The Maine Senate voted 23-10 Tuesday in favor of a bill that would require MaineCare to cover gender-affirming care.

Joining all Democrats voting in support of L.D. 1040 were Republicans Eric Brakey of Auburn and Rick Bennett of Oxford. There was little debate before the Senate vote.

The House approved the bill Friday in a 75-65 vote, largely along party lines with Democrats in support. Pending final votes in the Legislature, it will go to Gov. Janet Mills’ desk for a signature.

The Mills administration previously added coverage for gender-affirming care, including mental health counseling, surgery and hormone treatments, to MaineCare, the state’s Medicaid program. But the bill would codify that rule into law, which would make it more difficult for a future administration to eliminate the coverage.

Fifteen states already restrict gender-affirming care for people under 18, and 18 other states, including New Hampshire and New Jersey, are considering bans on gender-affirming care for minors, according to Human Rights Watch.

That comes even as age-appropriate, gender-affirming care has been endorsed by major medical associations across the country, including the American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics and the American Public Health Association.


On Friday, Rep. Michele Meyer, D-Eliot, said the rule that has been in place since 2019 “has helped hundreds if not thousands of our constituents to live fuller more rewarding lives in which they can truly be themselves.”

Another bill related to gender-affirming care has yet to be voted on in the House or Senate.

L.D. 535, sponsored by Rep. Erin Sheehan, D-Biddeford, would allow a minor who is at least 16 years old to receive gender-affirming hormone therapy without parental consent. That bill narrowly won passage in committee last month.

Although it would allow care for older teens without their parents’ consent, there are certain conditions that would have to be met.

First, they must be diagnosed with gender dysphoria, a term for when a person’s biological sex and gender identity do not align. Second, they must be experiencing or are expected to experience harm from not receiving gender-affirming hormone therapy. And third, the minor must receive certain detailed information and counseling from a health care professional prior to providing written consent.

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