices of those like Sterling Misanin and David Bell will continue to resonate, advocating for a future where all individuals, regardless of gender identity, have the right to access the care they need and deserve.
