The GOP’s state fights over LGBTQ issues have moved to Congress

For decades, the federal government has been banned from directly funding abortion services under the Hyde Amendment. Enacting an equivalent restriction for trans health care now appears to be a major goal for congressional conservatives.

In the House, for instance, Republicans are looking to tie measures that would prohibit any use of federal money for gender-affirming care, regardless of a patient’s age, to upcoming appropriations bills — potentially cutting huge swaths of the country off from being reimbursed for treatment.

Lawmakers attached an amendment to the massive annual defense policy bill that passed last week that would ban the military’s health plan, Tricare, from covering gender-affirming surgeries or hormone therapy. A health appropriations bill would also block federal funding for gender-affirming care in Medicare and Medicaid. Meanwhile, an Energy and Commerce panel on Wednesday advanced a bill that would prevent children’s hospitals that offer gender-affirming treatment to minors from receiving federal funds to train pediatricians.

In the Senate, J.D. Vance, R-Ohio introduced legislation this week to ban all gender-affirming medical care for minors, including puberty blockers and hormone therapy, and render it a felony. A similar measure was introduced by Rep. Marjorie Taylor Greene, R-Ga. with 44 GOP cosponsors earlier this year.

“I think that we’re going way too far, way too fast on this stuff,” Vance told Semafor. “I think clearly, public policy needs to step in and say enough is enough here.”

The recent push by Republicans hasn’t been entirely focused on health care, however: One amendment to this year’s defense package would prohibit schools serving military children from buying books on trans themes for their libraries.

Nor has it been exclusively aimed at trans issues. House Republicans have recently forged ahead with proposals that would ban displays of pride flags at the Department of Defense and at national parks. At a budget markup on Tuesday, meanwhile, Republicans stripped funding for three LGBTQ-related community organizations, triggering fierce protests among Democrats who accused Republicans of putting “bigotry on display.”

Though much of the legislation touches on adult health care, Republicans insist they’re generally motivated by a desire to protect minors and their parents. “I do think there is broad concern about the things we’re seeing in schools and in some states taking away parents’ rights if their child says they are transgender,” a senior House GOP aide told Semafor.

LGBTQ activists see the recent moves as part of a much larger GOP campaign to marginalize their community and turn back the clock on gay rights. “You’ve decided that this entire group of people, by virtue of who they are or who they love, is untenable and undeserving of dignity or safety,” said Gillian Branstetter, a strategist working on gender justice issues at the ACLU. “So it makes complete sense from their perspective that they should be undeserving of senior housing or community centers.”

Conservatives may be making headway in the public debate. Polling indicates Americans support some transgender policies Republicans are promoting across the country on care for children, but also strongly oppose discrimination in the workforce, military, and schools

It seems unlikely that any of these provisions will end up passing the Democratic-controlled Senate, where even some key Republicans don’t appear to share the same fervor as some of their conservative House counterparts.

Sens. Susan Collins, R-Maine, and Shelly Moore Capito, R-W.Va. both told Semafor that blocking federal funds from paying for gender-affirming care hadn’t come up in talks among Senate GOP appropriators. Capito delivered an emphatic “no” when asked and said she hadn’t closely looked into the subject.

“Obviously, we always have different bills coming and they put their priorities in, and we’ll just see where we end up,” Capito said.