Puerto Rico, long regarded as a leader on transgender rights in the Caribbean, is facing a potential rollback as lawmakers push forward legislation to ban gender-affirming care for youth. The measure could criminalize parents and doctors and cut off vital medical support for the island’s trans community.

The bill, approved by both chambers of Puerto Rico’s legislature, is now awaiting action by Republican Gov. Jenniffer González Colón. Although she had proposed amendments to protect access to puberty blockers and allow minors already undergoing treatment to continue care, lawmakers did not adopt those changes. The governor now faces a decision to sign or veto the bill. The U.S. Supreme Court recently ruled that the government can limit this kind of care.

Late last month, the Puerto Rican Senate advanced the legislation, which would bar gender-affirming health care for trans people under 21 and impose fines, prison time, and professional sanctions on parents and medical providers who facilitate such care. The House recently passed the bill as well, starting a 30-day clock for the governor to act.

Parents of trans youth have pleaded with the governor to veto the bill, but instead, she sent it back for changes that ultimately failed.

Pedro Julio Serrano, president of the Puerto Rico LGBTQ+ Federation, stated that the island has long been “at the forefront” of trans rights, citing milestones such as allowing trans people to change their birth certificates and a recent court ruling that enabled nonbinary individuals to have an “X” gender marker. However, he warned that the political climate has shifted dramatically.

He told The Advocate that conservative forces in Puerto Rico, particularly the fundamentalist party Proyecto Dignidad, are using anti-trans legislation as a calculated political strategy to attract voters. Serrano noted that the same types of bills now moving through the legislature were blocked in the previous term through activism and lobbying, but have resurfaced under a more conservative government.

The current bill follows the passage of a religious liberty measure and another effort restricting care for trans minors, both of which Serrano said the community is also preparing to challenge in court. “We are on that waiting stage,” he said.

Serrano stressed that while Puerto Rico’s political environment has become more hostile, the island’s broader culture remains deeply supportive of LGBTQ+ people. He described Puerto Rico as a place that is generally “accepting, welcoming, respectful,” and one of the world’s top LGBTQ+ travel destinations. Yet, he acknowledged that pockets of violence and bigotry persist, recalling how Puerto Rico was the epicenter of anti-trans violence in 2020 when seven trans people were murdered.

He noted that the federation formed shortly after the 2020 election, anticipating conservative political gains both locally and nationally. Since then, the coalition has grown to include over 100 organizations and numerous political and community leaders. Its work has included large-scale marches, legislative outreach, community assemblies, legal planning, and grassroots organizing.

Serrano said the island has experienced a groundswell of local activism, with Pride events expanding from one march in San Juan decades ago to more than 20 events across Puerto Rico today, including on smaller islands like Vieques. He said the community is determined to resist efforts to strip away hard-won rights, even if the fight is long and complex. “We know that we’re going to have some setbacks,” he said. “But if we don’t do the fight right now, it’s going to be even harder to win back those things that are taken away from us.”

Related: Supreme Court rules states can ban gender-affirming care for youth in U.S. v. Skrmetti

Groups, including the Puerto Rico LGBTQ+ Federation and GLAAD, condemned the legislation, warning that it would impose unbearable burdens on families and cut off trans youth from lifesaving health care. “Lawmakers must vote to protect access to health care that saves lives, and allow families to make private health care decisions that help loved ones be themselves, be safe, and to thrive,” the groups said in a joint statement.

Advocates also stress that, unlike in the contiguous United States, trans Puerto Ricans cannot simply travel to a neighboring state for care if services are banned locally. Many would be left without options unless they could afford expensive travel to the mainland. Puerto Ricans are U.S. citizens but cannot vote for president in the general election unless they reside on the mainland.

Despite political divisions, President Donald Trump’s influence remains limited on the U.S. territory. 

“People don’t forget when he threw paper towels at us,” Serrano said, referring to Trump’s widely criticized visit after Hurricane Maria, which many on the island saw as dismissive and insulting during a humanitarian crisis. Serrano added that even Republicans on the island often distance themselves from Trump, and that his policies do not hold the same sway in Puerto Rico as they might in some U.S. states.

The Advocate contacted the Puerto Rican governor’s office to ask whether she plans to sign or veto the bill, but did not receive a response.