Georgia Senate OKs bill to ban state workers from gender affirming care under state health plan

Sen. Blake Tillery presents his bill banning gender-affirming care under the state health insurance plan to a Senate committee. The bill passed the Senate Tuesday on party lines. Ross Williams/Georgia Recorder

Sen. Blake Tillery. Ross Williams/Georgia Recorder

State employees who use the state-sponsored health plan may soon be blocked from receiving gender-affirming care like hormone therapy.

The state Senate passed a bill Tuesday that aims to do just that. Before it can become law, it will need to pass the House by April 4 and be signed by Gov. Brian Kemp. If that happens, state employees who get gender-affirming care through the plan will have until the start of 2026 to find different coverage.

"When the state goes through its open enrollment period, we're making clear to all state employees that we're not gonna use state taxpayer dollars to pay for this gender-affirming care and transgender surgeries any longer," said Senate Bill 39's sponsor, Vidalia Republican Sen. Blake Tillery.

The bill would apply both to state employees on the plan as well as their minor children.

Sen. Blake Tillery and Lt. Gov. Burt Jones listen to Sen. Nan Orrock. Ross Williams/Georgia Recorder

The state previously barred gender affirming care for minors, but Tillery said the bill is necessary because a loophole could allow parents to obtain banned treatments for their minor children by using the state plan.

"While the General Assembly has spoken and spoken clearly and said loudly we do not think that these surgeries should occur in our state, there's a back door that's happened here," he said. "The back door that's happened is, through settlements, court decisions and otherwise, we are paying for those surgeries, and we are allowing those surgeries on minors, and we're not just allowing those surgeries on Georgia minors, we're paying for those surgeries on Georgia minors. Transgender surgeries on Georgia minors, paid for with Georgia taxpayer dollars, but since we banned them in Georgia, guess where we pay for them at? Out of state."

Tillery said he does not know how many times a minor Georgian may have gotten gender-affirming care out of state. Experts say surgeries are rarely even discussed as an option for minors, and standard care for a minor would be more likely to include therapy, social transitioning and hormone replacement.

Tillery was referring to Rich v. Georgia, a 2023 case where a group of state workers who were denied gender-affirming care sued the state. The state agreed to a $365,000 court settlement with three employees.

Senate Democrats argued that seeking to skirt the terms of that settlement would open the state up to new lawsuits.

"Our own attorney general made the call to settle Rich v. Georgia, because under his expert opinion, he knew that this would be a fight that the state could not win," said Sen. Nikki Merritt, a Grayson Democrat.

Democratic Sen. Kim Jackson proposed an amendment to Tillery's transgender bill that she said would clarify that mental health treatments would not be barred for transgender people on the state health plan, but senators voted it down after Tillery said his bill would not ban such treatments. Ross Williams/Georgia Recorder

Senate Minority Leader Harold Jones said the bill could likely also violate Title VII of the Civil Rights Act, citing two Georgia cases. In Bostock v. Clayton County, the U.S. Supreme court held that an employer who fires a worker simply for being gay or transgender is in violation of the law. In Lange v. Houston County, a district court ruled that a health insurance provider can be held liable under Title VII for denying coverage for gender-affirming care to a transgender employee because he or she is transgender. Houston County has appealed that decision to the 11th Circuit Court of Appeals and the case is still ongoing.

"To me, the law is clearly illegal, quite frankly," Jones said. "There's no hope for the law to withstand any kind of constitutional challenge or Title VII challenge, especially when the law is clear – in our circuit. The 11th Circuit has addressed this issue. That Houston County case was a 2024 case, so it just actually did happen."

LGBTQ advocates also worry that unlike previous bills that targeted transgender minors through medical or sports participation bans, this bill would also affect adults' medical decisions.

Republican Sen. Matt Brass proposed an amendment to Tillery's transgender ban that would have forbade state contracts with any party that included transgender issues as part of the contract. Brass withdrew his amendment so as to not dilute the underlying bill. Ross Williams/Georgia Recorder

"The proponents of SB39 have been dishonest and misleading by characterizing the bill as a measure that would primarily ban state coverage of gender affirming care for minors, while finally today, the sponsor of the bill admitted that he simply doesn't want Georgia to provide best practice medical care for transgender adults," said Human Rights Campaign Georgia State Director Bentley Hudgins.

"SB39 is a cruel health care ban that is unconstitutional, discriminatory and poses a real threat to medical freedom for all Georgians," they added. "The government has no business stripping away medically necessary care from anyone, including transgender youth or adults. Once we concede that the government has this power, all of our care is at risk."

How to treat transgender Georgians under the law remains a hot button issue this year, and, fresh off a convincing victory for President Donald Trump, GOP lawmakers may perceive that pressing the issue could help them with their base.

The Senate has already passed a ban on transgender girls playing on girls' sports teams, and the House is set to put forward its own version. Lawmakers could also consider bills to ban puberty-blocking medications for transgender minors.

Sen. Colton Moore. Ross Williams/Georgia Recorder

Trenton Republican Sen. Colton Moore, whose far-right positions and unconventional tactics have put him at odds with fellow Republicans, called the health care bill the "most effective and the most beneficial piece of legislation we have passed thus far in this body."

"My friends on the Democratic side, they always like to talk about reproductive rights,"Moore said. "But we're denying people reproduction for eternity if we trans their gender. That's the basic foundation of a society is the family block. I believe taxpayer dollars ought to be used to promote a society, to grow a sovereignty, not to destroy it by using that money for transgender surgeries."

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