In a deeply concerning development, the S.C. House and Gov. Henry McMaster have exercised significant influence over the health care decisions made by the Medical University of South Carolina, the state’s premier academic health science center.
This influence has led MUSC Health to interpret H.4624, a law ostensibly meant to protect children,” as prohibiting the gender-affirming care it provides for transgender people of all ages due to the public funding the health system receives.
This interpretation is problematic not only because of its impact on patients, but also because it is a dangerous example to other providers across the state.
House Majority Leader Davey Hiott’s comments in the press reveal the extent of this legislative overreach. Hiott praised MUSC’s decision to end gender-affirming care for adults, suggesting it aligns with his party’s intention to restrict such treatments broadly. Rep. Hiott’s admission highlights the S.C. Republican Party’s real intent: trans erasure. This starkly illustrates how political ideologies are dictating health care policies, undermining the medical community’s ability to provide evidence-based, patient-centered care.
At its core, the issue concerns the erosion of health care autonomy. Academic health centers such as MUSC are supposed to be sanctuaries of evidence-based medical practice, where decisions are made based on the best available science and patient needs. The imposition of political agendas into these decisions compromises the integrity of medical care and undermines the trust patients place in these institutions.
H.4624’s broad language regarding the use of public funds has put MUSC in a position where it must choose between defying the Legislature and risking financial repercussions or complying and compromising the best-in-class health care it should provide. While I would have liked to see MUSC stand up and speak out against this law that ultimately puts the institution at odds with the standard of care for trans patients, I will admit that this is an untenable position for any health care institution that finds itself beholden to renegade politicians.
The immediate impact of this legislative overreach is on transgender individuals seeking gender-affirming care. Major medical organizations, including the American Medical Association and the World Professional Association for Transgender Health, recognize gender-affirming care as essential and life-saving. It encompasses services such as hormone therapy, surgical interventions, laser hair removal and speech-language pathology, and is crucial for the mental and physical well-being of trans individuals.
By interpreting H.4624 as requiring it to stop all gender-affirming care for trans adults because it receives a minute percentage of its annual budget from the state, MUSC has cut off access to these vital services for hundreds of transgender adults. As someone personally affected by this decision, I have faced difficulties finding a new provider, despite my comfort navigating health care situations. Many in our community, however, struggle to have the resources to access care and navigate these difficult situations. This decision will lead to increased rates of depression, anxiety and other mental health issues among trans individuals who cannot access the care they need. This underscores the human cost of allowing political agendas to dictate health care policies.
The situation at MUSC should be a wake-up call to all who value health care integrity and patient rights. We must push back against this dangerous overreach and advocate for policies that prioritize patient care over political ideologies. This includes supporting candidates who understand the importance of health care autonomy and believe medical decisions should be made by patients and qualified health care professionals, not politicians.
Additionally, supporting the trans community during this crisis is essential. LGBTQ+ organizations such as the Alliance For Full Acceptance and the Campaign for Southern Equality are providing patient navigation services and support to help individuals find new providers. However, it shouldn’t have to be this way.
The power that the Legislature has exerted through H.4624 over MUSC Health and all health care professionals providing gender-affirming care in our state is deeply problematic and sets a dangerous precedent. It compromises health care institutions’ autonomy, undermines evidence-based medical practice and is devastating to the transgender community. We must stand together to protect health care integrity and ensure all individuals have access to the care they need and deserve. The health and well-being of countless South Carolinians depend on it.
Transgender youth and adults in South Carolina impacted by this law can visit southernequality.org/SChealthcarehelp for support.
Chase Glenn is the executive director of the Alliance For Full Acceptance.
