Louisiana Republicans Reject Bill Targeting Adult Gender-Affirming Care, For Now

The bill requested that the anti-trans Louisiana Department of Health investigate whether gender-affirming care causes psychosis and would’ve likely resulted in restrictions on informed consent HRT.

The Louisiana State Capitol in Baton Rouge | Image: Wikimedia Commons

Today, Louisiana Republicans unanimously voted to defer action on anti-trans House Resolution 290. Because the Louisiana legislature must adjourn by June 1st, that deferral likely means that HR 290 will not be considered again this year. And this is a massive victory: in its words, HR 290 “urges and requests the Louisiana Department of Health to study the potential correlation between medications prescribed for any gender-affirming hormone therapy and the incidence of psychosis and related psychiatric conditions in individuals twenty-six years of age and younger.”

Although bills targeting care for trans adults are primarily sponsored by far-right Republicans and have all failed without a hearing, HR 290 is different. Its sponsor, Jessica Domangue, has not written or sponsored any anti-trans legislation in the past and is considered to be a relatively moderate Republican who has not leaned as much into anti-trans messaging. And yet, HR 290 presents a grave threat to gender-affirming care for trans adults both in Louisiana and in other red states.

It opens with two generic statements that are commonly found in bans on gender-affirming care for minors: that the state is responsible for “the health, safety, and well-being of children, adolescents, and young adults” and a description of gender-affirming hormone therapy. However, following this, it makes a problematic assertion:

“Certain medications affecting endocrine and neurological function have been associated in medical literature with possible psychological and psychiatric side effects in some individuals and…psychosis and related psychiatric symptoms, including hallucinations, severe mood disturbances, and dissociative symptoms may significantly impair an individual’s functioning and quality of life.”

This, of course, echoes the right-wing talking point that HRT makes trans adults mentally ill that often accompanies rhetoric about ‘trans shooters’ and associated calls to ban gender-affirming care for adults. But it gets worse. After stating that a review of “psychiatric outcomes in minors and adults would be beneficial to healthcare professionals, patients, and families,” HR 290 describes what the study will look like:

“(1) A review of available peer-reviewed medical and scientific literature concerning psychiatric outcomes associated with estrogen and testosterone therapy, androgen blockers, puberty blockers, cross-sex hormones, and related medications.

“(2) An examination of adverse event data, where available, relating to psychosis, schizophrenia-spectrum disorders, severe mood disorders, dissociative conditions, suicidal ideation, and other significant psychiatric symptoms.

“(3) Consultation with behavioral health specialists, endocrinologists, obstetrician-gynecologists, psychiatrists and therapists, pediatric specialists, pharmacologists, and other qualified healthcare professionals representing a diversity of medical perspectives.

“(4) Recommendations, if warranted, regarding informed consent standards, patient screening practices, mental health evaluations, monitoring protocols, and areas requiring additional research.”

The idea of the first point isn’t new: in November, Robert F. Kennedy Jr.’s HHS also released a ‘review’ of evidence for gender-affirming care for minors that entirely disavowed accepted medical standards in favor of a talk therapy approach. The outcome of this review was essentially predetermined; aside from the fact that the review’s authors were all known opponents of gender-affirming care, the review itself was specifically sought by Trump to justify Executive Order 14187’s ban on care for trans people under 19.

HR 290’s study would likely be no different. Since 2023, Louisiana has banned gender-affirming care for minors, and no amount of evidence—or opposition from the medical community—has changed that. Worse, like the HHS, the Louisiana Department of Health (LDH) has a record of opposing gender-affirming care: after Republican Governor Jeff Landry took office in 2024, it quietly cut trans Louisianans’ Medicaid coverage despite not having repealed a 2022 policy that affirmed coverage and labeled that care as ‘medically necessary.’

The second point lists a variety of medical conditions that Domangue implies could result from gender-affirming care, including psychosis, schizophrenia, and suicidal ideation. It’s worth noting that, as Transitics reported in March, the Trump administration reviewed—and ignored—similar evidence when making its anti-trans prison policy.

Finally, in the last point, HR 290 explicitly spells out its threat and asks the LDH to recommend changes to informed consent standards and patient screening practices, both of which could result in laws gatekeeping or even banning gender-affirming care outright.

In today’s committee hearing, Domangue justified her bill by saying she simply “would like to see the data,” and as part of that, she kept the discussion to care for adolescents while doing her best to cover up the fact that HR 290 also targets trans adults under 26. However, in doing so, she encountered opposition from an unexpected source: fellow Republican Representative Rhonda Butler.

Funnily enough, Butler took issue with the fact that the study has the potential to reopen discussion into Louisiana’s ban, saying that she “just [doesn’t] want to shift policy and discussions toward a broader acceptance of minors making gender-related medical decisions.” And Butler’s fear isn’t without precedent: after banning care for trans minors, Utah Republicans ordered the Utah DHHS to study patient outcomes. After that study ended up supporting gender-affirming care, it became a significant counterargument against the ban.

Telling Domangue that she “[didn’t] know how LDH would get this data if it’s illegal in Louisiana” and that the proposal “may hit some big roadblocks,” Butler moved to defer the resolution for later consideration. Rather than leave it up for a committee vote, a somewhat visibly defeated Domangue opted to voluntarily defer it before appearing to ask Butler to “come see her after.” Given the outcome of the hearing, Domangue may very well end up proposing a rewritten version next year that accounts for Butler’s issues.

Still, at least for now, this is a big victory. But if the study is eventually conducted and if it concludes similarly to the HHS review, its findings could be used by other states to justify restrictions on care for trans adults. Because, although there certainly seems to be a broad lack of political will to implement those restrictions at the moment, that sentiment may not last forever. If that dam breaks, it’ll likely start with a pretext that closely resembles House Resolution 290. Thankfully, that hasn’t come to pass today.