In step with protections afforded to abortion providers and patients, Maryland lawmakers are seeking to prohibit the state from participating in criminal investigations and lawsuits that other states may bring against health care professionals who provide gender-affirming care and transgender patients who travel to the state to receive it.
“That is the heart of this bill, protecting people in Maryland — both residents and patients — from out-of-state prosecution for procedures and health care that is legal in Maryland,” House Majority Leader David Moon, a Democrat, said during a joint hearing of the House Health and Government Operations and Judiciary committees on Wednesday. “That is all this bill does.”
House Bill 691 and Senate Bill 119 seek to expand the definition of “legally protected health care” under Maryland law to include gender-affirming treatment. It would prohibit Maryland officials from aiding other states in the criminal prosecution of health care professionals who provide gender-affirming care and patients who seek it. Additionally, the bill would prevent the governor from honoring requests for the extradition of providers to other states for administering gender-affirming treatment in Maryland.
The state would still be able to assist other jurisdictions in prosecution only if the acts are also criminalized in Maryland.
Under the bill, gender-affirming treatment includes hormone therapy, hormone and puberty blockers, hair alteration, voice therapy and lessons, and surgeries, among other health care procedures.
The bill also protects therapy and “mental health services that are designed to prevent suicide,” Moon said.
The bill seeks to put into state law an executive order Gov. Wes Moore, a Democrat, issued over the summer to protect gender-affirming health care in Maryland from legal repercussions in other states. It also builds on the Reproductive Health Protection Act of 2023, which protects abortion providers and their patients from other states’ criminal investigations and court proceedings.
“Women’s rights and trans justice are parallel struggles in the fight for bodily autonomy,” Jamie Grace Alexander, a representative of the Trans Rights Advocacy Coalition, testified Wednesday. “That protection needs parity.”
According to Moon, 11 states and Washington, D.C., have similar gender-affirming shield laws, and three more have established a similar policy via executive order.
“Just to put a fine point on this being not a theoretical exercise, this bill, if we don’t pass it, would expose our residents, patients, medical providers, caregivers and, dare I say, parents and their decisions to be overruled by politicians in other states that have come to different conclusions,” Moon said.
Michael Huber, the director of Maryland Government Affairs for Johns Hopkins University and Medicine, told lawmakers that gender-affirming care is “evidence-based, age-appropriate, medically necessary, life-saving health care.”
“The concerns that this bill seeks to address are not hypothetical,” Huber said, noting that 23 states have sought to ban gender-affirming health care.
Questioning the bill’s necessity, Del. Brian Chisholm, an Anne Arundel County Republican, asked Moon if any states have actively requested that Maryland participate in the investigation and prosecution of someone who provided or traveled to receive gender-affirming treatment.
Moon responded, saying that “whether or not this is going to materialize,” there has been enough legislation passed in other states that Maryland should act to protect physicians, patients and their medical records.
Del. Kathy Szeliga, a Republican from Baltimore County, asked if parental consent would be affected under the bill, and if someone could bring a minor from out-of-state to Maryland to receive gender-affirming care without their parents’ knowledge. Parental consent has been a major discussion point for Republicans on trans rights legislation.
Nothing would change in regard to parental consent, Moon explained. It would only prevent the prosecution of health care providers and patients.
“Once you’re in the walls of Maryland, this is a legal procedure,” he said.
The Senate version of the bill was heard in the chamber’s Finance Committee last month. Both iterations need to be passed out of their respective committees before they reach the House and Senate floor.
Coming at the issue from a different angle, Del. Lauren Arikan, a Republican from Harford County, is sponsoring House Bill 722, which would prohibit medical professionals from prescribing or administering gender-affirming care to minors without the consent of their parent or guardian.
Some lawmakers deemed Arikan’s bill unnecessary because it’s duplicative of existing state law, they said.
In Maryland, minors can legally consent to medical treatment or advice related to HIV prevention, sexually transmitted infections, drug and alcohol abuse, contraception and pregnancy. They can also consent to a physical examination following alleged rape or sexual assault without permission from their parent or guardian. Children aged 12 and up can seek out and consent to mental health care services without their parents. However, children under 16 are unable to consent to the use of medication to treat a mental health disorder.
Minors can consent to any medical treatment if they are married, have a child of their own or live separately from their parents and are able to support themselves.