Improving Access to Gender-Affirming Care in Hawaii

April 3, 2024

Getting gender-affirming care in the United States has become increasingly difficult. Across the country, there are laws or policies banning such care for minors. The Human Rights Campaign reports that an estimated 35.1% of trans youth aged 13-17 are living in states that have passed such bans. This year, efforts to target adults’ access to gender-affirming care are also on the rise.

But in Hawaii, for a subset of trans folks seeking testosterone as part of their care, there’s a glimmer of hope. Garnet Henderson notes that unlike many other drugs typically used for gender-affirming care – puberty blockers, hormones such as estrogen, and anti-androgens – testosterone is classified as a controlled substance and is thus regulated under the Controlled Substances Act (CSA). This classification brings added challenges to accessing care, including that “providers are required to see a patient in person before prescribing any controlled substance” – like testosterone – via telehealth. For many in Hawaii, this in person requirement is highly prohibitive. The statewide dearth of healthcare providers coupled with the potential need to travel to another island for a doctor’s appointment makes receiving in-person care challenging at best.

Thankfully, lawmakers are considering a bill that would remove the arbitrary and needless obstacle of an in person appointment for people wanting to obtain testosterone. HB 2079 proposes to relax the in person requirement for drugs prescribed as part of gender-affirming care. Critically, HB 2079 would also extend the protections of Hawaii’s “shield” law—which “guards abortion patients, providers, and anyone who helps someone get an abortion from out-of-state legal action”—to gender-affirming care providers and parents or guardians of minors who receive care.

We at the Woodhull Freedom Foundation firmly believe that access to quality, comprehensive healthcare – including gender-affirming care – is a human right. We firmly support HB 2079 in its efforts to protect the human rights of trans and gender-nonconforming people in Hawaii.