Aug 1
New Hampshire Governor Kelly Ayotte Signs Gender-Affirming Care Ban for Minors into Law
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On August 1, New Hampshire Governor Kelly Ayotte signed RSA Chapter 332-M into law, imposing new restrictions on gender-affirming medical care for transgender minors in the state. The legislation, which was brought forward as House Bills 377 and 712, prohibits physicians from performing certain gender-affirming surgeries and limits access to other medical interventions for individuals under 18 years of age. The law is scheduled to go into effect on January 1, 2026, giving providers, families, and patients time to adjust to the forthcoming changes .
The new law specifically bans “gender genital reassignment surgery” for minors. It also bars medical professionals from performing breast surgeries as part of gender transition and from prescribing or administering puberty blockers and cross-sex hormones to individuals under 18. However, the law contains several notable exceptions. It allows providers to continue care for transgender adolescents who have already begun treatment before the January 1, 2026 deadline. Physicians can also refer minors to out-of-state providers for care not available in New Hampshire, and the law does not impose criminal penalties on providers who offer these services within the permitted parameters .
New Hampshire’s move comes as part of a broader national trend. Over the past several years, more than 20 U.S. states have enacted laws or executive orders restricting access to gender-affirming care for transgender youth. These measures have been widely criticized by major medical organizations, including the American Academy of Pediatrics and the American Medical Association, which emphasize that gender-affirming care is evidence-based and essential for the well-being of transgender youth . Proponents of these bans often argue they are necessary to protect minors, while opponents assert that such restrictions interfere with established medical standards and exacerbate mental health risks for transgender youth.
LGBTQ+ advocacy organizations in New Hampshire and across the nation have expressed deep concern about the law’s potential impact. “This legislation puts politics between young people and the medically necessary care that their doctors and families know is best,” said a spokesperson for GLBTQ Legal Advocates & Defenders . Advocates argue that restrictions on gender-affirming care are not only harmful but also out of step with both medical consensus and the lived experiences of transgender youth.
Legal challenges are anticipated. Across the U.S., at least 17 lawsuits are pending against similar bans. Plaintiffs argue that these laws violate constitutional rights and federal anti-discrimination statutes, including those interpreted by the Supreme Court in Bostock v. Clayton County to protect gender identity under the umbrella of sex discrimination . In New Hampshire, legal advocates have already signaled their intent to explore possible litigation to challenge the new restrictions.
Leading medical organizations maintain that gender-affirming care—including puberty blockers, hormone therapy, and, in rare cases, surgical interventions—can significantly improve mental health outcomes for transgender youth. These treatments are typically provided in accordance with strict protocols and after thorough evaluation by multidisciplinary teams . Research consistently shows that access to gender-affirming care is associated with reduced rates of depression, anxiety, and suicidality among transgender young people .
Providers in New Hampshire now face uncertainty about how the law will affect their practice and their patients’ well-being. While those who have already started gender-affirming treatments before 2026 will be allowed to continue, families with children who may seek care in the future will need to explore out-of-state options or face the prospect of waiting until the individual turns 18.
As the January 2026 implementation date approaches, LGBTQ+ organizations, healthcare providers, and legal advocates are mobilizing to provide resources and support to affected families. Information about ongoing care, legal rights, and advocacy opportunities is being shared by groups such as GLBTQ Legal Advocates & Defenders and local LGBTQ+ community centers .
The debate over access to gender-affirming care is expected to remain at the forefront of state and national politics. For many in the LGBTQ+ community, the law represents a significant setback but also a call to action for continued advocacy, education, and resistance against policies that restrict essential healthcare for transgender youth.
