New Hampshire Governor Chris Sununu recently enacted two pivotal pieces of legislation that mark a significant shift in the state's policy on transgender rights and healthcare. Signed into law last week, these measures impose substantial restrictions on transition-related care for transgender minors and establish new regulations governing the participation of transgender students in school sports.

The first piece of legislation, House Bill 619 (H.B. 619), places significant limitations on transgender minors' access to transition-related surgeries. It also prohibits healthcare providers from referring patients to out-of-state facilities for such procedures. While the law does not extend to other forms of gender-affirming care such as puberty blockers or hormone replacement therapy, it represents a notable constraint on specific medical treatments for minors. This law is scheduled to take effect at the beginning of the coming year.

The second measure, House Bill 1205 (H.B. 1205), stipulates that students in grades 5 through 12 must participate in sports teams that align with the gender marker on their birth certificates rather than their gender identity. This legislation, which will be implemented next month, has been the subject of considerable debate. Critics argue that it undermines the rights of transgender students, potentially limiting their ability to compete fairly and inclusively in school sports.

Proponents of these laws argue that such measures are necessary to protect minors who they believe lack the maturity to make decisions regarding life-altering medical procedures. They also assert that transgender girls may have physical advantages over cisgender girls in sports, which they argue justifies separate competition categories.

Governor Sununu defended the newly signed laws, asserting that they reflect a balanced and pragmatic approach that aligns with the values of many New Hampshire residents. In his statement, Sununu described the legislation as "commonsense, bipartisan solutions" that uphold "safety, fairness, and common sense" for all citizens. He suggested that these measures are indicative of a broader consensus among the state's residents.

In contrast, Sununu vetoed another piece of legislation on the same day that would have prohibited transgender individuals from using bathrooms and locker rooms corresponding with their gender identity. Governor Sununu's veto of House Bill 396 (H.B. 396) was justified by his belief that the bill addressed issues that had not manifested in New Hampshire and could incite unnecessary discord.

With the recent enactment of these laws, New Hampshire joins the ranks of states that have introduced restrictions on transition-related care for minors and limitations on transgender students' sports participation. According to the Movement Advancement Project (MAP), an LGBTQ rights think tank, New Hampshire is now the 26th state to implement some form of restriction on gender-affirming care for minors. Additionally, it becomes the 25th state to impose restrictions on transgender students' participation in sports teams consistent with their gender identity.

Idaho was the first state to implement such restrictions on transgender students' sports participation in 2020, while Arkansas was the pioneer in restricting gender-affirming care in 2021. The swift adoption of these policies by Republican-controlled states underscores a broader trend within the party and state legislatures, which have increasingly focused on transgender-related issues in recent years.

Chris Erchull, a staff attorney at GLBTQ Legal Advocates & Defenders (GLAD), highlighted the broader implications of these legislative developments. Erchull noted a significant nationwide effort to restrict medical care for transgender individuals and to enact laws impacting their public and private lives. This movement has now influenced New Hampshire, resulting in the passage of such legislation for the first time.

Governor Sununu's recent actions represent a departure from his previous stance on transgender rights. In 2018 and 2019, Sununu signed laws expanding anti-discrimination protections for transgender individuals in various sectors, including employment, education, housing, and public spaces. However, his recent legislative decisions indicate a shift towards aligning with the current Republican stance on these issues.

The Tirrell family from Plymouth, New Hampshire, provides a poignant example of the personal impact of these legislative changes. Zach and Sara Tirrell, who live with their transgender daughter Parker, have expressed concern about the new health care law. Although Parker is not currently pursuing transition-related surgery, her family fears that this legislation might set a precedent for further restrictions on gender-affirming care.

The New Hampshire Women’s Foundation has strongly criticized the sports measure, arguing that legislative focus should be directed towards addressing more pressing issues, such as the mental health crisis among youth, rather than enacting laws that impact transgender individuals' rights.

The potential for legal challenges to the New Hampshire measures remains uncertain. Similar laws in other states have faced temporary blocks while undergoing judicial review.

In a related development, the Supreme Court has agreed to review a case concerning gender-affirming care for minors. This case involves a Biden administration appeal of a ruling that upheld a Tennessee measure prohibiting all gender-affirming care for minors. The court’s forthcoming decision, anticipated in the next term starting in October, could have broad implications for similar laws nationwide. The White House has stated its opposition to efforts to restrict transgender healthcare through legislation or legal challenges, while maintaining that gender-affirming surgery should be "reserved for adults."

The Tirrell family, with deep roots in New Hampshire, has indicated a willingness to relocate if future legislation or court rulings threaten Parker’s access to necessary medication. Sara Tirrell expressed that they would consider moving to a state that offers a safer environment for their daughter if such threats materialize.