CHARLESTON, W.Va. (WOWK) — A law banning gender-affirming care — with exceptions — for those under 18 in West Virginia went into effect on Monday, Jan. 1, 2024.

Gov. Jim Justice (R-W.Va.) signed the bill in March 2023, joining 19 other states that restricted some form of gender-affirming care for transgender people under 18 in 2023, according to U.S. News & World Report.

According to the Associated Press, the bill outlaws minors from being prescribed hormone therapy and puberty blockers. There are exceptions; doctors can prescribe the therapy if the person is at risk for self-harm or suicide, or has been diagnosed by two or more medical or mental health providers.

House Bill 2007 passed the West Virginia House of Delegates in February 2023, with a vote of 84-10. During a public hearing, only two people spoke in favor of the bill, and 79 spoke against allowing the bill.

The Senate passed the bill with amendments, one from Sen. Tom Takubo (R-Kanawha; Senate Majority Leader) — who is a physician — allowing minors to receive medication if they have been diagnosed by two or more medical or mental health providers with at least one being a mental health provider and both having relevant training in gender dysphoria in adolescents. The amendment passed 20-12, with two absent.

When discussing this amendment, Sen. Mike Maroney (R-Marshall) said it is “unbelievable” to tell others how to practice medicine.

“We’re pro-life – overwhelmingly – in this Caucus. These kids commit suicide, these 30 kids. There will be some suicides,” Sen. Maroney said. “Who are we – to win an election – and start telling people who to practice medicine; to change treatments? It’s unbelievable. I appreciate the Senator’s amendment. It’s going to help some people, it’s going to help some people who need help.”

On the other side, Sen. Mike Azinger (R-Wood) called it “dangerous” and “wrong.”

“A self-evident truth planted on the heart of man would tell mankind – by nature – that surgeries to change the sex or the attempt to change the sex would be self-evidently a fist in the face of the creator,” Sen. Azinger said. “But I would make the argument that also – Mr. President – that it is self-evident that when you block the natural course of a young person, that we commonly call puberty by using puberty blockers, that is self-evidently wrong… that is self-evidently dangerous.”

The next amendment – proposed by Sen. Patricia Rucker (R-Jefferson) – would make any licensed medical practitioner required to report any prescribing of gender-affirming medication to the Bureau of Vital Statistics without anything being used to identify the patient. It was found to be unfit for the bill.

Another amendment from Maroney would put certain provisions in sections to become effective on Jan. 1, 2024. This was passed by a voice vote on the Senate Floor.

This was a very controversial bill that came out of the 2023 Legislature. Critics say transgender youth have high suicide attempt rates, but bill supporters say they’re too young to make informed decisions.

The Associated Press contributed to this report.