House Bill 805, a sweeping law that redefines sex in state policy and restricts gender-affirming care, takes effect Wednesday, January 1, marking a significant shift in how North Carolina governs gender, education and public institutions.
The law formally recognizes “male” and “female” as the only two sexes in North Carolina administrative rules and public policies, defining sex strictly by biological reproductive characteristics at birth. Gender identity is excluded from legal recognition under the statute. Supporters say the change reflects biological reality, while LGBTQ+ advocates warn it erases transgender and nonbinary people from state policy and increases the risk of discrimination across public life.
“We cannot ignore the biological realities,” Buck Newton told the Senate chamber during floor debate earlier this year.
HB805 also prohibits the use of state funds for gender-affirming medical care for people incarcerated in state prisons, including surgery, puberty blockers and hormone therapy. Advocates note that incarcerated transgender people already face significant barriers to care and say the policy will further harm health outcomes for an already vulnerable population.
The law makes additional changes to how the state handles birth records and medical liability. When a birth certificate’s sex designation is changed, both the original and amended certificates must now be preserved together as a multi-page document. HB805 also extends the statute of limitations for medical malpractice claims related to gender transition procedures from three years to ten, a change critics say could discourage providers from offering care to transgender adults.
Public schools across North Carolina must also comply with new requirements. School boards are required to adopt policies generally preventing students of opposite biological sexes from sharing sleeping quarters during overnight activities, with limited exceptions for immediate family members or cases where written parental consent is provided. Students or parents may also request exemptions from classroom activities or assigned readings they believe burden their religious beliefs.
School systems are also required to make library catalogs publicly accessible online and to honor parental requests restricting which books a student may borrow. Civil rights organizations warn these provisions may be used to challenge or remove materials addressing LGBTQ+ identities and experiences.
While the bill’s original language focused on preventing sexual exploitation in online pornography, those provisions are now embedded within a law that also carries wide-ranging consequences for transgender people and public schools. The statute does not address intersex individuals, leaving unanswered questions about how the new sex definitions apply to people born with variations in reproductive anatomy.
The bill was vetoed by North Carolina Governor Josh Stein before lawmakers overrode his decision.
“My faith teaches me that we are all children of God no matter our differences and that it is wrong to target vulnerable people, as this legislation does,” Stein wrote, calling the LGBTQ-related provisions “mean-spirited.”
The North Carolina General Assembly overrode the veto in late July. As the law takes effect, advocates say focus will now turn to how its provisions are enforced, how agencies implement the changes, and whether legal challenges follow.