Transgender residents of South Carolina have filed a lawsuit against the state, challenging a sweeping ban on gender-affirming healthcare that has severely restricted access to essential medical treatments for both youth and adults. The lawsuit, filed by the American Civil Liberties Union (ACLU) on Thursday, targets one of the nation’s most restrictive anti-trans laws, enacted in May by Republican lawmakers.
The contested law, H4624, prohibits gender-affirming treatments such as puberty blockers and hormone therapy for transgender youth under 18, and blocks public funding for all gender-affirming care, including for adults. The law also bans surgeries for minors, which are rare in the U.S., despite major medical associations endorsing gender-affirming care as beneficial for mental health.
The law’s impact has been swift: the Medical University of South Carolina (MUSC), the state’s only public hospital system, halted all gender-affirming care for youth and adults in July, leaving many patients without critical medical support. LGBTQ+ advocates argue that these measures, often justified as protecting children, also intrude on the private medical decisions of transgender adults.
“We are seeing how these funding restrictions are cutting off access to essential care for transgender individuals,” said Gillian Branstetter, communications strategist for the ACLU’s LGBTQ & HIV Project.
South Carolina is among 26 GOP-led states that have enacted laws restricting trans healthcare, part of a broader trend targeting LGBTQ+ rights in areas such as sports participation, bathroom access, and literature.
One of the plaintiffs in the lawsuit, Sterling Misanin, a 32-year-old trans man from Charleston, described his struggle after his long-scheduled hysterectomy was abruptly canceled due to the new law. “It was really hard to process,” Misanin said. “I felt frustrated, angry, and scared that I might never get the care I need.”
Misanin had been receiving care at MUSC for years and had already undergone top surgery, which he said significantly improved his mental health and alleviated his gender dysphoria. “It was like an immediate weight lifted off my shoulders,” he recalled. “Now, being denied further treatment feels like losing hope for my future.”
Although Misanin managed to reschedule his surgery with a privately funded provider, he lamented the disruption of having to start over with a new healthcare team. “I’m still reeling,” he said, adding that he felt compelled to challenge the law for others who might not have the resources to fight back.
The ACLU argues that the South Carolina law sets a discriminatory double standard: while transgender youth are denied access to treatments like puberty blockers, cisgender youth can still receive them for conditions like early puberty. “This law clearly violates the constitutional rights of transgender people by discriminating against them,” said Sruti Swaminathan, an ACLU staff attorney.
Similar legal challenges in other states have had success. Recently, federal courts ruled against trans healthcare funding restrictions in North Carolina and West Virginia, declaring the policies “obviously discriminatory.”
The plaintiffs in the South Carolina case include other adults who have lost access to healthcare and parents of transgender children affected by the ban. As the legal battle unfolds, advocates continue to emphasize the critical importance of protecting transgender individuals’ rights to access medical care.
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