Iowa Gov. Reynolds signed SF538 banning gender-affirming care for transgender minors

On March 22, 2023, Iowa Gov. Kim Reynolds signed Senate File 538 into law, enacting a new section of the Iowa Code that bars health care professionals from knowingly prescribing puberty blockers or cross-sex hormones, or performing gender-transition-related surgeries, on minors for the purpose of aligning their appearance or perception of gender with a gender inconsistent with their sex assigned at birth. The bill passed the Iowa Senate 33–16 and the House 58–39.

The law took effect immediately on signing, while the treatment prohibition itself applied after a transition period; a grandfather clause allowed minors already receiving such care to continue until September 18, 2023. Narrow carve-outs exist only for minors with medically verifiable intersex conditions or for treating complications or emergencies. Health professionals who violate the law are subject to discipline from the appropriate licensing board and may face civil lawsuits.

Major medical associations, including the American Psychiatric Association, regard gender-affirming care as clinically appropriate treatment for gender dysphoria. The bill's sponsor argued the treatments were too experimental to be allowed, while opponents — including the Human Rights Campaign and One Iowa Action — and dozens of Iowa businesses opposed the measure. Iowa's action was part of a wave of 2023 state laws restricting gender-affirming medical care for transgender minors.