The Maryland General Assembly on Tuesday passed the Trans Shield Act, which will ensure that those states that ban gender-affirming care can’t wield private health records against transgender Marylanders and their physicians.
The House version of the legislation was sponsored by Silver Spring representative and House Majority Leader Del. David Moon (D-Dist. 20) and the Senate version was sponsored by Del. Clarence Lam (D-Dist. 12), who represents Anne Arundel and Howard counties. The legislation was co-sponsored by a majority of the Montgomery County delegation.
If signed into law by Gov. Wes Moore (D), the legislation will add gender-affirming care to the state’s definition of legally protected health care. It will protect Maryland residents and patients who live outside of the state who receive gender-affirming care within the state, as well as their physicians, from legal action and prosecution for receiving or providing that care. Moore’s record on transgender rights and previous legislation indicates he is likely to sign the bill.
“It’s a really big deal to know that Maryland is the 12th state to have a shielding law that includes gender-affirming care,” Maya Holliday, co-leader of the Trans Rights Advocacy Coalition, a Maryland group that advocates for trans civil rights, told MoCo360 Tuesday. “Our neighbors can come here and access lifesaving care from our world-class health care providers.”
The aim of the legislation is to stop out-of-state criminal and civil judgments, subpoenas, investigations, extraditions and warrants. Under the bill, no other state will be able to suspend a physician’s professional license in Maryland for providing gender-affirming care.
The Trans Shield Act mirrors abortion shield laws passed last year in Maryland. Moon has said the legislation reflects existing anti-discrimination laws. It doesn’t make any changes to the laws regarding who can legally receive gender-affirming care and does not change the scope of care. It only addresses legal privacy. It also does not prohibit patients from filing malpractice claims and suits against medical providers.
“It all happened really quickly; it feels amazing to have it done today,” Holliday said, noting that at one point trans advocates were concerned time would run out for the legislation as it stalled in committees. The General Assembly session is scheduled to end on April 8.
Montgomery County Council Vice President Kate Stewart (D-Dist. 4), who has worked closely on addressing LGBTQ+ health disparities and gender-affirming care access, told MoCo360 Tuesday she hopes the legislation, if it becomes law, will make it easier and safer for medical professionals in the county to provide health care to trans patients.
“We need to make sure that we have providers and staff in Montgomery County who aren’t afraid to provide [gender-affirming care], so these laws are really important,” Stewart said. “Now we’re telling them, ‘Come here, we will protect your patients and we will protect you.’”
In a March 2023 report, the U.S. Department of Health and Human Services defined gender-affirming care as “a highly specialized model of care that uses evidence-based practices to address distress arising from gender dysphoria.”
This care can vary based on the individual, but may include hormone replacement therapy, surgery and alterations to various parts of the body, voice therapy, and other healthcare intended to help align a person’s body with their gender identity.
Major medical organizations including the American Medical Association, American Academy of Pediatrics, and the American Psychological Association designate gender-affirming care as medically necessary. The federal government has named gender-affirming care as an “essential health benefit” protected under Section 1557 of the Affordable Care Act, and last year, Maryland lawmakers passed the Trans Health Equity Act sponsored by Montgomery County-based Del. Anne Kaiser (D-Dist. 14), which requires Maryland Medicaid to cover gender-affirming care for transgender residents.
The Trans Shield Act was endorsed by medical organizations including the Maryland Board of Physicians. However, it faced opposition from critics who are opposed to gender-affirming care access and who said the legislation would encourage people to seek the care and make it easier to access.
A failed amendment proposed on Tuesday by Del. Nino Magione (R-Dist. 42A), who represents Baltimore County, would have banned gender-affirming care involving surgery for minors. Another amendment, proposed by Del. April Miller (R-Dist. 4), who represents Frederick County, also failed; it would have required each parent and/or legal guardian of a child receiving gender-affirming care to submit a notarized consent form.
The expansion of gender-affirming care became a hot topic in Montgomery County after Moore declared Maryland a sanctuary state for transgender health care access in June, making it the 11th state to do so alongside the District of Columbia.
The Trans Shield Act is part of the larger effort by LGBTQ+ advocates and local legislators to support policies that will make Maryland a true sanctuary state for transgender people and their families. This effort can be seen on the county level as well.
A Jan. 16 report by the Montgomery County Office of Legislative Oversight commissioned by Stewart found the county government could be doing more to support its transgender residents. It recommended officials consider creating a resource center and lobbying the state to require cultural competency training for medical providers throughout the state.
“The momentum can’t stop and won’t stop here,” Holliday said. “It puts Maryland ahead, but it’s not the end of the road.”