(NEW YORK) — After months of targeting transgender youth medical care, legislators in some states are now setting their sights on restricting funding for care for transgender adults.
Lawmakers in at least eight states are seeking to restrict state or public funds from being used for gender-affirming care, limiting a patient’s ability to use Medicaid to help pay: Arizona, Georgia, Idaho, Kentucky, Mississippi, Oklahoma, Texas, and Virginia.
For Mason Kalinsky, that would mean he may no longer be able to access the hormone therapy that he has been taking for roughly three years. Kalinsky, a 27-year-old transgender activist in Kentucky, told ABC News in an interview that hormone therapy changed his life.
Before accessing hormone therapy, Kalinsky said he and his doctors tried a slew of medications including antidepressants to address his mental health challenges, including his struggles with addiction.
Hormone therapy and gender-affirming care made him feel “more awake and alive in my body in a way that no other medication had,” Kalinsky said.
“It’s a necessary medication for me,” he said. “And this bill, if it passes, would mean that I would no longer be able to get this care, as would a lot of other people who also have insurance that is in some way paid for by the public.”
Kentucky state Rep. Josh Calloway, a Republican, is one of the legislators behind the Kentucky bill. He told ABC News in an interview that he believes state funds should not go toward gender-affirming health care.
His bill would bar state funds from going toward services related to gender transitioning, including mental health counseling or therapy, hormone therapy or any surgical procedures.
Calloway could not provide details about how much in state funding currently goes to gender-affirming care for transgender patients. Instead, Calloway stated that the Kentucky Cabinet for Health and Family Services informed him that if his bill were implemented, it could cost the state between $12 to $21 million in the need for psychiatric care, counseling and hospital stays from impacted patients who may need increased mental health services.
“What they are saying by that statement is that we have a mental health crisis,” Calloway told ABC News, adding “they’re saying that these people will be in psychiatric care and treatment if we remove the ability to use these medications.”
ABC News has reached out to the Kentucky Cabinet for Health and Family Services to confirm the estimate.
“The truth is there’s only male and female, and there is no way that either can transition to the other,” said Calloway.
The bill has exceptions for intersex people – such as those with differences in sexual development – and does not restrict such care for non-transgender people.
“This is what is best: men, women, having a family, having babies, procreating,” said Calloway. “Those aspects of our society are under attack through many different avenues. This is just one of those avenues — promote confusion. Cause kids to be confused. They become unstable. They become adults, and before you know it, our society is totally disrupted.”
Transgender Americans — who are estimated to make up less than 1% of the U.S. population over the age of 13 — have been the target of hundreds of Republican-backed bills in recent years.
These bills target bathroom usage and sports participation by transgender residents and restrict certain content in schools or libraries that refer to transgender identities.
However, many anti-LGBTQ bills fail to move forward each year. In 2024, 533 anti-LGBTQ bills were considered by state legislatures and only 49 passed, according to the ACLU.
Kentucky, like other states behind the new wave of restrictive bills, previously passed a gender-affirming care ban for people under the age of 18.
In 2023, the gender youth care ban was vetoed by Kentucky Gov. Andy Beshear, which was quickly overridden by the state legislature and passed into law.
Beshear argued that the bill allowed too much government interference in personal health care decisions.
Many of the laws that have been signed or passed into law have led to ongoing legal battles. The Supreme Court is currently considering a case, U.S. v. Skrmetti, which would decide the constitutionality of gender-affirming care bans for transgender minors.
For Carma Marshall Bell, a 34-year-old trans Kentucky resident who has been on hormone therapy for five years, she said she is “terrified” about what could happen if she’s unable to afford her treatment, which could include hormone withdrawal symptoms, which may lead to physical changes and a potential negative impact on mental health.
“I feel like I’m in a good place. I used to be in a really dark place at the beginning. I didn’t see myself in who I used to be versus who I see myself now,” said Marshall. Losing her hormones “would exacerbate depression and just those dark feelings that so many Americans right now are battling and fighting against.”
She continued, “Hormones, to a degree, have saved my life. If I hadn’t got on them, I don’t know where I would be right now.”
Marshall plans on attending a rally with other LGBTQ advocates and allies to call on lawmakers to vote against the bills impacting the transgender community in the state.
“We are people that are deserving of love, respect, humanity. We deserve our little piece of the American dream,” said Marshall. “We actually take a lot of steps to ensure that there’s nothing wrong with us, by ensuring that we see our mental health professionals, by ensuring that we’re in those doctor’s offices taking care of our health and well being, because health is wealth, and we want to prosper in this country known as America.”
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