The sponsor of a bill that passed the Idaho House earlier this month said gender-affirming care for kids was tantamount to “sterilizing and mutilating children.” The governor of Texas last month ordered the state agency directing child protective services to investigate families of transgender kids for child abuse. The author of a bill in Alabama prohibiting trans people under the age of 19 from receiving gender-affirming care compared that treatment to vaping and drinking.
2022 has seen a storm of anti-trans legislation and orders all over the country, with lawmakers and state officials framing healthcare for transgender minors as inherently violent and dangerous, and portraying their opposition to transgender girls in sports as an issue of basic gender equity. And LGBTQ+ advocates say the push has only served to demonize transgender people and terrify the very children and families these lawmakers claim they want to protect.
There are 41 active bills in 22 states that would exclude transgender girls from school sports, and 29 bills active in 16 states restricting gender-affirming healthcare for minors, according to the Equality Federation, which tracks LGBTQ+-related legislation. More than 100 anti-transgender bills have either been introduced or seen movement this year.
So far, one state—Arkansas—has passed a law banning gender-affirming treatments for minors, over the veto of GOP Gov. Asa Hutchinson. Nearly a dozen states, all of them Republican-led, have banned trans high school athletes (and college athletes, in some cases) from participating in sports consistent with their gender identity. These laws largely target girls, but some states ban boys as well.
The language of such bills and the legislators who back them portray transition care for kids as overwhelmingly irreversible. But providers say procedures such as surgeries are very rarely performed on minors, while teenagers spend years on reversible puberty blockers before being permitted to move onto hormone therapy—and major medical groups such as the American Academy of Pediatrics and American Medical Association have opposed bills that limit gender-affirming care.
“It feels like the [Idaho bill] sponsors made it seem like people pull up to some sort of doc-in-a-box in a strip mall…that’s not the case,” Mistie DelliCarpini-Tolman, the Idaho state director for Planned Parenthood Alliance Advocates, told VICE News last week. “Everything is highly personalized, everything is informed consent-based, and those are decisions we feel are best left to be made between medical providers, families, and trans youth at the center of that.”
In Alabama, the House has passed bills in recent months that would require K-12 bathrooms and locker rooms to be marked on the basis of gender assigned at birth and prohibiting doctors from prescribing hormone therapy and puberty blockers to people under the age of 19—meaning not only children, but people legally considered to be adults would be barred from receiving gender-affirming care.
Rep. Wes Allen, the sponsor of the latter bill, compared the need for the proposal to states banning “vaping [and] drinking,” while Rep. Scott Stadthagen said his bathroom bill was needed to ensure privacy rights and prevent “men’s assault on girls.”
Such bills are all part of a “national campaign to regard these children as a security threat,” according to National Women’s Law Center press secretary Gillian Branstetter.
“The language that I think best describes it is a ‘purge,’” Branstetter said. “The right wing in this country is absolutely terrified by the very idea that you could be trans and happy.”
“It’s a threat to the very strict gender roles that live at the heart of their worldview. And they believe their top priority must be erasing trans people from public life in every avenue they can find.”
The wave of legislation, which doesn’t even count state-level orders such as the one issued by Gov. Greg Abbott in Texas, has been accompanied by a surge in demeaning rhetoric about transgender people in general.
Last week, for example, Texas Attorney General Ken Paxton—whose office eagerly provided the legal underpinning for Abbott’s order last month—posted a screenshot to Twitter of Dr. Rachel Levine, the Biden administration health official who’s been named as one of USA Today’s “Women of the Year,” and added: “Rachel Levine is a man.”
The trend is also not limited to state-level Republicans. Last February, during Levine’s confirmation hearing, Sen. Rand Paul of Kentucky compared transition surgery to “genital mutilation.” And in February, U.S. Rep. Marjorie Taylor Greene, responding to since-disproven claims that a transgender camp counselor had slept in the same cabin as cisgender girls, bragged that if her family ever found themselves in a similar situation, her husband would have “beat him”—a hypothetical transgender woman—“into the ground.”
Chelsea Gaona-Lincoln, Idaho program manager for Legal Voices and a former candidate for the Idaho House, told VICE News that the attacks on trans people are intended to “erase the existence of trans folks.”
“They compile it into a fictional morality issue,” Gaona-Lincoln told VICE News. “They just continue to further stigmatize and build off of that fear they’ve already inserted in people.”
In the years following North Carolina’s House Bill 2, which passed in 2016 and was partially repealed in 2017 after a year of boycotts that cost the state billions, conservatives in the states had an ally in the White House—former President Donald Trump reversed an Obama-era public facilities policy for transgender students almost immediately after taking office—and there appeared to be a relative decrease in state-level action discriminating against trans people.
Beginning in 2020, however, states were flooded with all sorts of legislation targeting transgender people, from a Tennesee “bathroom bill” to Arkansas’ ban on gender-affirming care, both of which have been blocked in the federal courts. The most salient attack has come on the issue of transgender athletes. Nine states either passed legislation or enacted executive orders in 2021 barring transgender girls from playing sports, and more have followed this year.
All indications are that the policy issue such legislation claims to want to fix is not common. In his veto message to legislators, Cox, the Utah governor, said that there are only four transgender athletes currently playing high school sports in the state, and just one of them is a girl.
“Rarely has so much fear and anger been directed at so few,” Cox wrote. “I don’t understand what they are going through or why they feel the way they do. But I want them to live. And all the research shows that even a little acceptance and connection can reduce suicidality significantly.”
But such bills have nonetheless been passed at a swift rate in Republican-led states. Idaho passed such a law in 2020, introduced by state Rep. Barbara Ehardt, a former women’s college basketball coach at Cal State Fullerton. Ehardt told Bloomberg Law in 2020 that the right-wing legal nonprofit Alliance Defending Freedom, which she described as a “pro-family group,” helped her write the legislation.
The group is perhaps best known for its efforts to restrict abortion and representing at the Supreme Court a Colorado baker refusing to make cakes for same-sex weddings, but the Arizona-based ADF has long played a key role in fighting protections for transgender people of all ages, both in the courtroom and in legislatures around the U.S. The ADF sued the city of Houston over its 2014 nondiscrimination ordinance, for example, and sued in defense of North Carolina’s House Bill 2.
Like the “bathroom bill” debate before it, the ADF and Idaho created something of a template for anti-trans rights legislators around the country; of 71 similar bills introduced in state legislatures during 2021, a USA Today analysis found, more than half included at least one element of the ADF template.
The ADF’s goal is to see these laws implemented at every level. A February blog published to the ADF website criticized legislation that didn’t include a ban at the collegiate level as a capitulation to “powerful lobbyists employed by progressive state colleges,” and said that “every female athlete deserves to compete on a fair and level playing field—from kindergarten to college.”
Ehardt has since lobbied in support of similar bills in states like Montana, where she testified earlier this year that without legislative action, “it will come to the day where there will be no room, no place, for girls and women to compete.”
The bill passed in the Idaho House last month would make providing gender-affirming care to kids punishable by up to life in prison. The author of the bill, Rep. Bruce Skaug, compared the care to getting a tattoo, smoking, and “mutilation.”
“If we do not allow minors to get a tattoo, drink alcohol, smoke cigarettes, sign a legal contract, why would we allow them to go through these physical mutilations because of their feelings during puberty time?” Skaug said during a floor debate.
“There’s a lot of sentiment behind it for religious reasons, but at the end of the day, it’s just completely dehumanizing,” Gaona-Lincoln said of the flood of bills targeting transgender people in Idaho. “And they continue to try to turn up the heat wherever they possibly can.”
These actions are wrapped in the language of fairness and safety for cisgender girls. South Dakota Gov. Kristi Noem, a Republican who’s been rumored to have presidential aspirations, ran a national ad for her re-election campaign earlier this year saying she “has been protecting girls sports for years,” and championed a bill—which later passed—she said “would give South Dakota the strongest law in the nation protecting female sports.”
By insisting that transgender girls and women are in fact boys and men, the bills and laws also fundamentally deny the legitimacy of transgender identity. A bill in Kentucky which has passed the state Senate and a key House committee would designate athletics “based upon the biological sex of the students eligible to participate,” and “prohibit male students from participating in athletic teams, activities, and sports designated as ‘girls,’” according to a summary of the bill by its authors.
Branstetter said that the right has exploited the issue of transgender athletes, such as University of Pennsylvania swimmer Lia Thomas, to “drive a wedge between the empathy of the broader public and trans people’s existence.”
“They are eager to try and prove that trans rights come at the expense of other people,” Branstetter said. “And they latched onto athletics because there are always winners and losers in athletics.”
Delaware state Sen. Sarah McBride, the highest-ranking transgender elected official in the U.S., chaired a state Senate Health Committee hearing Wednesday in which a bill barring transgender girls from playing on teams consistent with their gender identity was heard.
During the hearing, one witness compared transgender girls playing youth sports with Jim Crow laws, while another claimed—without evidence—that cisgender boys “might be encouraged or even forced to undergo genital mutilation, such as surgical removal of testicles, so that they could more successfully compete as girls or women.”
“The preoccupation with trans kids’ bodies reduces trans people to abstract concepts,” McBride said. “It makes it easy to forget that we’re talking about real people. Real young people. Being a trans kid in a world that so often rejects who you are is already hard enough. I don’t understand why we would pass a law that makes their lives even harder.” More than half of transgender youth said they contemplated suicide in 2020, according to the Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health.
“The collection of these bills nationally seeks to strip away any layer of support that a trans kid may have—parents, doctors, therapists, teachers, [and] in this case coaches and teammates—leaving trans kids isolated,” McBride said. “The outcome of that strategy is to make life so difficult for trans kids, to make them feel so alone, that some never grow up to be adults.”
But advocates for bills attempting to end transition care for transgender youth are portraying gender-affirming care as abusive and violent.
Tennessee state Rep. John Ragan introduced a bill this year called the “Youth Health Protection Act,” which is currently in committee. The bill would make it illegal for medical providers to provide gender-affirming care such as puberty blockers to patients under 18, or as the legislation puts it, “to facilitate the minor’s desire to present or appear in a manner that is inconsistent with the minor’s sex.”
“Children at that age are incapable of understanding the consequences of their decisions,” Ragan told a local chapter of the League of Women Voters earlier this month.
Katherine Croft, the program manager of the University of North Carolina School of Medicine’s transgender health program, told VICE News that medical decisions are “complex,” even for adults, which informs how the center treats transgender children.
“When it comes to minors and transitioning, medical intervention is actually really limited,” said Croft, a registered nurse. Children who haven’t yet reached puberty are provided with “mental health support and social support,” she said, while undergoing a social transition that can include changing names, pronouns, and gender presentation.
Croft said that at her clinic, hormone therapy is only prescribed to adolescents who’ve already spent two years on puberty blockers, which are reversible and already used to treat minors who hit puberty too early. More generally, mastectomies for people younger than the age of 18 are rare and only done in private practice—UNC does not perform this procedure on children, Croft said—and genital surgery is never performed on minors.
The care transgender adults receive also often has substantial barriers to access, including cost and long wait times. UNC is the only provider within hundreds of miles which offers phalloplasty procedures, and although UNC’s program, which is fairly new, has a waiting list approximately three months long, Croft said that’s relatively short compared to other programs.
“There are so few providers, even nationally, that are doing these procedures in the first place,” Croft said.
In Idaho, the bill targeting transgender minors and their families is dead—for now, at least.
In a statement last week, Republican Senate leaders cited the Idaho Medical Association, which confirmed that minors receiving gender-affirming surgeries “is already outside the generally accepted standard of care and is not being done by physicians in Idaho.”
Gaona-Lincoln said that mental health providers for LGBTQ+ youth in Idaho are hearing “a great deal of relief from their adolescent clients” since the bill was tabled, but the damage for some had already been done; one medical provider in the state has treated at least three transgender youth for suicide attempts since the legislation was introduced, Gaona-Lincoln told VICE News.
“We’re excited to celebrate HB675 being held,” Gaona-Lincoln told VICE News in an email last week. “But we know it’s not the last battle in Idaho where members of our LGBTQI+ community will have to attempt [to prove] their humanity.”
If you or someone you know is considering suicide, help is available. Call 1-800-273-8255 to speak with someone now or text START to 741741 to message with the Crisis Text Line.
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