Puerto Rico’s Republican Gov. Jenniffer González-Colón signed into law Wednesday a far-reaching ban on gender-affirming medical care for transgenderpeople under 21, enacting one of the harshest measures of its kind in the United States and its territories and prompting swift condemnation from medical experts and LGBTQ+ advocates. 

The law, Senate Bill 350, prohibits the use of puberty blockers, hormone therapy, and gender-affirming surgeries for anyone under 21, threatening doctors and other health professionals with up to 15 years in prison, a $50,000 fine, and the permanent loss of their licenses and permits. Public funds are also barred from being used for such care.

In recent days, the College of Physicians and Surgeons, the Association of Psychology, the College of Social Work Professionals, the Puerto Rican Association of Professional Counseling, and the Bar Association, among other organizations, had urged that the bill be vetoed.

The Advocate previously reported that González-Colón had asked for amendments to protect access to puberty blockers and allow minors already undergoing treatment to continue care, but lawmakers did not adopt those changes. Last month, the U.S. Supreme Court ruled in Skrmetti that a Tennesseeban on gender-affirming care for minors could be enacted, which allowed other states and territories to continue to ban such care.

“What a disgrace! Jenniffer González, through her actions, declares herself the most anti-equality governor in history. She ignored her own Secretary of Health and the medical associations that support treatment for trans minors. By signing Senate Bill 350 into law, she has just endangered trans youth and their families and criminalized health professionals for doing their job,” Pedro Julio Serrano, president of the Puerto Rico LGBTQ+ Federation, said in a statement to The Advocate.

GLAAD President and CEO Sarah Kate Ellis also criticized the new law. “Everyone deserves to live free from discrimination and with access to essential health care supported by every major medical association,” she said. “Banning this care and stripping the rights of parents to make the best medical decisions for their families creates unbearable burdens for the most marginalized in Puerto Rico.”

Harvard Law Instructor Alejandra Caraballo reacted to the law’s signing on Bluesky. “A twenty-year-old trans person can go drink themselves to death but can’t legally get hormones,” she wrote, noting that the drinking age in Puerto Rico is 18.

The Federation, a coalition representing hundreds of individuals and more than 100 organizations, said it would pursue legal action against the new law.