Misanin v. Wilson

House Bill 4624, signed into law by Governor Henry McMaster in May 2024, prohibits doctors from providing potentially lifesaving care for transgender youth as well as many transgender adults. The law restricts access to “gender transition procedures,” including evidence-based treatments like puberty delaying medications and hormone therapy that are recommended for treatment of gender dysphoria by the leading medical associations.

HB 4624 includes a prohibition on medical professionals providing gender-affirming care to South Carolinians under age 18, a prohibition on the use of public funds for gender-affirming care for South Carolinians regardless of age; and a prohibition on gender-affirming care coverage under South Carolina’s Medicaid program. The law led multiple health care providers, including th Medical University of South Carolina, to cease providing any gender-affirming medical care.

In August 2024, transgender South Carolinians and their families sued the state of South Carolina in federal court to block enforcement of a ban on gender-affirming healthcare. They are represented by attorneys from the American Civil Liberties Union, ACLU of South Carolina, and Selendy Gay.

“I feel so lucky and fortunate to be supported and affirmed by so many wonderful people who accept me for who I am,” said plaintiff Sterling Misanin of Charleston, South Carolina. “My family continues to be extremely supportive of me living as the man that I am. In Charleston, I have a wonderful community who make me feel safe and seen. But the actions by MUSC have caused me significant harm, and I am devastated that my state has interfered in my access to life-saving health care. I am an adult, and I know myself better than my state does, and I cannot stay silent about the very real harms that this law inflicts on transgender people like me.”

The plaintiffs in the lawsuit argue that H. 4624 violates the Equal Protection Clause of the 14th Amendment because it discriminates against transgender individuals on the basis of sex and transgender status. The plaintiffs also argue that the law violates the due-process rights of parents and the anti-discrimination clauses of the Medicaid Act, Affordable Care Act, Americans with Disabilities Act, and Rehabilitation Act.