A bill (HB 174) signed into law last week by Utah Governor Spencer Cox (R) expands the state’s restrictions on the dispensation of puberty blockers and cross-sex hormones to minors who identify as transgender. The law is a positive development after the Utah legislature largely whiffed on a chance to fully protect minors in January 2023, but it still leaves room for improvement. Undue credulence for the same pro-transgender talking points debunked in other states may be the culprit.

The bill permanently prohibits health care providers from supplying “a hormonal transgender treatment to a patient who is a minor.” While the bill does not define “a hormonal transgender treatment,” its general description says that it is “related to the provision of cross-sex hormones and puberty blockers to minors.” The prohibition takes effect on January 28, 2027, giving time for minor patients to be weaned off the artificial hormone treatments.

“This is about protecting minors from making decisions that have permanent, life-altering consequences,” explained bill sponsor Rep. Rex Shipp (R).

However, the Utah legislature devoted considerable attention to determining exactly which minors would be protected under the bill. In its original form, the bill contained a grandfather provision allowing cross-sex hormone treatments to continue without interruption for minors aged 17 years or older by the bill’s effective date, who had been receiving cross-sex hormones for at least two years. For all other minors currently receiving cross-sex hormones, health care providers were required to gradually phase out the hormone treatments by January 2027.

On February 20, the Senate Judiciary, Law Enforcement, and Criminal Justice Committee adopted an amendment proposed by state Senator Todd Weiler (R) to expand this grandfather exemption by a vote of 7-1. The final language reads, “beginning on January 28, 2027, a health care provider may not provide a hormonal transgender treatment to a patient who is a minor if the patient: (a) would be younger than 16 years old as of the effective date of this bill; or (b) has not received cross-sex hormones as of the effective date of this bill.” This language would allow health care providers to continue supplying cross-sex hormones to Utah minors, who are currently 16 years old, into 2028.

“If parents and their children made a decision when the child was 13, I’m not comfortable cutting off that care for a few months or even a year until they turn 18, so that’s why I brought the amendment,” said Weiler, who chairs the committee and who was one of only a few Utah Republicans to vote against the relatively mild measure that passed in 2023. “But I also support the ban because I do believe that these are decisions that are best made by an adult.”

Shipp objected to the change, stating, “I think we’re always going to run into the same issue that you’re trying to avoid, because there’s going to be others that will be on the treatments in 2028,” he said. A one-year runway would “allow the time for these kids that are on them to taper off,” but, he added, “I just don’t want to agree to continue to damage healthy bodies.”

The Utah House passed the bill (54-15) on February 5. The Senate then amended the bill before passing it (20-6) on February 27, and the House concurred (53-15) with the Senate’s amendments on March 2. Governor Cox signed the bill on March 18.

HB 174 built on a law the Utah legislature previously enacted in January 2023. That bill imposed a temporary “moratorium” on starting “hormonal transgender treatment to a patient who: (a) is a minor … and (b) is not diagnosed with gender dysphoria before the effective date of this bill.” FRC Senior Fellow Joseph Backholm told The Washington Stand at the time, “These days, that is a very low bar.” All it takes is an “activist psychiatrist” willing to say that a minor has gender dysphoria, he said, and “everyone knows, ‘Hey, that’s the doctor you’re looking for.’”

The 2023 moratorium was scheduled to last until the Utah Department of Health and Human Services finished conducting a “systematic medical evidence review … to provide the Legislature with recommendations to consider when deciding whether to lift the moratorium.” The law provided no time frame for this review.

After the passage of the 2023 law, FRC predicted that the Utah Health Department’s review would come down in favor of gender transition hormone treatments for minors, given the participation of the University of Utah and a Utah hospital system, which financially benefited from these procedures.

When the Drug Regimen Center at University of Utah Health presented its 1,000-page systematic review to lawmakers in May 2025, its work was widely panned as biased. The report described itself as “likely the most comprehensive” systematic review but omitted key studies from 2024 and came to the opposite conclusion from systematic reviews conducted by European governments and the U.S. Department of Health and Human Services.

“It totally dismissed core issues about the propriety and ethics of administering cross-sex hormones to children,” argued Dr. Alan Smith, a member of the Utah Physician Licensing Board. “It was clearly biased in favor of gender-affirming hormone treatments in minors. It simply ignored the most serious and irreversible consequences to these treatments, such as sexual dysfunction, infertility and even sterilization.”

Nevertheless, Utah lawmakers hoping to protect children had to contend with the weight of this Utah-issued study that opposed their efforts. The false medical conclusions of this survey were reinforced by the testimony of transgender activists such as Blair Massimi, a 20-year-old man identifying as a woman, who told the legislature, “I would not be where I am today if I did not transition. Transitioning truly saved my life.”

In fact, such false medical claims did succeed in sinking a companion bill that would have protected Utah taxpayers from paying for gender transition procedures through public health insurance. On February 19, the Senate Business and Labor Committee sunk the bill (HB 193) in a 5-1 vote, after a doctor testified that paying for gender transition hormone treatments would save the state money in the long run.

“If you’re trying to balance cost, this is not the way to do it,” claimed Intermountain Health Dr. Harris Carmichael, testifying in a personal capacity. “We know that gender-affirming care reduces depression, anxiety, and suicidality. Costs from those are also quite high.”

This claim is false. Systematic reviews of the evidence conducted by the U.S. Department of Health and Human Services and the U.K. National Health Service have concluded that there is no solid evidence showing that gender transition hormone treatments reduce depression, anxiety, and suicidality. In fact, putting young people on a path of gender transition medications often results in their underlying mental health issues going unaddressed, and sometimes growing worse.

Once again, Senator Weiler emerged as an opponent of HB 193. “Why would it be my right as a legislator, as a taxpayer, to decide what health decisions that other adults are doing just because I don’t like the procedure? I’m really struggling along those lines,” he suggested. “Let’s say you have two women, and they’re both 35 years old, and one of them … just wants a double mastectomy. Their [Her] co-worker wants a double mastectomy because she’s now identifying as a male … why would the insurance cover for one of them but not cover for the other one?”

Here, Weiler’s hypothetical refutes itself through its sheer absurdity. No 35-year-old woman “just wants a double mastectomy” for no reason at all. She either faces a life-threatening condition, such as breast cancer, which forces her to accept an operation she would not otherwise choose, or she suffers from some other mental health calamity — such as body dysmorphia — for which surgery is not a recommended treatment.

In addition, the libertarian framing of Weiler’s argument is misplaced. The issue HB 193 sought to address was not some people (legislators) preventing other people (those who identify as transgender) from obtaining treatments they disliked. Rather it was over whether some people (those who identify as transgender) could force other people (taxpayers) to pay for treatments they found deeply morally objectionable.

Alas, such is the state of Republican dominance in Utah, where false claims and utter absurdities roam the hall of the State Capitol, wild and untamed.

Yet, bolstered by the example of the Trump administration and 26 other state legislatures, Utah legislators did find the courage to buck the pro-transgender recommendations of their own Health Department’s legislatively ordered review and act to provide firmer protection for children. On December 30, 2025, TWS identified Utah as one of the states with weak laws protecting minors from gender transition procedures, who “could make their current legislation even better.” Now, Utah joins the list of states that have actually done so, after West Virginia and New Hampshire both strengthened their laws in 2025.

Utah could still do more to protect minors from gender transition procedures (by eliminating loopholes), and to protect taxpayers from paying for them, but it at least took a step in the right direction. Oddly, Governor Cox seemed to apologize for signing HB 174, remarking, “While we understand our words will be of little comfort to those who disagree with us, we sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures.”

But he did sign the bill — a result that seemed unlikely in 2023. Perhaps, in another three years, Utah lawmakers will have the courage to robustly affirm that men are men and women are women.