Trans rights

For the last few years, the GOP has coalesced around an idea that would short-circuit essentially all trans health care in America: banning federal funds from going to businesses that provide health care specific to changing one’s sex or gender identity, including hormones and surgeries. It would essentially signal to the private sector that if it wants federal dollars, it needs to stay away from sex- or gender-affirming care, and bow down to right-wing pundits who aim to, in their own words, “eradicate” and “erase” this form of health care. 

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Bans like these can lead to the private sector discontinuing behaviors altogether — and once they are in place, they are hard to get rid of: The Hyde Amendment, enacted in the 1970s, led to most abortions no longer being performed in hospitals, and is continually renewed each year. 

Medical groups and civil rights advocates in D.C. tell Rolling Stone they believe that if a Hyde-level ban on federal funding were enacted, many hospitals will simply prioritize federal dollars over continuing this highly specialized form of medical care. So much medicine is performed through hospital systems and universities that this could mean ending access for many.  

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“I think if they had to make the choice of, ‘Do we provide this care and potentially have to close our doors to everybody,’ they probably won’t do it,” says Asa Radix, head of the World Professional Association for Transgender Health. “It’s very disturbing. Legislation like this — even if it hasn’t passed — creates an environment where people are incredibly afraid. This is the type of issue where people actually feel suicidal. Are we going to see folks dying by suicide because potentially of laws like this being passed?”

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Right now many in the LGBTQ+ advocacy community, as well as some Democratic lawmakers and staff, are quietly terrified the party might let Republicans enact it anyway, should they be forced to choose between funding the government or allowing the medical system to continue to provide this care unabated. 

At a minimum, anxious Democrats and advocates believe that party leaders will capitulate on trans health care coverage in federal funding negotiations on the margins, allowing language that bans government-backed insurance plans from covering these services. 

This conflict is actually playing out before Trump has taken office or the GOP controls the Senate. Democrats just this week compromised on a military authorization bill that will ban TRICARE and other Defense Department health plans from covering care for servicemembers’ trans children.

Erin Reed, a transgender rights activist and writer, tells Rolling Stone that it’s an absurd distinction. There is no difference between a ban on “transgenderism” and an attack on transgender people, she says: “They are one and the same, and there’s no separation between them.”

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 “I called to ban transgenderism entirely … They said that I was calling for the extermination of transgender people. They said I was calling for a genocide … One, I don’t know how you could have a genocide of transgender people because genocide refers to genes, it refers to genetics, it refers to biology,” Knowles said, ahistorically.

“Nobody is calling to exterminate anybody, because the other problem with that statement is that transgender people is not a real ontological category — it’s not a legitimate category of being,” Knowles continued. “There are people who think that they are the wrong sex, but they are mistaken. They’re laboring under a delusion. And so we need to correct that delusion.” 

Carl Charles, a senior attorney at the LGBTQ rights group Lambda Legal, noted that Knowles’ goals are clear, even as he muddles the meaning of his words. “At the end of the day, it doesn’t really matter if by using the inflammatory term ‘eradicate’ Mr. Knowles specifically meant trans people should be killed. What does matter is the reality of what he is saying and the impact it is having and will have at this particular moment in history,” Charles says. “He is advocating that trans people should not be free to live their lives with dignity and autonomy like Mr. Knowles presumably does —  instead, they should be relegated to non-existence: carrying on in secret and shame and living a lie for the rest of their days, which, he must realize, will mean some trans people opt not to do.” 

Slimy git.

Streeting acknowledged that the decision would not be welcomed by everyone but sought to reassure young trans people. He had met many of them since taking up his post in July, he said, and listened to their concerns, fears and anxieties.

In a message directly to them, and referencing having come out as gay, he said: “I know it’s not easy being a trans kid in our country today, the trans community is at the wrong end of all of the statistics for mental ill health, self-harm and suicide.

“I can’t pretend to know what that’s like, but I do know what it’s like to feel you have to bury a secret about yourself, to be afraid of who you are, to be bullied for it and then to experience the liberating experience of coming out.

“I know it won’t feel like it based on the decisions I’m taking today, but I really do care about this and so does this government. I am determined to improve the quality of care and access to healthcare for all trans people.”

Decisions were being taken “based on the evidence and advice of clinicians, not politics or political pressure”, he added.

The BBC has published an article by Deborah Cohen on the NHS puberty blocker trial that is due to begin in 2025. In this article, Cohen quotes a member of conversion therapy activist parent organisation Bayswater Support Group as a neutral source.

The article is heavily weighted with those opposing trans healthcare for children and young people. It quotes WPATH, yet all of the other medical opinions are from those opposing the use of hormonal treatments. The section on parent opinions includes an academic whose research involves parents of young trans people, but no quotes from supportive parents themselves.

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Bayswater Support Group are a conversion therapy parent group operating under the guise of a support group for parents of trans children. The organisation's internal forums were exposed earlier this year which uncovered evidence of parents preventing their children from accessing Childline, mental health resources and rape crisis centres for fear of those services affirming their children's gender identity. Parents in the forum openly admitted to destroying or damaging their children's belongings, such as accessories and clothing, behaviour that constitutes domestic abuse. Bayswater support group still link to a DIY conversion therapy manual on their website.

Some world-class hand-wringing going on in Washington. Take that, fascism! We are resolute in our misgivings about supporting you every step of the way!

The 2025 NDAA, which authorizes an astronomical military budget of $895 billion, contains numerous policy items including a 4.5% pay raise across the board, a more substantial 14.5% raise for junior service members, and over $600 million in military funding for Israel. It also includes multiple sections that would place new restrictions on gender-affirming medical care for military families on government TRICARE health plans, the military’s health insurance program for active duty members. Under Sections 708 and 709 of the bill, no Department of Defense funds or facilities may be used to “perform or facilitate sex change surgeries,” and TRICARE plans may not provide hormone therapy, puberty blockers, or “other medical interventions for the treatment of gender dysphoria that could result in sterilization” to anyone under 18. (Right-wing sources have increasingly pushed false and misleading claims that puberty blockers and hormones lead to sterilization.) Another section would prohibit the Department of Defense from establishing any new positions “relating to diversity, equity, and inclusion,” or from adding those responsibilities to existing DoD positions.

On Wednesday, members of the House approved the NDAA in a 281-140 vote, CBS reported. 81 Democrats voted in favor of the budget, while 16 Republicans voted against it. The bill will now be sent to the Senate for another vote.

Normally, party leaders “whip” members into voting one way or another based on their party’s collective goals — but House Minority Leader Hakeem Jeffries said he would not whip Democratic votes for or against the NDAA on Wednesday, even though the bill contains overtly anti-trans policy (for the second year in a row). “We’re not whipping on the National Defense Authorization Act. It’s a member-to-member, case-by-case analysis in terms of people making decisions as to what is the right thing to do,” Jeffries told reporters ahead of the vote, according to The Hill. Jeffries added that the bill contains “a lot of positive things” but “some troubling provisions in a few areas, as well.” The New York representative slammed Republican extremism in a press conference on Wednesday, but also told reporters that he and his party “are ready, willing and able to find bipartisan common ground with the incoming administration on any issue.” Jeffries was among the 81 Democrats who voted in favor of the NDAA on Wednesday.

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In a series of Bluesky posts on Wednesday, Virginia Rep. Bobby Scott called the gender-affirming care ban “reprehensible” and called on Republicans to “prioritize national security and servicemembers, not culture wars,” but voted in favor of the bill that day. As The Hill reporter Brooke Migdon observed, 50 other Democrats who signed a September letter denouncing the NDAA’s anti-LGBTQ+ provisions voted to advance it this week.

The World Professional Association for Transgender Health said the refusal or withdrawal of HRT for trans patients raised “ethical and clinical” concerns.

“Hormones should not be stopped for political reasons or in the absence of a recognised medical issue,” a spokesperson told TBIJ. “If GPs are withdrawing prescriptions despite recommendations, this could result in negative impacts on patients' mental and physical wellbeing.”

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The issue appears to reflect a wider rollback of access to gender-affirming healthcare in the wake of April’s publication of the controversial Cass Review into health services for trans young people. This review claimed that the evidence base of using puberty blockers and gender-affirming hormones for young people was “weak”. Some of the same medicines are used in adult care.

The review did not recommend a ban on puberty blockers but resulted in one for young people experiencing gender dysphoria (they are still permitted for children experiencing early puberty). The ban was extended by the new Labour government in August. Adult gender services are now also under review.

The World Professional Association for Transgender Health said the refusal or withdrawal of HRT for trans patients raised “ethical and clinical” concerns.

“Hormones should not be stopped for political reasons or in the absence of a recognised medical issue,” a spokesperson told TBIJ. “If GPs are withdrawing prescriptions despite recommendations, this could result in negative impacts on patients' mental and physical wellbeing.”

Puberty blockers delay the onset of puberty, but don’t necessarily result in a measurable effect at the time they are taken. The main impact is seen when people are older. The physical effects of a puberty that does not match a person’s gender can have serious negative consequences for transgender adults.

In my role as a GP, I regularly hear from transgender adults (who have not had puberty blockers) struggling with distress related to bodily changes which occurred during puberty.

I have met people who don’t speak because their deep voice causes others to make incorrect assumptions about their gender. Some harm themselves or avoid leaving the house because of the distress caused by their breasts. Others seek costly surgical treatments.

This is when the benefits of maintaining equitable access to puberty blockers for those who need them become obvious. People are seeking hormones, surgery and mental health support for changes which could have been prevented by using puberty blockers when they were younger.

The ministry’s position statement recommends that puberty blockers are prescribed by health professionals who have expertise in this area, with input from interdisciplinary colleagues.

In my experience this describes how puberty blockers are currently being prescribed in New Zealand. Clinicians are already cautious in their prescribing. They work with multidisciplinary input to best support the young person and their family. They recognise the importance of mental health and family support for young people. 

Using chaos and fear to enforce conformity:

Some bathroom bills cover all K-12 schools, colleges, and government-owned buildings or spaces. Some cover just K-12 schools, while others cover some government buildings but not others, according to the Movement Advancement Project. Proposed drag bans are similarly haphazard: North Dakota’s proposed ban characterized all drag shows as “adult-oriented,” making them equivalent to strip clubs, while West Virginia lawmakers floated a ban that appeared to criminalize transgender people being around minors, period. The net effect is that it is impossible to know for sure what is permitted and what is prohibited.

This is a feature, not a bug. Just as the earlier “cross-dressing” laws were vague enough to make any non-conformity treacherous, modern-day analogs do the same. Anyone who falls outside the mainstream of traditional gender presentations, regardless of whether they happen to also be queer, now faces heightened scrutiny thanks to a patchwork of laws across the country.

All of these laws and proposals have one goal: making LGBTQ+ people—or anyone else not wedded to traditional gender roles—feel uncomfortable and unsafe. If people feel unsafe in this fashion, they will retreat from public life or radically change their self-presentation to conform better. Conservatives are likely thrilled with either result, as in both cases, they will have robbed queer people of their ability to fully and authentically participate in society. And that’s exactly the point.

A new poll from Gallup about Americans’ attitudes around transgender rights reveals a growing distaste for far-right efforts to ban gender-affirming care.

According to the poll, six in 10 U.S. adults oppose laws banning gender-affirming care for minors.

At the same time, a slim majority – 51% – of Americans think transitioning is morally wrong. Just forty-four percent call it “morally acceptable.”

The morality of transitioning – which the survey called “changing one’s gender” – falls along partisan and generational lines.

Those who consider it morally acceptable include political liberals (81%), Democrats (72%), those who don’t identify with a religion (67%), those who don’t attend religious services regularly (59%), young adults aged 18 to 29 (56%) and college graduates (53%).

It's intentionally the opposite of public safety. It's giving violent bigots carte blanche to assault any woman who doesn't meet their expectations of femininity. It's not designed to "work"; it's designed to sow chaos and fear.

These state bathroom bans provide few, if any details about how they would be enforced because they don’t need to — private citizens are often meant to be the enforcers, said Logan Casey, director of policy research at the Movement Advancement Project, a nonprofit that tracks LGBTQ+ legislation.

“The way that the laws are de facto enforced is often through the emboldening of private individuals to police other people’s bathroom use,” he said. “There’s no written enforcement because the proponents of these bills know that just by talking about this, let alone enacting these laws, that they are emboldening individual people themselves to enforce these bathroom bans.”

A recent example that takes this formula to an extreme can be seen in Odessa, Texas. A new expansion of the West Texas town’s ordinance allows individual citizens to sue transgender people caught using bathrooms that match their gender identity and seek “no less than $10,000 in damages,” per the Texas Tribune.

Deputizing private citizens to enforce this kind of law enables high rates of harassment and violence against transgender people as well as cisgender people, Casey said, particularly women who do not conform to traditional ideas of femininity.