Families, trans adults sue state to block gender-affirming care ban

Transgender South Carolinians and their families filed a lawsuit Thursday to block the enforcement of restrictions on gender-affirming health care in their state.

The lawsuit comes just over three months after Gov. Henry McMaster signed House Bill 4624, which includes prohibiting gender transition procedures to a person under 18 years of age and prohibits the use of public funds for gender transition procedures -- including puberty blockers, hormone therapy and surgeries.

The law also prohibits gender-affirming care coverage under South Carolina's Medicaid program.

Plaintiff Sterling Misanin, a 32-year-old transgender man, said his scheduled surgery was abruptly canceled at the Medical University of South Carolina after the law passed.

"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," said Misanin. "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."

McMaster's office told ABC News that he was "proud" to sign the law and vowed to "continue to support our state's efforts to fight back against those who wish to force harmful gender transition procedures on our children."

In a statement on the law at the time, State Rep. Davey Hiott said: "We do not know how many surgeries have taken place in South Carolina related to this issue, but one is too many. It is past time that we protect our children."

The law is set to take effect on Jan. 31, 2025. The plaintiffs are seeking a preliminary and permanent injunction on the law's gender-affirming care provisions, arguing that they violate the Equal Protection Clause of the 14th Amendment.

The ACLU argues that it discriminates against transgender individuals because while it bans the use of puberty blockers for trans youth, it does not prohibit the prescription of the same medications to treat central precocious puberty. The law also restricts hormone therapy for youth and some trans adults, but allows the same treatment for non-trans patients, the ACLU states.

The plaintiffs also argue that the law violates the due-process rights of parents and the anti-discrimination clauses of the Medicaid Act, Affordable Care Act, Americans with Disabilities Act, and Rehabilitation Act.

"A law that takes away health care from people, that strips away the ability of parents to make medical decisions for their children, that criminalizes doctors who follow the established standards of care isn't just mean-spirited and harmful - it's also unconstitutional," said Jace Woodrum, executive director of the ACLU of South Carolina, in a statement.

The plaintiffs include two parents and their children who would be denied care, as well as three adults whose care has been disrupted.

The legal challenges come as the Supreme Court prepares to take up a constitutional challenge to state bans on gender-affirming care for minors.

ABC News has reached out to the defendants -- including the state Attorney General's Office, the state Department of Health and Human Services (SCDHHS), the state Public Employee Benefit Authority and the Medical University of South Carolina (MUSC) -- for comment.

The state Attorney General's Office told ABC News that it does not comment on pending litigation, "but we can say we will vigorously defend the state's laws."

The MUSC and SCDHHS told ABC News that they do not comment on matters of active litigation.