Further Comment: What’s at Stake for the Transgender Community

Families in the transgender community are readying themselves for a heated 2024 presidential election. Transgender rights are undeniably under attack, and fear runs rampant in this community. Supporting the right candidate is more important than ever, and one of the top priorities for transgender voters and their loved ones is gender-affirming care.

As 2023 came to a close, conservative legislators continued pushing restrictions on federal funding to block supportive policies for transgender children, including gender-affirming care. This follows a steady increase in these types of legislative attacks, including the introduction of more than 500 anti-trans bills in state legislatures across the country last year alone.

During this presidential race, several Republican candidates, many who have since dropped out, vowed to ban gender-affirming care if elected, including Vivek Ramaswamy, Florida Governor Ron DeSantis—who pushed for that state’s infamous “Don’t Say Gay” legislation—and former Vice President Mike Pence.

As a queer voter, I worry about protecting the progress we’ve seen under the current administration of President Joe Biden.

I grew up as a transgender kid in a small, rural, Wisconsin town where locals were more concerned with deer-hunting season and getting to church on time than discussing topics like human rights for the transgender community. The first time I met a gay person was in high school, long before I would find the words to describe my own gender dysphoria and sexuality. I believe this was a direct result of the conservative and patriarchal culture of my hometown.

In such a setting, it seems to me that many children were parentified in large family structures. They had to care for younger siblings and were cheated out of their childhoods, used as free labor, and coached into growing up with conservative political views.

According to a recent analysis by the Pew Research Center, “70 percent of white, born-again or evangelical Protestant parents said it was extremely or very important for their children to hold similar religious beliefs, compared with just 8 percent of religiously unaffiliated parents.” As I reflect on my religious upbringing, I can now clearly see the effect of such children growing up to be politically active conservative adults.

A survey by NBC News last year asked respondents if they wanted the country to “become more tolerant and accepting of the LGBTQ+ community.” The percentage of Republicans who responded affirmatively—38 percent—was far lower than that of Democrats and Independents. This is one reason the issue of transgender rights affects where my transgender friends and their families choose to live.

In 2023, the Republican-dominated Wisconsin State Assembly approved restrictions on transgender athletes in high school and college and banned gender-affirming surgery for minors. Thankfully, Democratic Governor Tony Evers has vowed to veto any such bills, but the fact that this type of legislation can make it through the state’s legislature is terrifying. Many other states have also passed or are considering similar discriminatory laws to appease conservative voters.

As Faith E. Pinho notes in the Los Angeles Times, “After the Supreme Court legalized same-sex marriage in 2015, much of the national conversation around LGBTQ+ rights shifted to focus on transgender rights.” And, as ABC News observes, the issue that has garnered “the most attention among the prospective primary field is transgender rights.”

If we let this first domino fall with a ban on gender-affirming care, I fear that the flat-out criminalization of being transgender or gay could follow.

In basic terms, any child or teen who is diagnosed with gender dysphoria—a feeling of distress by people whose gender identity differs from their sex assigned at birth—or who simply doesn’t identify with the gender they were assigned at birth, can use the label transgender.

CNN’s Devan Cole points out that “major medical associations agree that gender-affirming care is clinically appropriate for children and adults with gender dysphoria.” Yet for children, gender-affirming care is already limited. Prepubescent transgender children typically focus on social transitioning and puberty blockers to delay the onset of secondary sex characteristics such as the development of breasts, menstruation, a deepening of the voice, or muscle growth.

According to the Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ+ Young People, “Among transgender and nonbinary young people, 11 percent reported being on gender-affirming hormones, and 2 percent reported taking puberty blockers; 65 percent who were on gender-affirming hormones were somewhat or very concerned about losing access to this care.”

In my experience, puberty blockers as gender-affirming care can also be considered a part of suicide prevention efforts, because puberty can be challenging for any person’s mental or physical health, but especially for transgender children. Transgender people have one of the highest suicide risk rates of any group in the United States, because of several factors including fear of rejection, violence, and isolation. For a transgender person, being forced to live as the sex assigned at birth, without access to gender-affirming care, can be deeply harmful.

Even some of the types of gender-affirming care for people under eighteen that Republicans want to ban are limited to a person’s appearance, such as hormonal replacement therapy, which is reversible. “Surgical interventions,” Cole writes, “are not typically done on children and many health care providers do not offer them to minors.”

Children receiving gender-affirming care do so with parental consent, and after many counseling and therapy appointments, both one-on-one and in group settings. Parents are present for some of these sessions, but not all of them.

I have found that transgender youth are turning to online forums, such as Facebook groups, Reddit, and Quora, to understand what is at stake in terms of their rights. One of their top concerns is a possible federal ban on insurance coverage of gender-affirming care.

If we let this first domino fall with a ban on gender-affirming care, I fear that the flat-out criminalization of being transgender or gay could follow. This is why progressives need to hold the line with transgender youth, and why we must vow to protect them. Protecting people is why we protest. This issue is just as important as protecting the reproductive rights of all Americans. It’s all about keeping kids alive and families together.

The 2024 presidential election is important. In communities small and large across the country, transgender youth are speaking out. Their rights and their voices matter, and they deserve to be heard.