South Carolina enacted a budget proviso barring state funds for gender-affirming care for transgender youth under 16 at MUSC

On June 3, 2025, South Carolina completed enactment of its FY2025-26 General Appropriations Act (H4025) carrying Proviso 23.4, which bars the Medical University of South Carolina from using state funds for gender-affirming care for patients under 16 at its Pediatric Transgender Clinic. The General Assembly ratified the budget on May 28, 2025, and Governor Henry McMaster left the proviso intact when he issued his line-item veto message on June 3, declining to strike it. The remainder of the act took effect for the fiscal year beginning July 1, 2025.

The proviso uses the state's appropriations power to withhold public funding for a specific category of medical care sought by transgender minors, a restriction that does not apply to other patients or other forms of care at the same public teaching hospital. Advocacy organizations, including South Carolina United for Justice & Equality, condemned the budget's adoption, characterizing Proviso 23.4 as singling out transgender youth for exclusion from care that remains available to others.

This entry records the FY2025-26 budget proviso restricting gender-affirming care. It is distinct from South Carolina's standalone Student Physical Privacy Act (H4756, Act No. 152), signed May 15, 2026, which separately barred transgender students from school restrooms and is recorded elsewhere in the archive.