By Judd Legum and Tesnim Zekeria, April 12, 2021, Popular Information

Seven members of the North Carolina Senate have introduced draconian anti-trans legislation targeting children, adults, and medical professionals. An investigation by Popular Information reveals that these legislators have received hundreds of thousands of dollars from corporations that purport to be champions of LGBTQ rights and equality. 

There have been more than 100 anti-trans bills introduced in statehouses across the country, according to a database maintained by the ACLU. But S514, introduced this month in North Carolina, is notably extreme:

1. S514 bans anyone under the age of 21 from receiving gender-affirming treatment, including reversible hormone therapy. This provision would impact children under the age of 18 as well as young adults. It would force doctors to stop therapy in the middle of treatment, regardless of the impact on the patient. Dr. Deanna Wilson Adkins, director of Child and Adolescent Gender Care at the Duke University School of Medicine, said this could have a “devastating” impact on the children in her care. Adkins noted that most “most minors with gender dysphoria don’t need or qualify for treatment with gender-affirming or cross-sex hormones.” Minors that receive hormone treatment do so only after a consensus is reached “by a team of medical experts, mental health experts, the patient, and the family.” 

2. S514 imposes fines on medical professionals who provide gender-affirming treatment to anyone under the age of 21. Doctors and other health care professionals who provide hormone therapy to anyone under the age of 21 would face a fine of $1000 “per occurrence.” They would also be considered to have “engaged in unprofessional conduct and shall be subject to revocation of licensure and other appropriate discipline.” 

3. S514 requires government employees, including teachers, to report children who demonstrate “gender nonconformity” to their parents. This provision could impact cis and trans children. It could also force teachers to “out” students to their parents before the students are ready. Teachers that fail to do so will be subject to professional “discipline.”

4. S514 protects the practice of “conversion” therapy. Conversion therapy is a debunked practice that attempts to change a person’s sexual orientation or gender identity. It has been rejected by medical experts for decades. 

Kendra R. Johnson, Executive Director of Equality NC, told Popular Information that the bill is an “egregious attack” on the LGBTQ community that “directly undermines access to health care” and sanctions the “policing of gender identity.” It targets a vulnerable group of people that “already faces barriers to receive compassionate and culturally competent care.” 

Yet the sponsors of S514 are supported by corporations that hold themselves out as ardent supporters of LGBTQ rights. For example, Duke Energy, in a company blog post, celebrates National Pride Month and touts the company’s “commitment to diversity and inclusion.” It highlights the story of an employee who says the company’s “position on LGBTQ issues” convinced him to accept a full-time position. “Duke Energy talks the talk and walks the walk,” he says. 

In a January 2021 press release, Duke Energy touts that it provides “equal health coverage for transgender individuals.” The release says that the company’s 500 member “LGBTQ Equality employee resource group” is “supported by the company’s senior leadership.”

The company also touts its commitment to LGBT equality on Twitter:

A Popular Information investigation, however, reveals that Duke Energy has donated $75,200 to the sponsors of S514 over the last three years. That makes Duke Energy the top corporate donor to the politicians pushing this anti-trans measure. 

Duke Energy has donated $16,800 to Senator Ralph Hise (R), who authored S514, including $10,800 last year. Hise also vocally supported North Carolina’s notorious “bathroom bill,” which prohibited trans people from using the bathroom that matched their gender identity, in 2016. Hise voted against the successful repeal of HB2 the following year. 

Popular Information asked Duke Energy if the company supported S514 and would continue to provide financial support to its sponsors. A company spokesperson sent this statement:

We remain firmly committed to supporting diversity, equity and inclusion in the workplace and in the communities we serve. We support policymakers on both sides of the aisle to ensure our customers and communities have a voice on key energy topics. We do not always agree with their positions on each and every issue. Our primary focus is on how North Carolina can continue its clean energy transition in a reliable, affordable way to benefit all customers.

Johnson rejected Duke Energy’s ambiguous response as self-serving and counterproductive. “Being silent for the sake of your business interests is detrimental to North Carolina,” she said. Johnson said that Duke Energy and other corporate donors have an obligation to “stand in opposition” to a bill that is “wrong, harmful, and damaging.” 

Health care companies back sponsors of a bill that would prohibit them from serving their customers

Blue Cross Blue Shield North Carolina (Blue Cross NC) claims it has a “fearless culture” that supports “LGBTQ+, diversity, and inclusion.” 

Blue Cross NC is also a top corporate donor to the sponsors of S514, donating $35,900 to the group since 2018. The company donated $9,400 to North Carolina Senator Joyce Krawiec (R), who has repeatedly shared anti-trans articles on Twitter, including one that claims the “transgender movement has strong totalitarian overtones that Americans don’t fully understand.” 

The bill not only conflicts with Blue Cross NC’s corporate messaging but also its stated views on hormone therapy as essential medical care. Blue Cross NC considers hormone therapy “medically necessary” for adults and children under 18 under certain conditions. 

In response to an inquiry from Popular Information, Blue Cross NC sent a statement that was critical of S514 — and reaffirmed Blue Cross NC’s commitment to providing appropriate medical care — but stopped just short of explicit opposition.

Blue Cross and Blue Shield of North Carolina stands against discrimination of any kind, including discrimination based on sexual orientation or gender identity. Individuals have unique medical needs and deserve understanding, compassion and equity in the access and delivery of their own health care. Limiting access to care based on gender identity is against our vision and values.

Recent legislative activities do not impact or change our ongoing collaboration with health care providers, employers, elected officials and community partners across the state to make health care better for all in North Carolina. We recognize gender dysphoria as a medical condition and continue to cover treatments related to gender affirmation as a standard benefit on all plans, in addition to conducting ongoing reviews to update policies that expand coverage and prohibit discrimination.

Atrium Health, the largest hospital group in North Carolina, has donated $6,000 to two of the bill’s sponsors since 2018. The hospital runs the Levine Children’s Center for Gender Health –– one of the first health clinics to provide gender-affirming care for pediatric patients in Charlotte, North Carolina. On its website, the hospital states: 

Everyone deserves to be their best, most authentic self. For children and adolescents who don’t identify with their sex assigned at birth – such as transgender and nonbinary youth – gender-affirmative care can help enhance their overall health and feelings of self-worth.”

The company did not respond to a request for comment.

Cigna, another company that promotes itself as an LGBTQ ally, has also donated at least $3,000 to three of the sponsors of S514. In 2017, the healthcare company wrote that it “understands the importance of addressing health disparities facing the LGBT population and is working to close these gaps.” In July 2020, the company published a statement on its commitment to providing health care to all and said that it “continue[s] to view gender diversity as standard health care.”

“As an extension of Cigna’s mission and values – and as part of our long-standing commitment to health equity and support for the LGBTQ community – Cigna continues to view gender identity as integral to whole person health,” read the statement. 

Other health care providers that are top donors to the sponsors of S514 include UnitedHealth Group and Anthem. Neither company responded to a request for comment. 

American Airlines is “reviewing” North Carolina’s anti-trans bill

Since 2018, American Airlines has donated $3,000 to two sponsors of S514. In March 2021, the company signed a statement opposing anti-trans legislation across the country, including “many specifically targeting transgender youth – for exclusion or differential treatment.” The company told Popular Information that it has “a longstanding and unwavering commitment to standing up for LGBTQ rights, including in North Carolina where we vocally opposed the so-called bathroom bill” and said it is “reviewing the newly introduced legislation.” 

Major corporate donors to the sponsors of S514

In total, Popular Information contacted 36 companies. 31 did not respond. Eli Lilly declined to comment and Bristol Myers Squibb shared its guidelines on political giving without disclosing its stance on the bill.

Below is a full list of the companies contacted by Popular Information, along with the amounts donated to the sponsors of S514 since 2018:

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