North Carolina lawmakers voted Wednesday to enact a ban on gender-affirming care for youth by overriding Gov. Roy Cooper’s veto. In Minnesota, meanwhile, providers are seeing an increase in families from out of state seeking care.

Children’s Minnesota has experienced a 30-40% increase in calls to its gender health program since February.

“We were averaging 100 calls a month into the program, and now we’re averaging more like 130 to 140 calls per month,” said Angela Kade Goepferd, gender health program director for Children’s Minnesota.

According to Goepferd, calls started increasing in early 2023 as restrictions in other states continued to be passed. Children’s Minnesota now has a waitlist in place.

“In many cases, families are waiting up to a year or longer to even be seen,” Goepferd said. “I wish we could throw our doors open and see every kid that needs care. We just don’t have those resources, and it is heartbreaking to have to tell a family, ‘Well, we can add you to our waiting list,’ or have to tell a family there are more urgent kids we need to see now.”

Gender-affirming care can include a range of components.

“It’s a lot of answering questions. It’s a lot talking about how do I navigate this situation in the world?” explained Goepferd. “Sometimes it involves medical treatments, like medications, but not for all kids and not for all families.”

There are typically two medication options. Gender-affirming hormone medication is one, while the other medication suppresses puberty, according to Goepferd. Children’s Minnesota does not provide surgical treatment.

Policies restricting or banning gender-affirming care for youth have been implemented in at least 18 states, including North Dakota, South Dakota and Iowa.

There have been legal challenges in several states across the country.

Minnesota is one of about a dozen states that are considered trans refuge states. During the last week of April, Gov. Tim Walz signed protections into law that prevent courts or officials from complying with extradition, arrest and other requests related to receiving gender-affirming care in Minnesota.

HealthPartners has also seen an increase in patients from outside Minnesota seeking care in its clinics.

“Many patients and families are trying to find a provider or clinic to continue the gender-affirming care that’s now unavailable in their home state,” a HealthPartners spokesperson wrote in a statement. “Traveling long distances is a barrier to their care and burden for families, but families able to get to us have been relieved to continue care. We expect to see more patients from outside Minnesota as their families figure out where to go for gender-affirming care.”

Both HealthPartners and Children’s Minnesota acknowledge seeking care out of state can be a burden on families.

“This is care that happens over months to year,” Goepferd said. “This is probably going to involve families relocating to new states to live.”