in Hawai’i!
โParents and caregivers who affirm, support, and seek medically appropriate care for their keiki [child] are exercising their fundamental right.โ
s. baum
After a three-year push, Hawaiโi officially has implemented a shield law to explicitly protect providers and patients of gender-affirming care for the trans community.
House Bill 1875, also known as Act 059, was signed by Governor Josh Greenโhimself a physicianโlate last week. The bill explicitly adds gender-affirming care to its existing shield law, which broadly covered reproductive health, and established safeguards from โabusive litigationโ coming from outside states.
Shield laws create โlegal protections for patients, health care providers, and people assisting in the provision of certain health care in states where that care is legal from the reach of states with civil, criminal, and professional consequences related to that care,โ according to the Center for Reproductive Health, Law and Policy at UCLA. For example, it means Hawaiโi state actors may not aid out-of-state attacksโsuch as, say, through the extradition of health care providersโover lawful care rendered in Hawaiโi.
โThe legislature finds that the people of Hawaiโi have a long tradition of protecting an individualโs right to privacy and bodily autonomy independently of, and more broadly than, the United States Constitution,โ the bill reads. It emphasized that the right to privacy and bodily autonomy extends to minors.
โIt is the policy of this State that the rights of equality, liberty, and privacy guaranteed under […] the Hawaii State Constitution are fundamental rights and that those rights include an individualโs right to make health care decisions about oneโs own body, including the right to seek and receive health care services that affirm their expressed gender.โ
The signing was a resounding victory for LGBTQ activists on the islands. Hawaiโi was among the last of the blue states to enact a shield law for the transgender community and their providers.
โWeโve heard from legislators that this is considered a controversial topic and that theyโd rather not engage in bills that could draw attention to Hawaiโi from the Trump Administration,โ Abby Simmons, Chair of the Stonewall Caucus of the Democratic Party of Hawaiโi, told Erin in the Morning last year.
Now, sheโs singing a more triumphant tune. โThis bill truly was a team effort,โ she said in an interview this week. โLawmakers wanted to understand the legal implications, hear from stakeholders, and make sure they were crafting legislation that would withstand challenges. While that process can sometimes feel slow, it also means that when legislation succeeds, it often has a stronger foundation.โ
Simmons also said the playbook for getting the bill over the finish line was rooted in building a big tent. โI think what finally made HB1875 successful was that supporters increasingly focused on a message that resonated far beyond the LGBTQ+ community,โ she continued.
โThe conversation wasnโt simply about gender-affirming care. It was about protecting patients, families, and healthcare providers who are following Hawaiสปi law. It was about preventing out-of-state actors from interfering with healthcare decisions made here in Hawaiสปi. It was about provider stability at a time when Hawaiสปi already faces healthcare workforce shortages. And it was about preserving Hawaiสปiโs ability to govern itself.โ
The bill arrived on the Governorโs desk amid rising federal threats from the Department of Justice against hospitals, including the use of judge and forum shopping to prosecute gender-affirming care providers in conservative jurisdictions based outside of their state. Last month, the Northern District of Texasโan infamously conservative federal courtโordered Rhode Island Hospital, which is almost 2,000 miles away, to hand over patient records from its transgender youth care program. That legal battle is ongoing.
โGender-affirming care is lawful in Hawaiสปi, grounded in established medical standards, and essential to the well-being of transgender, nonbinary, mฤhลซ, and gender-diverse people,โ Hawaiโiโs LGBTQ political action committee, HOKU, wrote in submitted testimony from when the bill was being considered by the legislature.
โFailure to protect access to gender-affirming care is not only an attack on patients and providers; it is a violation of parental rights,โ reads another submission from Pride at Work Hawaiโi. โParents and caregivers who affirm, support, and seek medically appropriate care for their keiki [child] are exercising their fundamental right.โ
Donavan Kamakani Albano, Policy Fellow at the ACLU of Hawaiสปi, further spoke to the importance of gender diversity in Hawaiian tradition. Some right-wing officials may push the myth that transness is somehow novel or a โtrend.โ But Hawaiโi has especially rich ties to its pre-colonial cultureโincluding non-binary concepts of gender.
โIn Kanaka Maoli culture, mฤhลซ describes someone who embodies kฤne and wahine [the masculine and feminine] energies,โ Albanoโs testimony said. โWhile the visibility of mฤhลซ individuals has recently increased, ongoing barriers to gender-affirming care remain.โ
This united LGBTQ advocacy with other causes. โThose principles brought together a broad coalition of supporters and helped lawmakers see the bill as a matter of healthcare access, privacy, and state sovereignty,โ Simmons said.