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Tennessee Gov. Bill  Lee, a Republican, on Thursday signed two bills targeting LGBTQ+ people in the state — one to ban gender-affirming health care for minors and another to ban drag performances that could be viewed by minors and seen to cause them harm. 

The ban on gender-affirming care, effective July 1, bars trans youth who have not yet sought puberty blockers or hormone therapy from obtaining such treatments — which are crucial for many trans people to offset harmful effects of gender dysphoria. Trans youth currently accessing care, or those who start care before July 1, will have until March 31, 2024, to continue accessing gender-affirming care in Tennessee. The law enables the attorney general to fine health care providers up to $25,000 per violation and to take action against “any person that knowingly violates” the law.  

Lambda Legal, ACLU and the ACLU of Tennessee have pledged to sue the state over the ban becoming. While no such lawsuit has been announced in response to the drag ban, the ACLU of Tennessee said that the organization will challenge its enforcement “if it is used to punish a drag performer or shut down a family-friendly LGBTQ event.” 

The Campaign for Southern Equality and LGBTQ+ advocacy group Inclusion Tennessee said families should see their current provider as soon as possible to discuss options for continued gender-affirming care. If a trans child is already on the path to receive care, the groups advise initiating the process before July 1 and filling current prescriptions. 

The groups are also pointing families to a directory of trans-affirming providers in Southern states and rapid-response emergency grants of $250 to parents and caregivers of youth who are impacted by the ban. 

Elizabeth Knight, a 17-year-old transgender girl who lives in Montgomery County, Tennessee, with her family, said that she’s spoken with friends currently receiving treatments who are worried about their futures. 

“They tell me that they’ll have to find some other way,” she said. Some of her friends order hormone treatment therapy online and she hopes they will  be able to receive care that way, she said. Knight, who came out to her social circle in 2020, is waiting until she’s 18 to start hormone therapy for a few reasons — including that the process at Vanderbilt University Medical Center would take longer than is practical, and her father doesn’t support her starting hormones as a minor. 

Knight says although she feels lucky for her support system, she has still experienced mental duress from the spread of anti-trans bills and hostile political climate of the last few years, which she’s navigated while planning her future at college and her own coming out. 

“I’ve struggled with depression and anxiety over the past few years because of it,” Knight said. “I’d say it’s been a major factor.” 

Sruti Swaminathan, a Lambda Legal staff attorney and the organization’s lead attorney for the planned lawsuit over the gender-affirming-care ban, said that Tennessee families the group has  spoken with throughout the process of finding plaintiffs for the lawsuit are “terrified.” Families are putting together plans for how to manage their children’s care through next March. While moving out of state is generally seen as a last resort, they will if they have to. 

In the incoming lawsuit, Swaminathan and attorneys with the ACLU plan to argue that the gender-affirming-care ban is unconstitutional as a violation of the 14th Amendment’s equal protection and due process clauses, arguments seen previously in lawsuits against care bans in Arkansas and other states.  

Four states have passed gender-affirming-care bills into law so far this year — Utah, South Dakota, Mississippi and now Tennessee, which is also the first state to criminalize drag performances this year. 

The drag ban goes into effect April 1. Advocates and legal experts have stressed that the scope of the bill is limited, as many trans people have responded with anxiety over whether they will be allowed to exist publicly in Tennessee without being policed over their gender expression or presentation. 

Chase Strangio, who serves as counsel in the American Civil Liberties Union’s challenge to Arkansas’ ban on care for trans youth, as well as other legal challenges, stressed the importance of not overstating the scope of Tennessee’s drag ban.  

“It is not accurate to say that this bill bans all drag in public and that it bans being trans in public,” Strangio said in an Instagram reel last week. The amended language of the bill prohibits “adult cabaret entertainment” that is harmful to minors in public or in a location where a minor may be present. While the bill targets “male or female impersonators,” the entertainment in question must be harmful to minors — meaning that it displays nudity, sexual content, excess violence or abuse or is “patently offensive”. 

“That doesn’t mean that we shouldn’t be worried about the ways in which law enforcement will target drag performers and trans people in public. We should already be worried about that,” he said. “That said, this bill has a very specific set of definitions.” 

Stella Yarbrough, legal director for the ACLU of Tennessee, said in a statement that the law does not make it illegal to perform drag in the state, asserting that  drag performances are not inherently obscene. Drag performances are protected by the First Amendment, the organization said.

“However, we are concerned that government officials could easily abuse this law to censor people based on their own subjective viewpoints of what they deem appropriate, chilling protected free speech and sending a message to LGBTQ Tennesseans that they are not welcome in our state,” Yarbrough said. 

For Knight, heightened rhetoric against transgender people in her state — and watching the bills that lawmakers propose — are symptoms of an emboldened push against trans rights.  

“The general climate in Tennessee, as far as the political and social climate, is becoming increasingly extreme,” she said.  “It’s becoming scarier to live in Tennessee as a transgender person, even as someone who won’t be affected by most of these laws.”