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16 Attorneys General From Red States Threaten to Sue Maine for Health Care Bill

The bill protects providers offering gender-affirming care to patients from states where such care is prohibited.

The Maine State House is pictured in Augusta, Maine.

Sixteen state attorneys general from various Republican-led states, including Texas, Florida and Kentucky, are threatening to sue Maine if it proceeds with a bill aimed at protecting healthcare providers offering gender-affirming care to patients from states where such care is prohibited. Maine’s Attorney General Aaron Frey responded, saying that he was “thoroughly dismayed” by the threatening letter written by the states’ attorneys general.

“This is not unprecedented, as at least 17 states and the District of Columbia have already enacted similar ‘shield laws,’” Frey wrote. “Our Republic endures.”

This bill, LD 227, would make Maine the 18th state, according to Frey, that has implemented protective “shield” laws, ensuring access to care for transgender youth by providing legal protection for doctors and parents who prescribe or seek medical treatment. Additionally, in January transgender activist and journalist Erin Reed wrote that the bill would “ban healthcare providers, practitioners, facilities, and similar institutions from disclosing protected healthcare information about their patients to out of state investigators.”

“Harmony between our states would be best preserved and promoted by the exercise of restraint by all parties seeking to control health care related policy choices in other states,” Frey wrote.

According to the Movement Advancement Project (MAP), currently 35 percent of the transgender population aged 13 and above reside in states with “shield” laws in place, safeguarding access to transgender healthcare. Additionally, 8 percent of transgender individuals reside in states with executive orders implementing similar gender-affirming care “shield” measures.

However, shield laws also protect access to gender-affirming care for the remaining 57 percent of transgender individuals, many of whom may reside in states that have banned such care for transgender youth. According to the Williams Institute at UCLA Law’s October 2023 report, more than 100,000 transgender youth aged 13 to 17 live in states where gender-affirming medical care is prohibited.

“We do have a right to disagree and I fully concur that one state cannot control another. Recognizing these shared values, I welcome your respect for Maine’s ability to decide what access to health care people in Maine receive, free from interference by out-of-state actors,” Frey wrote in response to the attorneys general’s letter.

Without shield laws in place, states may investigate transgender patients who go out of state for access to gender-affirming care. For example, in November of last year, Texas Attorney General Ken Paxton requested private information about transgender patients from Texas who had received gender-affirming care at clinics in Georgia and Seattle. Paxton also recently requested records from PFLAG, a prominent LGBTQ advocacy organization in the United States, regarding their assistance to families of transgender minors seeking gender-affirming treatments like puberty blockers and hormones. Paxton’s demands have prompted lawsuits from one of the clinics and from PFLAG.

“LD 227 is a straightforward bill to ensure that Maine law can continue to govern Maine health care.” Polly Crozier, director of Family Advocacy, GLBTQ Legal Advocates & Defenders (GLAD) said in a statement. “Yet politicians in some states have shown their intent to prevent people from accessing this vital health care anywhere.”

“This legislation will safeguard Maine’s health care infrastructure from hostile laws passed for political, not medical, purposes in other states and ensure Maine providers can continue to deliver high quality, standard-of-care medical care,” Crozier continued.

Should Maine pass the shield law, the bill would also safeguard patients and providers who perform abortions or in-vitro fertilization, which might be under legal restrictions in other states.

“Full spectrum reproductive health care and gender-affirming health care are essential, lifesaving services that are safe and legal in Maine. With LD 227, our elected leaders have an opportunity to stand up for safe, legal medical care by protecting providers who offer that care and the patients who seek it,” Lisa Margulies, vice president of public affairs for Planned Parenthood Maine Action Fund and Planned Parenthood of Northern New England said in a statement.

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