North Carolina legislature overrode Cooper's veto to enact H808 banning gender-affirming care for minors

On August 16, 2023, the North Carolina General Assembly overrode Democratic Gov. Roy Cooper's veto of House Bill 808, enacting it as Session Law 2023-111. The Republican supermajorities completed the override with a 73-46 vote in the House and a 27-18 vote in the Senate, each clearing the three-fifths threshold required to override a veto. The law took effect immediately.

Session Law 2023-111 prohibits medical professionals from performing surgical gender-transition procedures on minors and from prescribing, providing, or dispensing puberty-blocking drugs or cross-sex hormones to anyone under 18 for the purpose of assisting a gender transition. Minors who were already receiving such care as of August 1, 2023 may continue under a grandfather exception if a physician deems it medically necessary and a parent consents; no exception exists for new patients even with parental consent. The statute (codified at G.S. 90-21.150 through -21.154) creates civil-liability exposure for providers who violate it, grants immunity to providers who decline to offer the care, and bars the use of certain State funds for gender-transition care for minors.

Gender-affirming care is recognized as safe and medically necessary by leading professional health associations, including the American Academy of Pediatrics, the American Medical Association, and the Endocrine Society. Gov. Cooper condemned the override, saying the legislature had returned "to pass legislation that discriminates." North Carolina became the 22nd state to restrict or ban such care for transgender minors.

Updates

2023-10-11 — Families and providers filed federal suit to block the ban [4]

On October 11, 2023, Lambda Legal and the National Health Law Program, joined by private firms, filed Voe v. Mansfield in federal court on behalf of a transgender adolescent's family, a North Carolina physician, and the organizations PFLAG National and GLMA, challenging H808 and simultaneously moving for a preliminary injunction to block enforcement while the case proceeds.

2025-08-04 — Court stayed litigation pending Fourth Circuit appeal [5, 6]

On August 4, 2025, the U.S. District Court for the Middle District of North Carolina granted a joint motion to stay Voe v. Mansfield, pausing the pending preliminary-injunction and summary-judgment motions until the Fourth Circuit resolved Kadel v. Folwell and Anderson v. Crouch on remand from the Supreme Court's June 2025 ruling in United States v. Skrmetti. The preliminary-injunction motion remained unruled at the time of the stay.

2026-06-19 — Parties dismissed the suit with prejudice after Skrmetti-driven settlement [6, 7]

On June 19, 2026, the parties jointly stipulated to dismiss Voe v. Mansfield with prejudice, ending the challenge to H808 without a ruling on its merits. The dismissal followed the Fourth Circuit's post-Skrmetti reconsideration of the related Kadel v. Folwell and Anderson v. Crouch cases; each side bore its own costs, with no fees awarded. Plaintiffs cannot refile the same challenge, leaving H808 in effect.