Transgender health: Comparing model bills to real proposals

May 19, 2023, 9:35 PM

FILE - State Rep. Barry Usher, R-Billings, speaks during a meeting of the Joint Rules Committee on ...

FILE - State Rep. Barry Usher, R-Billings, speaks during a meeting of the Joint Rules Committee on the House floor at the Montana State Capitol in Helena, Mont., on Dec. 7, 2020. The dozens of statehouse bills to restrict health care for transgender youths were in many cases not born of grassroots despair and a groundswell of constituent demand, but were pre-written and shopped out by a handful of conservative interest groups. One of the clearest examples is in Montana, where nearly all the language in Senate Bill 99 can be found in Do No Harm's model bill. Usher voted in favor of the bill. (Thom Bridge/Independent Record via AP, File)

(Thom Bridge/Independent Record via AP, File)

Many of this year’s statehouse proposals to restrict gender-affirming care for youths, as introduced or enacted, are identical or very similar to some model legislation, or ready-made bills suggested to lawmakers by interest groups, an Associated Press analysis has found.

The AP obtained the texts of more than 130 bills in 40 state legislatures from Plural, a public policy software company, and analyzed them for similarities to model bills touted by the conservative groups Do No Harm and the Family Research Council.

Some statehouse bills share similarities with Do No Harm’s rebutted by major medical organizations — that the risks of gender-affirming care outweigh its benefits.

They both also include nearly the same list of circumstances under which the care would be permitted and similar descriptions of how the provisions of the bill should be enforced.

The AP’s analysis was not exhaustive; not all model legislation was analyzed and cross-referenced with actual statehouse bills. But here are some similarities the AP found:


Nearly all the language in Montana passed in March retained much of the model’s language. Publicly available emails from December show the Republican sponsor, Sen. John Fuller, tweaked Do No Harm’s model before introducing it weeks later.


This year’s signed into law — and Do No Harm’s model bill both cite studies from Europe with similar framing to assert that the benefits of gender-affirming care are not backed by evidence.

Arkansas Sen. Gary Stubblefield, a Republican and the chief sponsor of Senate Bill 199, said he had not talked with Do No Harm about the legislation.


The preamble of signed into law in March.

Iowa Sen. Sandy Salmon, a Republican who sponsored Senate File 129, and a spokesperson for Republican Gov. Kim Reynolds, who was consulted on Senate File 538, did not respond to requests for comment.


The sponsor of Mississippi House Bill 1125 denied in a conversation with AP reporters this year that he used model legislation or consulted with a specific group, saying that his constituents raised concerns and that legislative attorneys helped craft the language.

In addition to the similarities to Do No Harm’s model, the bill also contains several references to exempted health procedures that were worded similarly in the Family Research Council’s model. Republican Gov. Tate Reeves signed the bill in February.

When contacted for comment recently about the AP’s findings, the sponsor, Republican state Rep. Gene Newman, said he had received his information from legislative staffers, that they pulled language from other states’ bills, and that he didn’t know who else they might have spoken with.


A bill in New Hampshire closely resembles the 2021 Arkansas bill put forth as a model by the Family Research Council. It shares the same preamble, definitions and enforcement process. It is being held in committee for further work.


Two bills in West Virginia share the same preamble, definitions and enforcement process as the 2021 Arkansas bill suggested by the Family Research Council as a model.

signed into law in March.

A West Virginia Republican, Sen. Mark Maynard, opposed adding mental health exemptions, saying during floor debate, “Fifteen states already have this exact language in their code.”


Contributing to this report were Associated Press journalists around the country, including Andrew DeMillo in Little Rock, Arkansas; Amy Beth Hanson in Helena, Montana; Michael Goldberg and Emily Wagster Pettus in Jackson, Mississippi; Scott McFetridge in Des Moines, Iowa; Holly Ramer in Concord, New Hampshire; and Leah Willingham in Charleston, West Virginia.


Harjai is a corps member of the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

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Transgender health: Comparing model bills to real proposals