In May 2024, the Maryland General Assembly and Governor Wes Moore enacted SB119 and HB691,[1] deeming Maryland one of fourteen states to adopt a trans-shield law.[2] Shield laws prohibit state law enforcement and administrative agencies from engaging in interstate investigations on matters already legally protected within the state.³ By legislative design, trans- shield laws enable Maryland to proactively[3] respond to the rise of gender-affirming care bans across the U.S. and intend to protect patients and healthcare providers from out-of-state investigations linked to gender-affirming treatments.[4] Supporters of SB119/HB691 contend that shield protections are crucial for safeguarding the rights of transgender individuals, allowing healthcare providers to offer gender-affirming care without the threat of civil or criminal liability from other states.[5]

SB119/HB691 expands on 2023 legislation which designated abortion as protected healthcare and established abortion shield protections.[6] Now, protected healthcare includes hormone therapy, puberty blockers, alterations to the body, and “other treatments as prescribed to suppress the development of endogenous secondary sex characteristics, align the individual’s appearance or physical body with gender identity, and alleviate symptoms of clinically significant distress resulting from gender dysphoria.[7]”

As legally protected healthcare, Maryland and its agents cannot expend state resources to support interstate investigations or legal actions aimed at imposing civil, criminal, or administrative penalties for activities related to gender affirming treatment unless the action is “subject to civil or criminal liability or administrative sanction in the State.[8]” The law specifically forbids the issuance of subpoenas, ex parte orders, and the enforcement of out-of-state judgments related to gender affirming care unless the underlying cause of action would constitute a legal action under Maryland law.[9]

The legality of trans-shield laws faces scrutiny nationwide, primarily due to their imposition into interstate dynamics and the divisive topic of gender-affirming care for minors.[10] The tension between states offering protections and those imposing bans illustrates the deep political divide present in the U.S. This divide raises critical constitutional questions, particularly concerning the Full Faith and Credit Clause, which mandates that “Full Faith and Credit shall be given in each State to the public Acts, Records, and judicial Proceedings of every other State.[11]”

SB119/HB691, which will go into effect in October of this year,[12] prevents Maryland from participating in out-of-state judicial proceedings involving gender-affirming care. This challenges the balance between state sovereignty and the constitutional mandate to respect judicial proceedings in other states, setting the stage for potential Constitutional challenges to the law which may require federal judicial intervention to resolve.

Kayla Hoffmaster is a third-year student at the University of Baltimore School of Law and serves as a second-year staff editor for the Law Forum. She graduated from Youngstown State University with a Bachelor’s degree in Political Science and a Master’s degree in Criminal Justice and Criminology. After graduation, Kayla plans to pursue a career in employment and labor law.

[1] See S.B. 119, 2023 Gen. Assem., 446th Sess. (Md. 2024).

[2] Equality Maps: Transgender Healthcare “Shield Laws,” MOVEMENT ADVANCE. PROJ. (Sep. 11, 2024) https://www.lgbtmap.org/equality-maps/healthcare/trans_shield_laws.

[3] John P. Elwood, Understanding Shield Laws, 51 J.L. MED. & ETHICS 91 (2023), https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/understanding-shield-laws/D6909947E5171F000D4293334AE8237F.

[4] Zane McNeil, Maryland Senate Passes Bill That Would Codify Access to Gender-Affirming Care, TRUTHOUT (Mar. 6, 2024), https://truthout.org/articles/maryland-senate-passes-bill-that-would-codify-access-to-gender-affirming-care/.

[5] PPM Applauds MGA Governor Moore for Enacting Shield Protections for Gender-Affirming Care in Maryland, PLANNED PARENTHOOD MD. (Mar. 26, 2024), https://www.plannedparenthood.org/planned-parenthood-maryland/newsroom/ppm-applauds-mga-governor-moore-for-enacting-shield-protections-for-gender-affirming-care-in-maryland.

[6] See Md. Code Ann., State Pers. & Pens. § 2-312 (West 2024).

[7] S.B. 119, Legally Protected Healthcare- Gender-Affirming Treatment, Gen. Assem., 446th Sess. (Md. 2024).

[8] Id.

[9] Id.

[10] Katherine Florey, The New Landscape of State Extraterritoriality, 102 TEX. L. REV. 1135 (2024).

[11] U.S. CONST. art. IV, § 1.

[12] See supra note 1.