AUGUSTA, Maine — The Democratic-led Maine House of Representatives voted Friday to lock some of the nation’s strongest protections for transgender health care into state law over opposition from all Republicans except for one.
After Gov. Janet Mills took office in 2019, her administration changed state rules to cover transgender-specific health services under MaineCare, the state’s version of the federal Medicaid program. It now covers five major categories of procedures, including hormone therapy, gender reassignment surgery and mental health counseling.
The bill comes during a national firestorm over LGBTQ+ rights. Transgender issues, with gender-affirming care for children chief among them, have been at the center of many of those battles from Congress to school boards. Republican-led states have passed laws that prohibit gender-affirming care, while a smaller number of Democratic states have shielded it.
Maine’s effort, led by Rep. Matt Moonen, D-Portland, would move the 2019 rule shift to state law, making it so any changes would have to go back through the Legislature. The measure was motivated by laws on the subject being passed in conservative states, Moonen said.
“To me, that is all the evidence I need that we need to take action to prevent it and make sure that it is very difficult to remove this from Maine law,” he said.
The measure, which was supported by health groups and the Mills administration, looks set to pass after it got through the House in a 75-65 vote on Friday. All Democrats who were present backed it, while all Republicans but Rep. David Boyer of Poland opposed it. The measure faces further action in both chambers.
Since 2018, the American Academy of Pediatrics has had a policy emphasizing a gender-affirming approach to caring for transgender children. This care can begin in adolescence with puberty-blocking drugs. Gender reassignment surgeries typically come at age 18 or later with some exceptions for older teenagers.
Many of the Republican-led laws in other states have focused on puberty blockers, which are used to block unwanted bodily changes and are generally considered safe with some side effects including lower bone density. The St. Louis Children’s Hospital has pointed to potential long-term side effects that have not been fully identified.
On the House floor on Friday, some Republicans made statements in direct opposition to the general medical consensus. Rep. Michael Lemelin, R-Chelsea, said “transgender interventions are experimental and dangerous” and noted those who have indicated regret about procedures but have amounted to a small share of those who transition overall in studies.
“I oppose this bill because of love, not because of hate,” he said. “It’s because I love our children and this is where it starts.”
The debate applies to a small share of Mainers. The state has roughly 5,700 adults and 1,200 children who identify as transgender, according to 2022 estimates from the Williams Institute at UCLA in California.
Boyer, the only Republican who backed Moonen’s bill, said he supported a failed amendment from a colleague that would have mandated coverage of de-transitioning but also wished his colleagues would show more “nuance and compassion” on the issue.
