Transgender surgery, Fort Lauderdale, FloridaPhoto byAiden Craver/UnsplashonUnsplash

State Representatives Rebecca Alexander (Jonesborough) and Tim Hicks (Gray) of Washington County are 2 of 35 co-sponsoring legislation prohibiting transgender medical procedures for minors. The bill, known as the Protecting Children from Gender Mutilation Act (HB0001), was filed by Tennessee’s republican majority leaders, Senator Jack Johnson (Franklin) and Representative William Lambert (Portland).

Reps. Rebecca Alexander, R-Jonesborough, and Tim Hicks, R-Gray, are among 35 co-sponsors of the Protecting Children from Gender Mutilation Act. The bill was filed by the state General Assembly’s two GOP majority leaders, Representativ William Lamberth of Portland (District 44) and  Senator Jack Johnson of Franklin, on November 9, 2022. Other co-sponsors from Northeast Tennessee include John Crawford (District 1) and Bud Hulsey (District 2) of Sullivan County, and Jeremy Faison (District 11) of Cocke County.

The bill’s caption reads: The legislation would prohibit “a health care provider from performing on a minor or administering to a minor a medical procedure if the performance or administration of the procedure is to enable a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex.”

Bill overview

According to the Tennessee General Assembly website, current Tennessee law generally prohibits health care providers from prescribing a course of treatment that involves hormone treatment for gender dysphoric or gender incongruent prepubertal minors. HB0001 would replace current law and establish prohibitions related to the performance of children of specific medical procedures related to gender identity, creates private causes of action for violations, and establishes additional penalties for violations.

The proposed legislation bill would prohibit “licensed health care professionals, establishments, and facilities (collectively referred to as a “health care provider”) from performing or offering to perform on a person under 18 years of age (a “minor”), or administering or offering to administer to a minor, a medical procedure if the performance or administration of the procedure is for:

• Enabling a minor to identify with, or live as, a purported identity inconsistent with the immutable characteristics of the reproductive system that define the minor as male or female, as determined by anatomy and genetics existing at the time of birth (the minor’s “sex”); or

• Treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity.

The legislation also reads: “For this bill, a ‘medical procedure’ includes surgical procedures and the prescribing, administering, or dispensing of a drug or device.”


Several states with Republican-controlled legislatures, such as Alabama and Arkansas, have passed a similar law on transgender medical care. Other states have also passed or proposed similar legislation.

March 2022 – Estimated number of transgender youth ages 12 and up at risk for being denied access to gender-affirming medical care.Photo byWilliams Institute of Law/UCLA

Meanwhile, the American Medical Association urged governors to oppose legislation prohibiting medically necessary gender transition-related care for minor patients, calling such efforts “a dangerous intrusion into the practice of medicine.” 

State Senator Rusty Crowe of Johnson City said passing this legislation is the first order of business for the 113th General Assembly. Republicans in the legislature say the bill is a direct response to the reports of medical providers conducting irreversible elective procedures on minors, removing healthy body parts. 

A video of the Matt Walsh show surfaced on social media, where they investigated medical providers touting “gender-affirming care” as a huge moneymaker. Rep. Alexander said reports that Vanderbilt University Medical Center provided gender-affirming care to minors is troubling to GOP lawmakers.

A barrier to care?

Tri-Cities Pride Community and Education Center president, John Baker, says the bill would harm the children they are trying to protect by placing obstacles between transgender children, their parents, and their healthcare providers.


The reaction to the publicity of Vanderbilt’s clinic was so intense they took down its entire web presence for a time. Vanderbilt agreed to pau surgeries in response to demands from Republican legislators.

Vanderbilt revealed they conduct roughly five surgeries on minors (related to transgender issues) each year – only on patients 16 and older and never on genitals, and only with full parental consent. Vanderbilt has declined requests for interviews and comments.

Other clinics and specialists around the country have faced similar backlash. In NPR’s Health Shot (November 2022) Dr. Michele Hutchinson, chief of pediatric endocrinology at the University of New Mexico Health Sciences Center, says physicians specializing in transgender care worry their patients will try to hurt themselves or seek medications or hormones through the internet or black markets – where the quality is not regulated.


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