On Saturday, Governor Spencer Cox of Utah signed a complete ban on hormone replacement therapy and gender affirming surgery for transgender youth in the state. The bill targets the most vulnerable kids in our country, who face the highest rates of suicide of any group, but to hear him say it, he’s really doing it to protect kids. Yet he had to lie outright to try and make that point.
“More and more experts, states and countries around the world are pausing these permanent and life-altering treatments for new patients until more and better research can help determine the long-term consequences,” Cox said, despite the fact that (1) hormone treatment is not permanent but reversible, and (2) the experts uniformly agree that such measures are of tremendous benefit to trans youth.
Seeming to acknowledge that he was doing something truly awful, Cox continued, "While we understand our words will be of little comfort to those who disagree with us, we sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures.” But “love and respect” are the furthest things from what is being offered. And again, the science and consequences of this bill are already clear: The lack of treatment options within the state for trans youth will lead to higher rates of depression and suicide.
This is the first bill of its kind this year but certainly not the last. So why are red states rushing to enact such laws? Why are they ignoring the experts and punishing families who just want to help their already hurting kids? Why take away medical options from the most vulnerable among us? Let’s take a look at what and more importantly who is behind these anti-trans laws.
Far-right Christian extremists are pushing copycat legislation
In 2021, the Southern Poverty Law Center (SPLC) reviewed the origin and driving forces behind scores of anti-trans bills filed in 28 states last year. (The number this year already tops 120.) The bills fell into two general types: those seeking to prevent trans kids from competing in sports as the gender with which they identify, and those seeking to outlaw or criminalize gender affirming care for youth and even adults. (Earlier anti-trans bills targeted the use of public facilities by trans people.)
SPLC reported that groups such as the ironically named Alliance Defending Freedom have created “model legislation” and are assisting anti-trans legislators to craft their bills and providing attorneys to defend these bills in court. Other extremist groups pushing the anti-trans agenda include the Heritage Foundation, the Family Policy Alliance, and The Family Research Council. All are deeply involved in efforts to demonize trans people and criminalize trans health care.
In short, this is not some grassroots movement of concerned parents. It is instead a prime example of “astroturfing”—making it appear that local concerns are driving interest and policy, when in fact these bills are being shaped, guided, funded, and pushed from specific organizations with specific extremist agendas.
They are using time-tested wedge tactics
When the anti-trans bathroom bills of the last decade faced a public backlash, the far right workshopped a new approach. This time, they would co-opt members of the left to argue against trans inclusion and to play upon imagined “unfairness” in sports to get parents on their side. This was a classic “wedge” move because it sought to pit parts of the left against one another on a hot button issue. This time, they succeeded.
In the public discourse around trans rights, there are now anti-trans “feminists” such as J.K. Rowling and anti-trans gay, lesbian or bisexual celebrities such as Martina Navratilova willing to make the far-right’s talking points for them. The idea that trans women present a threat to female identity and women’s sports in general may seem absurd, but to hear the press and certain celebrities talk about it, you might think every aspect of our society is under dire threat.
Most Americans, however, cannot name a single trans person with whom they have a close personal or work relationship. In Utah, they even passed legislation in search of an entirely imaginary problem: When the legislature overrode Gov. Cox’s veto of an anti-trans sports bill last year, there was only one student who identified as a trans girl out of the 80,000 who were competing in sports. Yet the legislature devoted itself to this issue as if it were its most pressing priority.
To gin up public interest and fear, the right has trotted out athletic coaches, a dad seeking parental rights over a transitioning child, and “experts” in sports or law to testify at public hearings using language and talking points that mischaracterize and misgender, such as “biological males” instead of trans girls or trans women. The result is a kind of “trans panic” with extremist legislators falling all over themselves to pass ever increasingly harsh bans and criminalizations.
Why are they doing this?
There is a general sense, even among radical Christian extremists, that the right has lost the battle over gay rights, with most American now in favor of keeping same-sex marriage legal and providing anti-discrimination protections for gay people. So they have very intentionally staked out a new battleground in the culture wars: gender identity.
For starters, targeting people who are vulnerable and different is nothing new, and doing so in the name of “protecting the children” is such a cliche that the media ought not to give it breathing space. But “mainstream media” never fails to disappoint in its coverage of “the trans question” or “the trans issue.” (Imagine for a moment any other minority group, such as Jews or Blacks, being so discussed and analyzed by the media.) Meanwhile, hate groups continue to fearmonger about trans people as predators and groomers while raking in small dollar donations to assist in their efforts to “keep the children safe.” (I should note here that recent calls to #SaveTheChildren dovetail with dangerous and delusional conspiracies such as QAnon—and the Christian right is well aware of the swamp from which it is cultivating its new culture warriors.)
What DO the experts say?
Because political leaders like Gov. Cox cite “experts” as justification for signing the anti-trans healthcare bill into law, it’s important to lay out what the actual experts say on this.
The American Academy of Pediatrics cites gender affirming care as “developmentally appropriate care that is oriented toward understanding and appreciating the youth’s gender experience.” Such care for kids suffering from gender dysphoria sometimes includes puberty blockers which are actually safe, effective, and fully reversible.
The Endocrine Society came out strongly against legislative efforts to block or criminalize gender affirming healthcare. “When caring for transgender and gender diverse youth, physicians and mental health professionals must be able to freely practice and choose the best available treatment options in consultation with the patients and their parents, as they would when treating any other condition.”
The American Medical Association blasted these bills as “a dangerous legislative intrusion into the practice of medicine,” while noting that it “has been working closely with state medical associations to vigorously oppose them.” The AMA has informed legislators across the country that it is “imperative that transgender minors be given the opportunity to explore their gender identity under the safe and supportive care of a physician.”
What can we do?
I’m going to editorialize here a bit more than usual. My nephew is a trans teen. He suffers from depression, and gender affirming therapies are the reason he is still with us today. So this is personal to me. I spend my free time volunteering for the Human Rights Campaign, which is battling against these anti-trans laws in every corner of this country.
The first responsibility we as participatory citizens have is to understand how many of us are simply being played. When we hear friends or family talking about how they don’t want to see “biological boys” playing on girls’ sports teams, we shouldn’t let it slide. We can point out that these are laws in search of a problem because the number of kids this affects in the state can literally be counted on your hands, but the damage it causes to trans youth who are stigmatized and bullied and increasingly suicidal is very real.
We can point out that using misgendering language is both deceptive and hateful. Let kids play, let kids be themselves. And don’t let them use edge cases about athletes in swim meets to justify discrimination on a massive scale. That’s not so different than how the right seeks to demonize whole groups of people by citing single examples.
When we hear “feminists” argue that trans people are “erasing women,” call this out as well. The struggle of women for equality—in pay, in position, and in control over their own bodies—is not under attack by trans people. It is cisgender men who are making the rules and passing these laws, including laws criminalizing abortion. We cannot allow ourselves to be distracted or even duped into thinking trans people present the true threat. They cannot be the party of freedom while taking away the right of parents to care for their children in consultation with their family’s doctors.
The culture war the right has ignited is also deeply cynical and self-serving, which is also a point we should make right away. Why, all of a sudden, is everyone freaking out about trans people? Like gay people, trans folks have been a part of our social fabric since the earliest of human societies. The panic of today is deliberately generated by the right, and they are doing it to drive dollars and motivate their base around fear, hate, and intolerance.
And we shouldn’t believe them when they say they want to protect the children; if they really did, they’d listen to the experts who work with such children daily. Show up at school board meetings and legislative hearings to make your voices heard. And of course, when given the chance to support groups like the Human Rights Campaign, the ACLU, or others on the front lines fighting for trans kids and their families, step up with donations if you’re able to.
We need to stand with the trans community. Not other them. Not draw exceptions to make rules. This is a defining human rights issue of our time, the kind that I hope in 20 years people will look back upon with shock and horror at what the bigots and the fearmongers did. We must stand on the right side of this history and of human rights, without exception, leaving no one behind.
As a practicing physician I can say very strongly and emphatically that politicians should stay out of the doctor's exam room. Ron DeSantis, Ted Cruz, Spencer Cox and the others have no business interfering with the doctor-patient relationship. They want 'freedom' only when it involves guns, vaccines or wearing masks. Complete hypocrites! Just reprehensible!
One thing is incontrovertible: that party as an entity in no way, no form, no nuance protects children, but weaponized the notion of children to raise money and ire.
I am not a developmental psychologist, an evolutionary biologist, a pediatrician, but in general it is understood that we are not a static species, and we respond epigentically, genotypically, phenotypically, psychosocially to pressures/influences exerted upon us by our environment. We are fluid and dynamic.
We no longer have to strictly hunt and gather in order to ensure propagation of the species.
Our success as an organism allows our psychoneurogenesis to proceed, perhaps in a manner outpacing our functional biology.
Of course, this is just speculation, but we are exploratory, inquisitive and curious creatures; for our fellow humans to seek a pejorative construct for this natural and human inclinations speaks to the baser component of our lot.
We must consistently and unabashedly decline to tolerate that contrived crap.