Transgender care targeted into adulthood in these states

When Lindsey Spero, 25, approached the podium at a Feb. 10 public hearing of the Florida medical board on a gender-affirming youth trans care ban, they used their allotted 2 minutes, 30 seconds to inject testosterone in front of board members and the audience.

The tension in the room was palpable, Spero said.

“I considered, going into it, all the things that I could write … all the things that I could say” to the medical board, said Spero, who is nonbinary, in an interview with ABC News. “I felt as though action is necessary because historically speaking, queer freedom and liberation has never been won through words alone.”

In some states, being able to take hormone therapies may soon become banned or restricted for adults like Spero.

Though Spero was protesting a ban against care for minors, they know they’re not in the clear. They believe their access to care in adulthood also could be restricted or limited.

Across the country, Republican-led efforts include seeking to ban or restrict gender-affirming care for people into adulthood or placing barriers for adults trying to access such care.

Research, including a study in JAMA Surgery, consistently finds that gender-affirming care reduces the risk of mental health problems and suicidal thoughts.

“It's necessary that – as trans people – even though this might not be immediately taking away my access to medication, I am still going to fight for each of my siblings. Because I know that this is my life on the line as well,” Spero said.

In Spero’s home state of Florida, adults are banned from using Medicaid to receive gender-affirming care.

Some states have gone further.

In Oklahoma, a proposed bill would make it a felony for anyone under the age of 26 to access gender-affirming care in the state.

The legislation, introduced by Republican state Sen. David Bullard, was met with protests from hundreds of opponents outside the Oklahoma state capitol building.

Bullard's office has not responded to requests for comment by ABC News.

In Virginia, a proposed bill would ban gender-affirming surgeries for people under the age of 21. The legislation was amended to remove bans on hormone therapies.

It also states that in order for someone over the age of 21 “to receive gender transition procedures, he must first obtain a referral from his primary care physician and a referral from a licensed psychiatrist.”

State Sen. Mark J. Peake, who is behind the bill, told ABC News that he wants to restrict gender-affirming surgeries until patients are 21 because “juvenile brains really are not developed as a teen."

Because of this, he believes people should have to wait for surgery until they are older.

“I think making a decision to permanently alter your body to remove a healthy body part is much more serious than buying a beer,” said Peake, a Republican.

He later continued, “There have been a lot of people who have come out who have had these surgeries and have indicated that they regret it.”

Research shows that rates of regret for gender-affirming procedures are extremely low — estimates are around 1%. Rates of regret for knee and hip replacement surgeries are much higher than gender affirmation surgery, according to studies.

A bill in South Carolina is identical to the original Virginia bill in that it bans gender-affirming procedures for people under 21 and makes it harder for people to access that care when they’re over 21.

“We have trans people who are under 21, but they're adults. Why do they not have their own bodily autonomy?” Zoë Glass, an LGBTQ advocate from South Carolina, told ABC News.

Republican state Sen. Daniel B. Verdin III, who is behind the South Carolina bill, has not responded to requests for comment by ABC News.

Advocates argue that lawmakers are slowly trying to legislate trans people out of existence.

“The existence of trans people under 21 [is] being criminalized in South Carolina and it's extremely frightening – extraordinarily frightening.”

According to the American Civil Liberties Union, there are roughly 275 anti-LGBTQ bills that are currently in state legislatures or have been passed in the United States this year. Many of these include banning transgender care for minors and criminalizing people who provide such care, banning transgender girls from playing on girls' sports teams, discussing or teaching about sexual orientation and gender identity in schools, and more.

Glass, who works with the LGBTQ advocacy group Harriet Hancock Center Foundation, said trans people in the state of South Carolina are preparing for the worst.

“Make sure all of our medical ducks are in a row. Make sure all of our paperwork is in a row. Our birth certificates are taken care of, our identification is taken care of,” Glass said. “So hopefully those things don't revert back if they decide to turn gender in South Carolina, constitutionally, back to what you're assigned at birth.”

Transgender activists want people to focus on the lives saved by gender-affirming care, which has been proven to improve mental health.

Spero said they had experienced barriers to accessing such care in their younger years and they believe gender-affirming care can be lifesaving.

"As somebody who felt acutely suicidal ... who was placed through multiple rounds of conversion therapy, I can tell you that it is incredibly hard to stay alive as a young trans person," Spero said.

"[Bans] will impact the lives of trans youth ... will cause mental distress and will cause, unfortunately, a lot of negative effects in the lives of these youth because they're not able to access life-affirming care."