The legislation would amend existing public health law to empower children under age 18 who are classified as “runaway or homeless youth,” or RHY, to give consent for medical, dental, health and hospital services, and comes amid a wave of legislation targeting trans kids elsewhere in the nation.

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New York lawmakers voted Saturday to allow homeless teens to make their own health care decisions without parental consent, including when it comes to gender-affirming care denied to them in other states.

The bill would amend existing public health law to empower children under age 18 who are classified as “runaway or homeless youth,” or RHY, to give consent for medical, dental, health and hospital services, and comes amid a wave of legislation targeting trans kids elsewhere in the nation. In Florida, Gov. Ron DeSantis has moved to prohibit minors or people with Medicaid from accessing hormone treatment or puberty blockers; in Texas, the state’s child services agency has begun investigating families whose children receive gender-affirming care. After a Senate vote last month, the Assembly approved the measure Friday, sending it to Gov. Kathy Hochul to sign.

“Today is a good day for runaway and homeless youth in New York State,” said Coalition for Homeless Youth (CHY) Executive Director Jamie Powlovich, who championed the measure. “At a time when numerous states are passing anti-trans legislation or trying to limit the autonomy people have over their own bodies, this legislative act is truly something to celebrate.”

The legislation covers more than just gender-affirming care, however. A document circulated by CHY and youth service providers reminded lawmakers that the bill would enable homeless young people to make routine medical decisions, like scheduling a physical exam, seeking therapy, getting a cavity filled at the dentist and picking up prescribed medication.

“We can offer vaccines, physicals, all the things we’ve been limited in offering them,” said Dr. Uri Belkind, the associate clinical director of adolescent care at the organization Callen Lorde. “It certainly is very important for gender-affirming care, but it certainly is so much more than that.”

The term “runaway and homeless youth” applies to unaccompanied or parenting young people under age 25 who lack stable housing, many of whom are served by a network of nonprofit organizations across the state that run housing programs and offer a range of social and health services.

Some 3,659 young people were admitted to a RHY crisis shelter or transitional living program across New York State in 2020, according to the most recent data published by the Office of Children and Family Services. About a third of them were under 18. But that data does not paint a complete picture because it excludes young people who visited drop-in centers, used other RHY-tailored services without entering shelter or who never engaged with a provider.

Runaway and homeless youth over 18—like nearly all adults—can already take control of their own healthcare. Current law also allows people under 18 who are married or who are parents, as well as young people who are emancipated or incarcerated, to make their own medical decisions.

Expanding the law to cover RHY will empower “some of the most vulnerable populations in New York,” the New York Civil Liberties Union wrote in a memo to lawmakers.

“The vast majority of runaway and homeless youth are simply unable to access healthcare, full stop,” said NYCLU attorney Allie Bohm. “Runaway and homeless youth, by definition, do not have parents who can consent.”

Many runaway and homeless teenagers who flee their homes or otherwise end up in New York City identify as LGBTQ+ and seek a more accepting environment with substantial support services compared to other parts of the country, said Nadia Swanson, the technical assistance director at the Ali Forney Center (AFC). Their New York City-based organization serves LGBTQ+ young people between ages 16 and 24 who experience homelessness.

Swanson said current health consent restrictions have posed a “huge barrier” for minors who visit AFC’s drop-in center or stay in their temporary housing facilities. Teens under 18 make up about 5 percent of AFC clients, they said.

While the organization can provide mental health counseling, staff cannot prescribe psychiatric medications or perform routine medical check-ups without guardian consent. Yet, most of the minors served by AFC have fled hostile home environments or have been rejected by their family because of their gender or sexual identity, Swanson said. About 40 percent of AFC’s clients come from outside New York.

“Minors who have faced family rejection then come to a place that’s supposed to provide safety and support but then can’t provide care they need,” Swanson said. “Young people are falling through the cracks.”

In the Capital Region, runaway and homeless youth tend to come from Upstate counties or have experienced trafficking from New York City, said Andy Gilpin, who runs the Saratoga-based provider CAPTAIN Community Human Services. CAPTAIN provides shelter for about 100 minors a year and engages with 4,000 young people 21 and under through its street outreach program, he said

“Most of the kids we encounter are having problems with their parents or caregivers, often with issues around their health and welfare — mental health, LGBTQ issues, vaccines,” Gilpin said.

The legislation comes as states across the country enact or propose policies persecuting or even criminalizing transgender children—including bills in Kansas, Ohio and Alabama that would criminalize hormone treatment for minors.

As those harsh anti-transgender laws take hold, more young people may choose to come to New York to access needed health care, said the bill’s Assembly sponsor, Richard Gottfried.

“We’re just beginning to see this kind of legal hostility to proper medical services for transgender youth and if that continues, New York may well find itself as a refuge and host for these young people,” Gottfried said. “If that happens I would certainly want New York law to be ready to provide appropriate care.”

But discrimination against transgender individuals is not just a phenomenon in conservative states. Transgender New Yorkers also face bigotry that contributes to a disproportionately high suicide rate.

State Senate sponsor Jabari Brisport said the measure is crucial for access to even routine health care, and acknowledged the potential impact for transgender youth in New York and beyond.

“If you are living in New York, you’re a New Yorker and this bill is for you,” Brisport said. “It is sad and also disgusting, the right-wing attacks on trans-people and if New York can be a beacon and an oasis, New York will be that beacon.”