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North Carolina family, doctor sue to block state’s gender-affirming health care ban

An override stamp is seen on legislation limiting LGBTQ+ classroom instruction in the early grades, after North Carolina state lawmakers override Democratic Gov. Roy Cooper's veto, Wednesday, Aug. 16, 2023, in Raleigh, N.C. The Republican-led General Assembly overrode the governor’s vetoes of the legislation and other bills touching on gender in sports and gender-affirming medical treatments.

Two national LGBTQ rights groups, a North Carolina doctor and a family with a transgender child are challenging a new North Carolina law preventing transgender minors from receiving gender-affirming health care.

The coalition argues in a federal lawsuit filed Wednesday that the law discriminates on the basis of gender identity and infringes on the right of parents to make medical decisions on behalf of their children.


North Carolina’s House Bill 808, which went into effect Oct. 1, prohibits health care providers in the state from administering gender-affirming medical care — including hormones, puberty blockers and certain surgical procedures — to transgender youths younger than 18. 

The state’s Democratic Gov. Roy Cooper vetoed the bill, along with two other measures targeting LGBTQ young people, in July. In August, North Carolina’s GOP-controlled Legislature voted to override Cooper’s vetoes, allowing measures that ban gender-affirming care for youth, prevent transgender women and girls from competing on female sports teams and limit classroom instruction about sexual orientation and gender identity to take effect.

Cooper called the trio of bills “a triple threat of political culture wars.”

North Carolina health care providers under House Bill 808 are expressly prohibited from prescribing or dispensing puberty blockers or doses of testosterone or estrogen to transgender individuals younger than 18, although identical treatments are still legally available to minors with a “medically verifiable disorder of sex development.” 

The measure also prohibits doctors from providing or recommending “surgical gender transition procedures” to transgender minors and bars state funds — including for North Carolina Medicaid participants — from being used to support gender-affirming health care for youth. Health care providers who violate the law risk losing their medical licenses.

Gender-affirming care for both transgender adults and minors is considered medically necessary and often life-saving by every major medical organization. The American Medical Association’s policymaking body during an annual meeting in June said the group will oppose “state and federal legislation that would prohibit or limit gender-affirming care.”

In the federal lawsuit filed Wednesday, a couple calling themselves Vanessa and Vance Voe, who live in North Carolina with their 9-year-old transgender son, Victor, said their lives will be “turned upside down” if House Bill 808 is allowed to remain in effect.

The family, which is proceeding pseudonymously to protect its privacy, said in Wednesday’s lawsuit that Victor Voe “is terrified of going through a puberty that is completely foreign to him” if he is prevented from taking puberty blockers, saying “his anxiety is growing.”

Vanessa and Vance Voe, the lawsuit says, “cannot bear to witness their child go through physical changes that will profoundly harm him,” but they “do not wish to uproot their lives, nor can they imagine bearing the long-term financial costs associated with leaving the state to get care for Victor.”

Victor Voe loves video games and music and he hopes to be a marine biologist one day, the family’s attorneys said Wednesday.

The Voe family is joined by Riley Smith, a North Carolina family physician, and the LGBTQ rights groups PFLAG and GLMA in suing the state over House Bill 808. 

The plaintiffs, represented by Lambda Legal and the National Health Law Program, are asking for a preliminary injunction to block the law’s enforcement while the legal challenge against it proceeds.

“As a family physician that serves transgender patients, I can confirm that gender-affirming care is lifesaving,” Smith said in Wednesday a statement.

“Laws banning gender-affirming care will have dire consequences for transgender youth. We do not need politicians in the exam rooms with us, overriding thew decisions of families and their doctor or putting our professional licenses at risk for doing our jobs,” he said. “Instead, providers in North Carolina should be able to provide the highest quality, evidence-based care to their transgender patients, just like we do for our other patients.”