West Virginia has enacted new legislation (SB 299) that substantially improves its protections for minors from gender transition procedures. In 2023, the Mountaineer State joined an avalanche of state legislatures protecting minors from the procedures — but with watered-down language. Now, West Virginia has become the first state since that watershed year to substantially improve upon its previously-enacted protections for minors.

West Virginia SB 299 added enforcement mechanisms to existing law, authorizing medical licensing boards to revoke the license of “a physician [who] provides either gender reassignment surgery or gender altering medication to a person who is under 18 years of age.” It also allows the attorney general or any injured minor (or the minor’s parents) to file a civil lawsuit against a practitioner.

SB 299 also removed a major exception in West Virginia’s previous law, which allowed physicians to provide puberty blockers and/or cross-sex hormones to minors, so long as two qualified health care providers endorsed the treatment and the child’s parents gave written permission.

This exception overlooked a “systemic problem in the psychologic profession,” Dr. Jennifer Bauwens, FRC’s director of the Center for Family Studies, said at the time. Since America’s politically captured medical organizations “dictate, through professional ethics and training, that gender affirmation is the way to go,” she said, “it’s going to be hard for a minor to get an opinion that’s different than affirmation.”

This was not how West Virginia’s 2023 law was initially written. The bill sponsor introduced it with all the strength and virility of bills protecting minors from gender transition procedures. But Senate Majority Leader Tom Takubo (R) — who works for the state’s second largest hospital system — effectively neutered it with a last-minute amendment from the Senate floor, which removed all enforcement mechanisms and added an exception that contradicted the bill’s original purpose. One might even say he provided the bill with surgical and chemical legislative transition procedures.

The resulting legislation was bathwater so tepid and murky that even the Biden administration looked favorably upon it. In assaulting Tennessee’s law protecting minors from gender transition procedures, Biden administration Solicitor General Elizabeth Prelogar argued before the Supreme Court in Skrmetti v. United States:

“But we do think there is a real space for states to regulate here, and I point to the example of West Virginia. West Virginia was thinking about a total ban, like this one, on care for minors, but then the Senate majority leader in West Virginia, who’s a doctor, looked at the underlying studies that demonstrate sharply reduced associations with suicidal ideation and suicide attempts, and the West Virginia legislature changed course and imposed a set of guardrails that are far more precisely tailored to concerns surrounding the delivery of this care. … And I think a law like that is going to fare much better under heightened scrutiny precisely because it would be tailored to the precise interests and not serve a more sweeping interest like the one asserted here in having minors appreciate their sex.”

It seems that many West Virginia legislators recognized the law they passed left much to be desired, but it was going to be hard to carry any such legislation around their own Senate majority leader.

In the intervening two years, electoral changes paved the way to codifying stronger protections for children. First, several incumbent Republicans in the West Virginia Senate lost their primaries in the 2024 election. This included Senate President Craig Blair (R), whose challenger, Tom Willis (R), described himself as “a constitutional Christian conservative.”

Then, in an apparently divisive, three-way race to succeed President Blair, Takubo placed second to state Senator Randy Smith (R). Smith announced that state Senator Patrick Martin would be the Senate Majority Leader. As a result of these elections, Takubo now holds no leadership position in the West Virginia Senate.

West Virginians also elected a new governor in 2024. Governor Patrick Morrisey (R) succeeded former Governor Jim Justice (R), a former Democrat, who took Senator Joe Manchin’s (D-W.Va.) seat in Congress. Morrisey is a strong proponent for recognizing biological reality, who pressed the legislature to adopt a bill defining man and woman.

As a result of these changes, West Virginia SB 299 passed both chambers with overwhelming margins. On March 6, the Senate approved it 32-2, with only the chamber’s two Democrats voting in opposition. (Even Takubo voted “yes.”) On April 12, the House approved the bill 86-12. Three Republicans — Joe Ellington, Joe Statler, and Bill Flanigan — joined the nine Democrats in opposition, while two Republicans — Majority Leader Pat McGeehan and George Street — did not vote.

This time, the body of the legislature intercepted last-minute amendments to torpedo the bill. An amendment to rewrite the bill as a conscience protection measure failed 26-70. An amendment to postpone the effective date from August 2025 to July 2026, creating a weaning period for gender transition hormones, failed 28-71 (this amendment was offered by Flanigan, and might explain his “no” vote).

On December 30, 2023, this author wrote in TWS, urging states like West Virginia to strengthen their laws protecting minors from gender transition procedures:

“Meanwhile, some states that already enacted SAFE Act-style laws could make their current legislation even better. At the risk of oversimplification, in 2023, six states passed extra-strong bills, seven states passed strong bills, and six states passed weaker bills. … The ‘weaker bills’ category also includes those that include no enforcement mechanisms (West Virginia) …. The state legislative season in 2023 saw immense progress in the movement to protect minors from the harmful effects of experimental, irreversible gender transition procedures, to which they are not old enough to meaningfully consent. This progress was good to see, but there is plenty more to do to protect children.”

It’s great to see that overwhelming majorities in the West Virginia House and Senate agree.

Such commitment to improve their laws demonstrates that these legislatures care about the underlying policy — not just about scoring political points. Politicians seeking only to woo the polls will treat any legislative product as a success (“I addressed that problem; let’s move on”). But returning to an issue to improve an inadequate solution takes follow-through. By following through on this issue, the West Virginia legislature has demonstrated that it doesn’t just care about political victories, but also about actually protecting minors from the harms of gender transition procedures.