On August 1, 2025, New Hampshire Governor Kelly Ayotte signed into law two bills that will ban nearly all forms of gender-affirming care for minors under 18, including hormone treatments, puberty blockers, and surgeries. The move, which will make New Hampshire the only state in New England to prohibit most gender-affirming care for transgender youth, has ignited a firestorm of reaction from both sides of the political spectrum and set the stage for potential legal battles, according to USA Today and reporting from New Hampshire Public Radio.
The new laws, House Bill 377 and House Bill 712, are set to take effect on January 1, 2026. Specifically, HB 377 prohibits healthcare professionals from administering hormone treatments or puberty blockers to minors for gender transition purposes, while HB 712 bans surgeries for transgender youth, including chest and genital procedures, unless certain medical conditions are present, such as cancer or reconstructive needs after injury. Violations will be subject to disciplinary action by medical boards. However, minors who begin care before the ban takes effect will be allowed to continue their treatments, as noted by activists and providers. "We are really asking folks in our orbit to publicize that the bill does not go into effect around puberty blockers and hormone blockers until Jan. 1, and if it is an appropriate choice for kids to seek care, we are strongly encouraging them to be in touch with Dartmouth Hitchcock and their gender affirming care clinic," Heidi Carrington Heath, executive director of New Hampshire Outright, told NHPR.
Governor Ayotte justified the legislation by stating, "Medical decisions made at a young age can carry lifelong consequences, and these bills represent a balanced, bipartisan effort to protect children." Yet, her decision has drawn sharp criticism from LGBTQ+ advocates and healthcare providers. Liz Canada, advocacy director at Planned Parenthood of Northern New England, responded, "Health care for transgender people is lifesaving care. Every major medical association agrees that gender-affirming medical care for transgender youth is essential treatment for those who need it. Governor Ayotte has decided to put politics before the health and well-being of transgender and nonbinary youth, and has taken away parents’ judgment and replaced it with politicians’."
The impact of the new laws will be significant for transgender youth and their families in New Hampshire. Beginning next year, new patients under 18 seeking estrogen- or testosterone-based therapy will no longer be able to access such care from Planned Parenthood or other clinics in the state. Providers will also be prohibited from referring patients to in-state clinics for these treatments. Alexis Nolan, director of clinical care at Planned Parenthood of Northern New England, explained, "While minors who are already on hormone therapy prior to Jan. 1 will be able to continue to get their prescriptions through PPNNE, new patients under 18 seeking estrogen- or testosterone-based therapy after that date will no longer be able to get that care from Planned Parenthood clinics in New Hampshire, even if they have their parents’ consent."
For those who wish to begin gender-affirming care after January 2026, the only option will be to travel out of state. This presents a host of challenges, including transportation, accommodation, and the possibility of higher costs if the out-of-state provider is not covered by the family's insurance. To help address these barriers, the Trans Youth Emergency Project, in partnership with organizations like 603 Equality and the Campaign for Southern Equality, offers families in states with bans up to $500 every three months to cover travel expenses for out-of-state care. The project also provides one-on-one consulting for families navigating the new restrictions. In a joint statement, the organizations urged, "603 Equality and the Campaign for Southern Equality urge families with transgender youth to consult with their child’s physician as soon as possible about care plans. The Trans Youth Emergency Project is here to provide support to families of trans youth in New Hampshire in this difficult climate."
The legislative developments in New Hampshire mirror a broader national trend, as conservative states move to restrict access to gender-affirming care for minors. The legal landscape shifted dramatically in June 2025, when the U.S. Supreme Court ruled 6-3 in U.S. v. Skrmetti to uphold Tennessee’s ban on gender-affirming care for minors, finding that such laws do not violate the Equal Protection Clause of the 14th Amendment. The ruling set a precedent, allowing 25 states to enforce similar bans and influencing subsequent court decisions, such as the 10th Circuit’s recent rejection of a challenge to Oklahoma’s ban. Lambda Legal, the ACLU, and the ACLU of Oklahoma described the outcome as "a devastating outcome for transgender youth and their families across Oklahoma and another tragic result of the Supreme Court’s errant and harmful ruling in Skrmetti."
Despite the Supreme Court’s decision, legal advocates in New Hampshire believe there may still be viable paths to challenge the new laws. Chris Erchull, staff attorney at GLBTQ Legal Advocates & Defenders (GLAD), argued, “I think we have ample evidence in this case that the motivation for the ban on medical care was an effort to single out transgender kids for different treatment and deny them access to care that they need.” Erchull and other attorneys point out that the Skrmetti ruling was narrowly focused on the Equal Protection Clause and did not address whether such bans violate parental rights under the 14th Amendment or state constitutional protections against sex discrimination. Michael Haley, a staff attorney at GLAD, emphasized, "That case was a very narrow ruling that focused just on whether these types of bans violate the equal protection clause of the Constitution. The Supreme Court in that case specifically declined to look at the parental rights question of whether these types of bills violate parents’ rights to make these decisions with their adolescent children, with their providers."
Meanwhile, the political and social debate in New Hampshire remains intense. While Governor Ayotte signed the bans on gender-affirming care, she also vetoed House Bill 148, which would have allowed businesses and organizations to separate bathrooms, locker rooms, and sports teams by biological sex. Her veto has drawn ire from conservatives, with Rep. Erica Layon of Derry declaring, "I was stunned to learn that Governor Kelly Ayotte vetoed a bill meant to protect women’s spaces from men — an unthinkable rejection of women’s safety and rights." Ayotte, in her veto message, explained, “I believe there are important and legitimate privacy and safety concerns raised by biological males using places such as female locker rooms and being placed in female correctional facilities. At the same time, I see that House Bill 148 is overly broad and impractical to enforce, potentially creating an exclusionary environment for some of our citizens.”
LGBTQ+ advocates, for their part, are focusing on community organizing and storytelling to counter what they describe as a flood of misinformation. Linds Jakows, founder of 603 Equality, said, “We want to spend more time organizing communities and getting people to talk to their friends and neighbors to share stories about transgender and nonbinary lives that counteract the flood of misinformation that is going on at the State House.” Listening sessions have already been held in Dover, New London, and Plymouth, and activists say they are planning more. High-profile advocacy events in 2025 included Manchester’s pride parade on June 28, where performer Bobby Bratwurst, dressed as Lady Liberty, highlighted the importance of bathroom access, and a demonstration at the State House in May where activists dressed as "genital observation police" to satirize proposed restrictions.
As the January 2026 implementation date approaches, the future of transgender healthcare in New Hampshire—and across much of the country—remains uncertain. The coming months will likely see continued legal challenges, political advocacy, and personal stories from families directly affected by these sweeping changes.