TRANSGENDWars Are Undermining American Health Care

These are dark days for American transgender citizens. In the past three months, The New York Times reports, 10 Republican-led states have passed laws banning gender-affirming care for minors. Thirteen states now have bans, and more are in the works.

Many on the right  are using familiar language in this quest. Perhaps most ominously, Daily Wire host Michael Knowles said, “For the good of society, ‘transgenderism’ must be eradicated from public life entirely.” The call was met with rousing cheers at CPAC, which sent a chill through many observers who were not part of the partisan crowd. What, exactly, does “eradicate” mean?

A disturbing number of states are trying to criminalize medical care for transgender youth, even though it is recommended by nearly all the prestigious groups of medical providers, including the American Academy of Pediatricians and the American Psychiatric Association (APA), as sound medical practice.

Tori Cooper, the director of community engagement for the Human Rights Campaign’s Trans Justice Initiative tells VOX, “There is an intentional effort to use misinformation and disinformation to deceive folks who don’t know any trans, nonbinary, or queer people personally to perpetuate harm and dissuade folks from living honest and true and accurate lives.”

In 2021, Arkansas became the first state to ban gender-affirming health care for transgender minors. Alabama’s ban includes making the provision of gender-affirming care a felony punishable by up to 10 years in prison. 

Roughly half the bills would bar insurance providers from offering coverage such care. A Missouri  bill would classify this care as child abuse, similar to an order recently issued in Texas.

In February 2022, the governor of Texas, Greg Abbott, issued an order restricting access to gender-affirming medical care for transgender youth—including the use of hormones to delay puberty and to promote physical development that is consistent with a child’s gender identity. The order calls such care “child abuse,” and orders Family and Protective Services to investigate any reported instances of health-care providers or parents who seek such care for children.

Texas political scientist Richard Murray, a senior researcher at the Hobby School of Public Affairs at the University of Houston, says that last year’s Texas state legislative session was “the most extreme session in modern Texas history. I’ve been here since 1966 and nothing was comparable in all of those years.”

Republicans have long been active in using LGBTQ issues as political wedges to hammer Democrats, but since gay marriage was recognized in 2015, “gays and lesbians aren’t scary anymore,”  Maria Gonzalez told the Texas Tribune. (She is a member of the Texas Transgender Nondiscrimination Scholars in Houston.)  A new target was needed, she said, so the right began to focus on transgender people. “It’s hard enough to raise a human being in Texas, but Texas just continually tries to make it harder.”

Politicians looking for ways to whip their right-wing voters into a frenzy simply rely on outright lies in their proposals. For example, the Texas bill implies that young children will receive surgery but, in fact, surgery is offered only for those who are legal adults, and after years of treatment. An Alabama bill states that those who undergo cross-sex cosmetic surgical procedures have been found to suffer from elevated mortality rates, higher than the general population. “They experience significantly higher rates of substance abuse, depression, and psychiatric hospitalizations,” the legislation reads. Not so.

The Centers for Disease Control and Prevention found that people who have gender-affirming surgery had significantly lower odds of psychological distress, tobacco smoking, and suicidal ideation compared with trans people with no history of such surgery.

Many Republicans are now making attacks on transgender people a central core of the culture wars prior to the 2024 elections. Senator Rand Paul ranted on the Senate floor, “You’re willing to let a minor take things that prevent their puberty and you think they get that back? You give a woman testosterone enough that she grows a beard, you think she’s going to go back looking like a woman when you stop the testosterone? You have permanently changed them.”

 Again, not so. Pre-adolescent children begin taking puberty blockers, which constitute a safe and reversible approach to halting puberty, notes the health website Stat

“Puberty blockers are fully reversible, cause few side effects, and have an overtly positive impact: They significantly reduce suicidal thoughts among transgender youths. The potential long-term side effects — infertility and bone density issues — are monitored by physicians through regular checkups. Contrary to Paul’s sensationalized assessment, puberty blockers for youths only present well-studied, monitorable side effects.” 

In Texas, however,  these facts have not calmed the culture wars, UPI reports. 

The mother of a 15-year-old transgender boy got a call from his doctor. “He calls from his personal number, calls my personal number [and] doesn’t use my child’s name because he’s scared somebody is recording the conversation,” the mother said.

The doctor told her he could no longer prescribe her son’s treatment. The medical malpractice insurance carrier, he explained, had stopped covering doctors who offered hormone therapy to minors. 

The attacks on transgender people and the lies that accompany them have stirred up a pattern of hate crimes and even murder.

“The media has rightly given attention to the increase in murders of transgender women of color,” said Andrew R. Flores, Affiliated Scholar at the UCLA Williams Institute. “Our study shows that both transgender women and men are also highly vulnerable to non-fatal physical and material victimization.”

The whole saga seems like a page out of George Orwell’s dystopian novel 1984. A mother takes her transgender child to a highly respected Medical Center for the most up-to-date treatment, and she’s called a child abuser, branded as a criminal and faces the threat that her child will be taken away by the state.

If you have a transgender child, Big Brother is watching—from the state house!

About the Authors: Dr. Rosalind  C. Barnett is a senior scholar at the Wellesley Centers for Women at Wellesley College and Caryl Rivers is a professor of Journalism at Boston University. They are the authors of The New Soft War on Women. (Tarcher/ Penguin.)

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