New Hampshire became the first New England state to protect minors from all gender transition procedures when Governor Kelly Ayotte (R) on Friday signed into law two bills that expanded on the state’s previous protections. In 2024, New Hampshire enacted a ban on gender transition genital surgery for minors. Now, the most conservative state in the country’s most progressive region protects minors from all gender transition surgeries and hormones.

The changes came in two separate bills. In HB 377, the General Court of New Hampshire — that’s the official name of the state legislature — forbade any person from administering “a puberty-blocking or cross-sex hormone medication” to a minor, “for the purpose of altering or attempting to alter the appearance of or affirm the minor’s perception of his or her gender or sex, if that perception is inconsistent with the minor’s biological sex.” An exception does grandfather-in any treatment that begins before January 1, 2026, the date when the law takes effect. The law is enforced through civil action by either the attorney general or the minor victim.

In HB 712, the legislature stipulated that “no physician shall perform transgender chest surgery on a person under 18 years of age.” This law can be enforced through a civil lawsuit by the minor victim. It is also enforced by the Board of Medicine, which regulates “unprofessional conduct.” If the state health department investigates an alleged violation, it must provide a “written report that identifies any noncompliance” that “shall be posted on the department’s website.”

Both laws passed by a comfortable margin. For HB 377, the final House vote was 202-161, and the final Senate vote was 16-8. For HB 712, the final House vote was 191-163, and the final Senate vote was also 16-8.

Both Senate votes broke along party lines, but the House saw party-crossing in both directions. On HB 377, State Reps. Nicholas Bridle (R), David Nagel (R), and Joseph Guthrie (R) voted against the bill, while state Reps. Dale Girard (D) and Jonah Wheeler (D) voted for it. On HB 712, state Reps. Bridel, Guthrie, Nagel, Andrew Prout, and Susan Vandecasteele voted against the bill, while State Rep. Wheeler voted for it.

These laws built on New Hampshire’s 2024 policy passed in HB 396, which only prohibited “genital gender reassignment surgery on minors.”

In improving its laws protecting minors from the harmful, irreversible effects of gender transition procedures, the New Hampshire General Court followed the precedent set by the West Virginia legislature. Out of 27 states with some form of protections for minors, West Virginia enacted some of the weakest protections in 2023. However, earlier this year, it substantially strengthened its laws, adding enforcement mechanisms and removing an unnecessary exemption.

Likewise, the New Hampshire legislature first passed a remarkably weak law covering a vanishingly small proportion of cases — genital gender surgery for minors. Now, the legislature has expanded that protection to all medical procedures, placing its laws squarely in the middle of the pack.

The passage of these laws was not a foregone conclusion. Last month, Governor Ayotte vetoed three other transgender-related bills. Conventional wisdom would label the vetoed bills — protecting women’s private spaces, allowing parents to complain about sexually explicit material in schools, and allowing parents to opt their children out of a controversial sexual survey — safer issues politically. If Ayotte felt the need to veto these bills, perhaps she would veto the medical bills too.

Fortunate for New Hampshire’s youth, Ayotte chose to sign the bills rather than veto them. “Medical decisions made at a young age can carry lifelong consequences, and these bills represent a balanced, bipartisan effort to protect children,” she said.

What accounts for the alteration of Ayotte’s attitude toward legislative protections against transgender ideology? One possibility is that she felt — and was responding to — the political pressure generated by her previous vetoes.

However, Ayotte had to know that these bills would provoke just as much criticism from the Left. ACLU Policy Advocate Courtney Reed called the laws “merciless, cruel, and painful,” while GLAD Law senior staff attorney Chris Erchull declared it “a big step backwards” that would “cause some serious harm to transgender adolescents and to their families.”

Another possibility is that recent developments on the issue of gender transition procedures for minors have fundamentally changed the perceived acceptability of legislatively postponing these treatments until adulthood. Greater scientific inquiry — especially comprehensive European reviews — has raised questions about the safety of these procedures for minors. Political revelations and successful state legislative efforts have exposed the radicalism of transgender ideologues who support these procedures. The resounding victory Tennessee’s law received at the Supreme Court in June served to fortify this policy as one on safe constitutional ground.

“It’s just this craze. It seems almost a cult-like following of this gender confusion,” reflected New Hampshire State Senator Kevin Avard (R), who said he was persuaded to support the bill through the testimony of detransitioners. “They realized that they did long-term and irreparable damage to their bodies. The testimony was overwhelming; they were confused.”

Whatever the reason that led Governor Ayotte to sign these bills, confused New Hampshire minors will now be protected from gender transition procedures that cause irreversible, harmful effects, before they are old enough to make decisions for themselves.