South Carolina Gov. McMaster signed H4624 banning gender-affirming care for minors and requiring schools to out trans students

On May 21, 2024, South Carolina Gov. Henry McMaster signed H4624, the "Help Not Harm" Act (Act 203, R219), into law, prohibiting healthcare professionals from knowingly providing gender transition procedures to any person under 18 years of age. The act defines those procedures as puberty-blocking drugs, cross-sex hormones, and genital or nongenital gender reassignment surgery. It also bars public funds from being used directly or indirectly for such procedures and precludes the South Carolina Medicaid program from reimbursing or covering them for people of any age. The law took effect immediately upon signing.

The measure adds a new Section 59-32-36 that requires public school staff and officials to notify a minor's parent or guardian if the student discloses that their perception of their gender differs from their sex assigned at birth, and prohibits staff from withholding or helping the minor withhold that information from parents. Providers who furnish prohibited care to minors face discipline from their licensing boards and civil liability, and a physician performing a prohibited surgery could face state charges and up to 20 years' imprisonment. The bill passed the state Senate 28-8 and the House 67-26 before the governor's signature.

With the enactment, South Carolina joined more than 20 states restricting gender-affirming care for transgender minors. The ACLU of South Carolina said the law inserts "the will of politicians into healthcare decisions" and tramples the liberties of transgender residents and the rights of parents of transgender minors.

Updates

2024-08-28 — Transgender residents and families sued to block the ban [4]

On August 28, 2024, transgender South Carolinians and their families, represented by the American Civil Liberties Union, the ACLU of South Carolina, and Selendy Gay, filed Misanin v. Wilson in the U.S. District Court for South Carolina. The suit seeks a preliminary and permanent injunction against the ban on care for people under 18, the bar on public funds for gender-affirming care at any age, and the exclusion of such care from South Carolina's Medicaid program.

2025-10-07 — Plaintiffs voluntarily dismissed the Misanin v. Wilson lawsuit [5, 6]

On October 7, 2025, following the U.S. Supreme Court's June 2025 ruling in United States v. Skrmetti upholding a similar Tennessee law and remanding related Fourth Circuit cases, the plaintiffs voluntarily dismissed Misanin v. Wilson.