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What Minnesota's Status as 'Trans Refuge State' Really Means

Newsweek 3/24/2023 Aleks Phillips
Democratic state representative Leigh Finke speaks to the Committee on Judiciary Finance and Civil Law on January 31, 2023 about HF 146, a bill she sponsored that would protect children seeking gender-affirming care from legal action by other states. © Minnesota State Legislature Democratic state representative Leigh Finke speaks to the Committee on Judiciary Finance and Civil Law on January 31, 2023 about HF 146, a bill she sponsored that would protect children seeking gender-affirming care from legal action by other states.

Amid a wave of proposed legislation that looks to limit access to medical treatment for transgender individuals, Minnesota is one state bucking the national trend by hoping to become a "trans refuge state."

A new bill passing through the state's legislature would seek to prevent children traveling to the state for gender-affirming care from facing legal repercussions, including warrants and extraditions, from other states.

Transgender rights and the sorts of care afforded to minors are proving to be deeply polarizing issues. In the U.S., a 2022 survey by the Pew Research Center found that 38 percent of Americans believe society had gone too far in accepting transgender people, while 36 percent said it had not gone far enough.

Republicans in several states, including Georgia and Oklahoma, are working to pass legislation that would instead limit the medical treatment that children are legally allowed to receive as part of their physical transition. Proponents argue that they are doing so over concerns that minors are being harmed by gender-affirming procedures, while opponents say they are limiting transgender rights.


As many states seek to limit transitional procedures for children, Minnesota is actively looking to ensure children who do wish to take up gender-affirming medical treatments can do so in the state without fear of reprisal.

On March 8, Minnesota's Democratic Governor Tim Walz signed an executive order that sought to protect LGBTQ access to transgender healthcare, including those from other states.

"We want every Minnesotan to grow up feeling safe, valued, protected, celebrated, and free to exist as their authentic versions of themselves," Walz said at the time, according to the Associated Press. "Protecting and supporting access to gender-affirming health care is essential to being a welcoming and supportive state."

What Would HF 146 Do?

The bill that would protect legal access to gender-affirming care in Minnesota, HF 146, was on Thursday passed by the state's House of Representatives by 68 to 62 votes. It has yet to be transferred to the Minnesota Senate, which has a single-seat Democrat majority.

Leigh Finke is the Democratic state representative and transgender woman who introduced the bill. She told the Committee on Judiciary Finance and Civil Law on January 31: "HF 146 would make Minnesota into a trans refuge state by protecting trans people, their families, and medical practitioners from the legal repercussions of traveling to Minnesota to receive gender-affirming care."

"We are a state that prides ourselves on providing world-class healthcare, and making that healthcare accessible to everyone who needs it," Finke added. "This need is desperate in my community."

Cases of gender dysphoria—distress caused by a difference between a person's gender and their biological sex—among children have seen a massive uptick in recent years, according to data from Reuters.

It found that in 2021, around 42,000 children across the United States had received a diagnosis—three times the amount in 2017.

HF 146 would prohibit a court order for the removal of a child from their parent or guardian's custody because they had sought gender-affirming care in Minnesota from being enforced. It would prevent subpoenas from other states and countries that relate to the seeking of transgender treatment being recognized in the state's courts.

The bill also looks to stop those seeking treatment from being arrested and extradited at the request of law enforcement in another state.

The bill defines gender-affirming care as "medically necessary health care or mental health care that respects the gender identity of the patient, as experienced and defined by the patient." Thus includes hormone therapy and gender-reassignment surgery.

According to the Associated Press, a debate on the bill was met with hundreds of protesters who gathered in the State Capitol, both for and against the proposed legislation. Republican lawmakers said the bill undermines parental rights and had "zero guardrails."

A 'Refuge' From What?

HF 146 effectively means that children who are increasingly unable to seek gender-affirming care in their home state will be able to travel to Minnesota to do so. They would not face legal repercussions that have been stipulated in anti-trans legislation, so long as those people were to remain in Minnesota.

Of course, other states would still have jurisdiction in their own territory, and could still take action against medical practitioners and parents were they to return, depending on the individual laws. As such, the bill could very well lead to families with transgender children relocating to Minnesota.

According to the Trans Legislation Tracker, there are 425 bills actively being considered in states across the U.S. that would limit access to transgender healthcare or greater legal recognition. Nineteen bills have so far passed.

On Thursday, Brian Kemp, the governor of Georgia, signed into law a bill that will ban gender-affirming medical treatment for minors from July 1.

The bill outlaws hormone replacement therapy—which alters certain physical traits to appear more aligned with the person's gender identity—as well as banning gender-reassignment surgery. Medical organizations such as the American Academy of Pediatrics believe this surgery limits the number of suicides among children with gender dysphoria.

Carden Summers, a state senator who sponsored the bill, told Newsweek that he believed "no child under 18 should have these irreversible surgeries." He hoped that it would not lead to an increase in suicides.

In February, transgender rights activists occupied the lobby of the Oklahoma state capitol building to protest about two bills. These seek to ban gender-reassignment surgery for those under the age of 26 and prohibit those aged under 18 from undergoing medical treatment for gender reassignment.

On February 28, the Oklahoma House passed HB 2177. This would stop medical practitioners from giving hormone therapy or performing gender-reassignment surgery on children under 18. The exceptions are for procedures for those with a "medically verifiable disorder of sex development" and when there is a threat to the person's life.

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