Kansas Gender-Affirming Care Bill: Bans, Exceptions, and Penalties

The Kansas gender-affirming care ban, formally the Help Not Harm Act (Senate Bill 63), prohibits healthcare providers from performing gender-transition surgeries or prescribing puberty blockers and cross-sex hormones to anyone under 18. The legislature overrode Governor Laura Kelly’s veto on February 18, 2025, and the law took effect on February 20, 2025.¹ Providers who violate it face mandatory license revocation and strict liability lawsuits that can be brought for years afterward. The law does not restrict gender-affirming care for adults.

What the Law Bans

SB 63 tells healthcare providers they cannot knowingly perform certain surgeries or prescribe, dispense, or give certain medications to a child for the purpose of treating distress arising from the child feeling their gender does not match their sex. A “child” is anyone under 18.¹

The prohibited treatments break down by biological sex. For female minors identifying as male, the ban covers surgical procedures, supraphysiologic doses of testosterone or other androgens, and puberty blockers. For male minors identifying as female, it covers surgical procedures, supraphysiologic doses of estrogen, and puberty blockers.¹ The statute uses the DSM-5 definition of gender dysphoria as its diagnostic reference.

Adults are outside the law’s reach. Kansans 18 and older can still obtain hormonal treatments and transition-related surgeries under state law.

The Narrow Exceptions

Two categories of care remain lawful.

The first is treatment for disorders of sex development: patients born with medically verifiable conditions where biological sex characteristics are ambiguous. The statute lists chromosomal variations such as 46 XX with virilization, 46 XY with undervirilization, patients with both ovarian and testicular tissue, and individuals whose genetic or biochemical testing reveals atypical sex chromosome structure or sex steroid hormone production.¹ A diagnosis supported by medical evidence is required; a patient’s or family’s assertion is not enough.

The second is treatment of complications. If a minor develops an infection, injury, disease, or disorder caused or worsened by a previously performed prohibited procedure, providers can treat those complications without violating the law.¹

There was a third, time-limited allowance for patients already on treatment when the law took effect. A provider could continue a course of puberty blockers or cross-sex hormones started before February 20, 2025, if the provider developed a plan to systematically taper the medication, documented in the medical record that abrupt discontinuation would cause harm, and ended treatment no later than December 31, 2025.¹ That deadline has passed. Continued prescribing to minors for transition purposes now violates the law regardless of when treatment began.

What Happens to Providers Who Violate the Ban

The penalties are built to end careers, not correct them. SB 63 adds violations to the statutory definition of unprofessional conduct for physicians under K.S.A. 65-2837 and requires the appropriate licensing entity or disciplinary review board to revoke the provider’s license.¹ Revocation is mandatory. Boards have no discretion to impose suspension, probation, or a fine instead.

A physician, nurse practitioner, or other licensed clinician who knowingly prescribes prohibited hormones or performs a prohibited surgery on a minor for gender-transition purposes risks permanent loss of the ability to practice in Kansas.

Private Lawsuits with Strict Liability

The civil exposure may be larger than the licensing risk. SB 63 creates two private rights of action.

Parents of a child who received prohibited treatment can sue the provider and recover actual damages, punitive damages, injunctive relief, and reasonable attorney fees and court costs.²

The patient can also sue after turning 18. The statute of limitations runs 10 years from the former patient’s 18th birthday, so a claim can be filed as late as age 28.²

Liability is strict. If the prohibited treatment or its effects cause any physical, psychological, emotional, or physiological harm to the child within 10 years of turning 18, the provider is liable without the patient having to prove negligence. The occurrence of harm is enough.² Combined with the long tail and the broad definition of harm that reaches psychological and emotional consequences, this creates financial exposure that lasts well into a patient’s adulthood.

Does the Ban Reach Out-of-State Telehealth Providers?

The statute targets any healthcare provider who “knowingly” provides prohibited treatments to a child, and it does not limit its reach to providers physically located in Kansas. A clinician in another state prescribing to a Kansas minor by telehealth could face questions about whether the Kansas law applies to them. Providers in that position should treat the risk as real rather than theoretical.

Separately, federal telehealth flexibilities allow DEA-registered practitioners to prescribe schedule II through V controlled substances by telemedicine without an in-person evaluation through December 31, 2026.³ Not all gender-affirming medications are controlled substances, but some formulations may be, and the federal flexibility does not override Kansas’s prohibition.

Is the Ban Being Challenged?

Yes, but it is in effect while the challenge proceeds. In May 2025, the ACLU of Kansas filed suit in Douglas County District Court on behalf of two minor plaintiffs, seeking an injunction to block enforcement. As of early 2026, no injunction had been issued.

The case is in state court and relies on the Kansas Constitution, which can offer broader protections than the federal Equal Protection Clause. That matters because the U.S. Supreme Court’s June 2025 decision in United States v. Skrmetti upheld a similar Tennessee ban 6-3, finding it did not violate the federal Equal Protection Clause.⁴ Skrmetti closes off most federal constitutional attacks on laws like SB 63, but it does not control how a Kansas court interprets the Kansas Bill of Rights. Arguments raised against similar laws elsewhere include infringement of parental rights to direct a child’s medical care and interference with the physician-patient relationship. The outcome of the pending state-court challenge is uncertain.

What Families and Adults Should Know

For families of transgender minors in Kansas, the law eliminates in-state access to medical transition treatments until the child turns 18, with the only exceptions being diagnosed disorders of sex development or care for complications of prior procedures. Because the statute reaches providers who knowingly treat Kansas minors without a clear geographic limit, families considering out-of-state care should consult an attorney before arranging treatment across state lines.

Adults are not restricted by SB 63 and retain access to hormonal and surgical care in Kansas. If insurance coverage falls short, the IRS allows a deduction for medical expenses, including medically prescribed hormone therapy and gender-transition surgical procedures, to the extent total medical expenses exceed 7.5% of adjusted gross income.⁵ The treatment must be medically prescribed, and patients should keep provider documentation of medical necessity. Qualifying expenses can also be paid through a Flexible Spending Account or Health Savings Account, within those accounts’ annual limits and documentation rules.

1
Kansas Secretary of State. Kansas Session Laws – Chapter 1 Senate Bill 63
2
Kansas State Legislature. Senate Bill No 63 – Enrolled
3
Telehealth.HHS.gov. Prescribing Controlled Substances via Telehealth
4
Supreme Court of the United States. United States v Skrmetti
5
Internal Revenue Service. Publication 502 (2025) – Medical and Dental Expenses