So far this year, Republicans have filed over 300 anti-transgender bills at the state and federal
levels, and we haven’t even reached the end of February. This list doesn’t even
include Senator Marco Rubio and Representative Jim Banks’s introduction of a transgender military ban even more draconian than the one the
Trump administration attempted to implement, which at least had a grandfather
clause for people already serving. The American Principles Project, a religious
conservative think tank and super PAC whose goal is to ban all transition-related health
care (even for adults),
is making a full-court press on Republican candidates to use
transgender people as the number one talking point during the 2024 election
cycle.
The most common type of bill, by far, involves bans on gender-affirming
care. Most of these bills target people under the age of 18, but increasingly
the bar is being raised to 19, 21, or even adults under the age of 26. Texas has just introduced a bill to
ban all treatment, regardless of age. It seems likely
that at least 10 to 13 bills will pass this year.
The chart below shows where these bills are being introduced,
and the frequency by type. The data comes from the ACLU, and
the chart was reproduced here with permission from Allison Chapman.
Accompanying each of these bills are hearings that follow an
utterly demoralizing pattern. Republican legislators first welcome “experts”
(who have never treated trans youth) from fake medical organizations. One frequent witness is a lapsed
plastic surgeon who runs a Botox clinic out of a strip mall next to a Pizza Hut. Then they feature a parent or two
who had a kid come out as trans and have grown estranged from their (now adult)
offspring because they continue to refuse to acknowledge or respect who they
are. Finally, there’s a handful of detransitioners who make the rounds, the same way ex-gays did a decade or two ago, being shuttled about by
the same organizations that paid Norma McCorvey to oppose abortion.
Almost all these individuals have been flown in from other
states by conservative organizations like the Heritage Foundation and the
Alliance Defending Freedom. The lineup rarely changes: It’s typically a sample
of the same 10 or 15 quacks and the same four or five detransitioners at every
hearing. The pattern only really changes when there are two hearings going on in
different states at the same time. What doesn’t change at all are the
half-truths, lies, and deliberate omissions used as talking points at every one
of these hearings.
It’s a Gish gallop of false information and leading questions
that could be answered or debunked with a few minutes on Google. But because
the GOP runs these hearings, and the few Democrats on these committees don’t
engage them on the facts, the lethal infection of lies spreads like Cordyceps
in a zombie movie. What makes it worse is that some of these falsehoods are
over a decade old.
For example, Republicans in these hearings still claim that
transition makes people more likely to commit suicide by citing a 2011 Swedish study by Cecilia Dhejne. Except, the
study explicitly says that you cannot reach this conclusion because there is no
control group of trans people who didn’t undergo treatment: just trans people
who underwent treatment and the public. Dr. Dhejne has gone on record saying that the study does not say
that treatment increases suicide risk.
Beyond even that, we’re friends, and I can tell you she’s disgusted by the
people who misuse her research this way.
The list goes on almost endlessly: They claim there’s no
evidence that puberty blockers are beneficial, yet here’s a list of 16 studies showing benefits. They bring up the closure of the
Tavistock clinic for transgender youth in the U.K., but leave out the part that
it was closed so new clinics acting as regional hubs could open
up scattered about the country in the interest of making care more readily
accessible. They claim that transition-related care for youth has been banned
in Sweden and Finland, but the truth is that it is still available as long as
it is part of a study.
Conservative legislators and witnesses claim desistance rates
(i.e., youth ceasing to identify as transgender) of anywhere between 80 and 97
percent. But they deliberately ignore that this does not reflect the latest
research. These numbers date back decades and are based on earlier versions of the Diagnostic and Statistical
Manual, or DSM, which allowed gender nonconforming children to be diagnosed with
“Gender Identity Disorder” even if they didn’t identify as the opposite sex.
The DSM-5 did away with that loophole in 2013, and recent studies in the prestigious Journal of Pediatrics and The Lancet using modern standards of diagnosis
both observed a desistance rate of less than 3 percent.
They frequently deride the research, claiming that there’s no
research that meets the “gold standard” of double blind with randomized control
groups. First, double blind is impossible: people notice if they do or don’t
develop secondary sex characteristics. Second, getting a control group through
a review board when you’re asking to deviate from the standards of care with
minors is exceptionally difficult. Finally, there are a handful of studies with
control groups (Mate-Kole 1990, Durwood 2017, Olson-Kennedy 2018, van der Misen 2020, and Ascha 2022), all of which found that
treatment is beneficial. Ascha’s study uses a true randomized control trial study
design, yet somehow this is conveniently forgotten when proponents of these
laws make their assertions.
Nor are they interested in learning. When medical providers
have pointed out that Sweden and Finland still allow affirming care as long as
it is part of a study, Republicans have rejected amendments to their bills to
follow the same model. They have also made it clear this is about transgender
people: Republicans have rejected amendments to their bills that would ban
breast augmentation or reduction for everyone under the age of 18, because that would mean that
cisgender girls couldn’t get “boob jobs.” Indeed, breast augmentation or
reduction is six times more common for cisgender youth than trans ones.
The sad truth is that these hearings, just like most of what
the GOP does today, is a dog and pony show. They have no interest in actual
answers. Or hearing from their constituents who would be affected by their
legislation. They cannot be bothered to learn about a topic when all their questions
have already been answered by peer-reviewed research, if they would just bother to read
so much as the abstract. This is about spreading misinformation, and giving the
appearance of doing something about the moral panic du jour.
Perhaps the worst irony in all of this is that while
Republicans are rejecting the accepted standards of medical care because they deem
the evidence insufficient, they are embracing and endorsing a model of treatment
that has no peer-reviewed supporting evidence in practice called “Gender
Exploratory Therapy” (GET) . This is essentially a rebranding of the type of conversion therapy that presupposes that some
undetermined trauma causes a person to be LGBT, and if you find and treat that
trauma the individual will stop being LGBT. Proponents of GET admit that there
are no clinical trials of their methods, and that the goal of GET is “100% desistance.”
What’s worse than sitting through hearing after hearing
featuring the recurring cast of Astroturf ideologues and grifters is how the
people opposed to this legislation are treated. The cast is different every
time, but it’s always local people whom these legislators are supposed to listen
to and represent. Panicked parents talking about how access to care saved their
child. Healthcare professionals who work with trans kids and their parents
every day. Expert researchers in the field. Trans youth talking about how
access to care has made their lives better, how it would affect them if they
lost access, and dismay at the thought of having to flee the state. They’re
disregarded or treated abominably.
Republican legislators demanding to know if transgender witnesses has a penis. Refusing to call a female physician who treats trans youth “doctor.” Assertions
that “[trans] kids don’t have a right to be treated kindly.” Calling transgender people a
“Chinese communist plot.”
Any rational person could see this isn’t a “two sides to
everything” sort of dilemma. Only one side is working to eliminate the other. Democrats
aren’t voting for these bills. There isn’t a vast upwelling of anti-trans
sentiment from the left: The backbone, money, legal representation, and
infrastructure are coming from large, wealthy, powerful right-wing
organizations that prop up a few people and organizations who claim to have
been liberal at one time, until all this trans stuff made them support
Republicans. Not only do they not care about getting the right answers, they
cannot even be bothered to ask some of the right questions, such as why should
we take parenting advice from people completely estranged from their children? Or why the
people supporting these bills cannot find actual experts in the field to
support their position? Or why the vast majority of their witnesses come from
out of state?
Instead, on one side you have a menagerie of a small group of
people promoted by these organizations doing a road show for credulous
Republican lawmakers eager to earn their conservative bone fides by going after
trans kids and their parents. On the other, you have the actual experts in the
field, care providers, parents of trans youth (who have great relationships
with their kids), and the kids themselves. It’s symptomatic of a deeper rot
within the body politic that goes back a long way and is only getting worse.
Dogma supplants knowledge. Belief trumps evidence, and like the old Soviet
commissariat state the assumption becomes that the right belief system will
always provide the right answer.
Republicans aim to make “parental rights” and “protecting
children” their number one talking point during the 2024 election, and
Democrats appear completely unprepared to engage with this. This is a mistake:
The strategy has been successful for Glenn Youngkin, Greg Abbott, and Ron DeSantis in their gubernatorial campaigns, and trans
people are leaving their states.
Sadly, families, and their children, will pay the price in
blood and treasure as they flee to states less hostile to their
existence, or risk permanent mental and physical harm.