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Atlantic
29-06-2025
- Health
- Atlantic
The Liberal Misinformation Bubble About Youth Gender Medicine
Allow children to transition, or they will kill themselves. For more than a decade, this has been the strongest argument in favor of youth gender medicine—a scenario so awful that it stifled any doubts or questions about puberty blockers and cross-sex hormones. 'We often ask parents, 'Would you rather have a dead son than a live daughter?'' Johanna Olson-Kennedy of Children's Hospital Los Angeles once explained to ABC News. Variations on the phrase crop up in innumerable media articles and public statements by influencers, activists, and LGBTQ groups. The same idea—that the choice is transition or death—appeared in the arguments made by Elizabeth Prelogar, the Biden administration's solicitor general, before the Supreme Court last year. Tennessee's law prohibiting the use of puberty blockers and cross-sex hormones to treat minors with gender dysphoria would, she said, 'increase the risk of suicide.' But there is a huge problem with this emotive formulation: It isn't true. When Justice Samuel Alito challenged the ACLU lawyer Chase Strangio on such claims during oral arguments, Strangio made a startling admission. He conceded that there is no evidence to support the idea that medical transition reduces adolescent suicide rates. At first, Strangio dodged the question, saying that research shows that blockers and hormones reduce 'depression, anxiety, and suicidality'—that is, suicidal thoughts. (Even that is debatable, according to reviews of the research literature.) But when Alito referenced a systematic review conducted for the Cass report in England, Strangio conceded the point. 'There is no evidence in some—in the studies that this treatment reduces completed suicide,' he said. 'And the reason for that is completed suicide, thankfully and admittedly, is rare, and we're talking about a very small population of individuals with studies that don't necessarily have completed suicides within them.' Here was the trans-rights movement's greatest legal brain, speaking in front of the nation's highest court. And what he was saying was that the strongest argument for a hotly debated treatment was, in fact, not supported by the evidence. Even then, his admission did not register with the liberal justices. When the court voted 6–3 to uphold the Tennessee law, Sonia Sotomayor claimed in her dissent that 'access to care can be a question of life or death.' If she meant any kind of therapeutic support, that might be defensible. But claiming that this is true of medical transition specifically—the type of care being debated in the Skrmetti case—is not supported by the current research. Advocates of the open-science movement often talk about 'zombie facts' —popular sound bites that persist in public debate, even when they have been repeatedly discredited. Many common political claims made in defense of puberty blockers and hormones for gender-dysphoric minors meet this definition. These zombie facts have been flatly contradicted not just by conservatives but also by prominent advocates and practitioners of the treatment—at least when they're speaking candidly. Many liberals are unaware of this, however, because they are stuck in media bubbles in which well-meaning commentators make confident assertions for youth gender medicine—claims from which its elite advocates have long since retreated. Perhaps the existence of this bubble shouldn't be surprising. Many of the most fervent advocates of youth transition are also on record disparaging the idea that it should be debated at all. Strangio—who works for the country's best-known free-speech organization—once tweeted that he would like to scuttle Abigail Shrier's book Irreversible Damage, a skeptical treatment of youth gender medicine. Strangio declared, 'Stopping the circulation of this book and these ideas is 100% a hill I will die on.' Marci Bowers, the former head of the World Professional Association for Transgender Health (WPATH), the most prominent organization for gender-medicine providers, has likened skepticism of child gender medicine to Holocaust denial. 'There are not two sides to this issue,' she once said, according to a recent episode of The Protocol, a New York Times podcast. Boasting about your unwillingness to listen to your opponents probably plays well in some crowds. But it left Strangio badly exposed in front of the Supreme Court, where it became clear that the conservative justices had read the most convincing critiques of hormones and blockers—and had some questions as a result. Trans-rights activists like to accuse skeptics of youth gender medicine—and publications that dare to report their views—of fomenting a ' moral panic.' But the movement has spent the past decade telling gender-nonconforming children that anyone who tries to restrict access to puberty blockers and hormones is, effectively, trying to kill them. This was false, as Strangio's answer tacitly conceded. It was also irresponsible. After England restricted the use of puberty blockers in 2020, the government asked an expert psychologist, Louis Appleby, to investigate whether the suicide rate for patients at the country's youth gender clinic rose dramatically as a result. It did not: In fact, he did not find any increase in suicides at all, despite the lurid claims made online. 'The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide,' Appleby reported. 'One risk is that young people and their families will be terrified by predictions of suicide as inevitable without puberty blockers.' When red-state bans are discussed, you will also hear liberals say that conservative fears about the medical-transition pathway are overwrought—because all children get extensive, personalized assessments before being prescribed blockers or hormones. This, too, is untrue. Although the official standards of care recommend thorough assessment over several months, many American clinics say they will prescribe blockers on a first visit. This isn't just a matter of U.S. health providers skimping on talk therapy to keep costs down; some practitioners view long evaluations as unnecessary and even patronizing. 'I don't send someone to a therapist when I'm going to start them on insulin,' Olson-Kennedy told The Atlantic in 2018. Her published research shows that she has referred girls as young as 13 for double mastectomies. And what if these children later regret their decision? 'Adolescents actually have the capacity to make a reasoned logical decision,' she once told an industry seminar, adding: 'If you want breasts at a later point in your life, you can go and get them.' Perhaps the greatest piece of misinformation believed by liberals, however, is that the American standards of care in this area are strongly evidence-based. In fact, at this point, the fairest thing to say about the evidence surrounding medical transition for adolescents—the so-called Dutch protocol, as opposed to talk therapy and other support—is that it is weak and inconclusive. (A further complication is that American child gender medicine has deviated significantly from this original protocol, in terms of length of assessments and the number and demographics of minors being treated.) Yes, as activists are keen to point out, most major American medical associations support the Dutch protocol. But consensus is not the same as evidence. And that consensus is politically influenced. Rachel Levine, President Joe Biden's assistant secretary for health and human services, successfully lobbied to have age minimums removed for most surgeries from the standards of care drawn up by WPATH. That was a deeply political decision—Levine, according to emails from her office reviewed by the Times, believed that listing any specific limits under age 18 would give opponents of youth transition hard targets to exploit. More recently, another court case over banning blockers and hormones, this time in Alabama, has revealed that WPATH members themselves had doubts about their own guidelines. In 2022, Alabama passed a law criminalizing the prescription of hormones and blockers to patients under 19. After the Biden administration sued to block the law, the state's Republican attorney general subpoenaed documents showing that WPATH has known for some time that the evidence base for adolescent transition is thin. 'All of us are painfully aware that there are many gaps in research to back up our recommendations,' Eli Coleman, the psychologist who chaired the team revising the standards of care, wrote to his colleagues in 2023. Yet the organization did not make this clear in public. Laura Edwards-Leeper—who helped bring the Dutch protocol to the U.S. but has since criticized in a Washington Post op-ed the unquestioningly gender-affirmative model—has said that the specter of red-state bans made her and her op-ed co-author reluctant to break ranks. The Alabama litigation also confirmed that WPATH had commissioned systematic reviews of the evidence for the Dutch protocol. However, close to publication, the Johns Hopkins University researcher involved was told that her findings needed to be 'scrutinized and reviewed to ensure that publication does not negatively affect the provision of transgender health care.' This is not how evidence-based medicine is supposed to work. You don't start with a treatment and then ensure that only studies that support that treatment are published. In a legal filing in the Alabama case, Coleman insisted 'it is not true' that the WPATH guidelines 'turned on any ideological or political considerations' and that the group's dispute with the Johns Hopkins researcher concerned only the timing of publication. Yet the Times has reported that at least one manuscript she sought to publish 'never saw the light of day.' The Alabama disclosures are not the only example of this reluctance to acknowledge contrary evidence. Last year, Olson-Kennedy said that she had not published her own broad study on mental-health outcomes for youth with gender dysphoria, because she worried about its results being 'weaponized.' That raised suspicions that she had found only sketchy evidence to support the treatments that she has been prescribing—and publicly advocating for—over many years. Last month, her study finally appeared as a preprint, a form of scientific publication where the evidence has not yet been peer-reviewed or finalized. Its participants 'demonstrated no significant changes in reported anxious/depressed, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, aggressive behavior, internalizing problems or externalizing problems' in the two years after starting puberty blockers. (I have requested comment from Olson-Kennedy via Children's Hospital Los Angeles but have not yet heard back.) The reliance on elite consensus over evidence helps make sense of WPATH's flatly hostile response to the Cass report in England, which commissioned systematic reviews and recommended extreme caution over the use of blockers and hormones. The review was a direct challenge to WPATH's ability to position itself as the final arbiter of these treatments—something that became more obvious when the conservative justices referenced the British document in their questions and opinions in Skrmetti. One of WPATH's main charges against Hilary Cass, the senior pediatrician who led the review, was that she was not a gender specialist—in other words, that she was not part of the charmed circle who already agreed that these treatments were beneficial. Because of WPATH's hostility, many on the American left now believe that the Cass review has been discredited. 'Upon first reading, especially to a person with limited knowledge of the history of transgender health care, much of the report might seem reasonable,' Lydia Polgreen wrote in the Times last August. However, after 'poring over the document' and 'interviewing experts in gender-affirming care,' Polgreen realized that the Cass review was 'fundamentally a subjective, political document.' Advocates of youth gender medicine have reacted furiously to articles in the Times and elsewhere that take Cass's conclusions seriously. Indeed, some people inside the information bubble appear to believe that if respectable publications would stop writing about this story, all the doubts and questions—and Republican attempts to capitalize on them electorally—would simply disappear. Whenever the Times has published a less-than-cheerleading article about youth transition, supporters of gender medicine have accused the newspaper of manufacturing a debate that otherwise would not exist. After the Skrmetti decision, Strangio was still describing media coverage of the issue as 'insidious,' adding: ' The New York Times, especially, has been fixated on casting the medical care as being of an insufficient quality.' Can this misinformation bubble ever be burst? On the left, support for youth transition has been rolled together with other issues—such as police reform and climate activism—as a kind of super-saver combo deal of correct opinions. The 33-year-old democratic socialist Zohran Mamdani has made funding gender transition, including for minors, part of his pitch to be New York's mayor. But complicated issues deserve to be treated individually: You can criticize Israel, object to the militarization of America's police forces, and believe that climate change is real, and yet still not support irreversible, experimental, and unproven medical treatments for children. The polarization of this issue in America has been deeply unhelpful for getting liberals to accept the sketchiness of the evidence base. When Vice President J. D. Vance wanted to troll the left, he joined Bluesky—where skeptics of youth gender medicine are among the most blocked users—and immediately started talking about the Skrmetti judgment. Actions like that turn accepting the evidence base into a humiliating climbdown. Acknowledging the evidence does not mean that you also have to support banning these treatments—or reject the idea that some people will be happier if they transition. Cass believes that some youngsters may indeed benefit from the medical pathway. 'Whilst some young people may feel an urgency to transition, young adults looking back at their younger selves would often advise slowing down,' her report concludes. 'For some, the best outcome will be transition, whereas others may resolve their distress in other ways.' I have always argued against straightforward bans on medical transition for adolescents. In practice, the way these have been enacted in red states has been uncaring and punitive. Parents are threatened with child-abuse investigations for pursuing treatments that medical professionals have assured them are safe. Children with severe mental-health troubles suddenly lose therapeutic support. Clinics nationwide, including Olson-Kennedy's, are now abruptly closing because of the political atmosphere. Writing about the subject in 2023, I argued that the only way out of the culture war was for the American medical associations to commission reviews and carefully consider the evidence. From the July/August 2018 issue: When children say they're trans However, the revelations from Skrmetti and the Alabama case have made me more sympathetic to commentators such as Leor Sapir, of the conservative Manhattan Institute, who supports the bans because American medicine cannot be trusted to police itself. 'Are these bans the perfect solution? Probably not,' he told me in 2023. 'But at the end of the day, if it's between banning gender-affirming care and leaving it unregulated, I think we can minimize the amount of harm by banning it.' Once you know that WPATH wanted to publish a review only if it came to the group's preferred conclusion, Sapir's case becomes more compelling. Despite the concerted efforts to suppress the evidence, however, the picture on youth gender medicine has become clearer over the past decade. It's no humiliation to update our beliefs as a result: I regularly used to write that medical transition was 'lifesaving,' before I saw how limited the evidence on suicide was. And it took another court case, brought by the British detransitioner Keira Bell, for me to realize fully that puberty blockers were not what they were sold as—a 'safe and reversible' treatment that gave patients 'time to think' —but instead a one-way ticket to full transition, with physical changes that cannot be undone. Some advocates for the Dutch protocol, as it's applied in the United States, have staked their entire career and reputation on its safety and effectiveness. They have strong incentives not to concede the weakness of the evidence. In 2023, the advocacy group GLAAD drove a truck around the offices of The New York Times to declare that the ' science is settled.' Doctors such as Olson-Kennedy and activists such as Strangio are unlikely to revise their opinions. For everyone else, however, the choice is still open. We can support civil-rights protections for transgender people without having to endorse an experimental and unproven set of medical treatments—or having to repeat emotionally manipulative and now discredited claims about suicide. I am not a fan of the American way of settling political disputes, by kicking them over to an escalating series of judges. But in the case of youth gender medicine, the legal system has provided clarity and disclosure that might otherwise not exist. Thanks to the Supreme Court's oral questioning in Skrmetti and the discovery process in Alabama, we now have a clearer picture of how youth gender medicine has really been operating in the United States, and an uncomfortable insight into how advocacy groups and medical associations have tamped down their own concerns about its evidence base. Those of us who have been urging caution now know that many of our ostensible opponents had the same concerns. They just smothered them, for political reasons.
Yahoo
26-06-2025
- Politics
- Yahoo
A decade on from Obergefell, setbacks prompt a reckoning among LGBTQ+ groups
When the Supreme Court ruled in the landmark Obergefell vs. Hodges case 10 years ago that same-sex couples have a right to marry nationwide, the sense of triumph was palpable. Celebrations broke out in the streets, and courthouses were flooded with newlyweds. But that wasn't the only response. Opponents of LGBTQ+ rights immediately began implementing new strategies to limit the decision's reach and reverse the broader momentum toward LGBTQ+ acceptance, including by casting a small, less understood subset of the queer community — transgender people — as a growing threat to American families and values. "Right after Obergefell, every effort to advance any equality measure was met with an anti-trans backlash," said Chase Strangio, a transgender attorney with the American Civil Liberties Union and one of the nation's leading voices on LGBTQ+ legal rights. In statehouses and governors' mansions across the country, the number of bills targeting LGBTQ+ rights have increased year after year, with 800 being introduced this year alone. The Trump administration also has embraced the shift, with federal agencies aggressively investigating California and threatening its funding over its trans-inclusive policies. Last week, the Supreme Court ruled that states may ban gender-affirming care for transgender minors. The strategy has delighted many conservatives. But it has also frightened a community that had seen itself as being on a path toward progress, reviving discussions about the legacy of the Obergefell decision and igniting a fierce debate within the community about the wisdom of its political strategy over the past decade. Some have questioned whether the efforts since Obergefell to broaden transgender rights were pursued too fast, too soon, playing into the hands of the movement's political foes. Others say those concerns sound strikingly similar to ones raised during the fight for marriage equality, when some argued that same-sex couples should settle for civil unions to avoid alienating religious moderates. The conversation is not a comfortable one. Nerves are raw and fear is palpable. Some worry that pointing the finger will further embolden those working to dismantle LGBTQ+ rights. But others argue that a strategic reassessment is necessary after years of setbacks. "This can be an inflection point for how we move forward — whether we galvanize resources in [an] aligned effort to push back, [or] continue to let ourselves be divided by campaigns and movements and strategies that seek to divide us," Strangio said. "That's the real question for this moment." Strangio, now co-director of the ACLU's LGBT & HIV Project, had worked on the Obergefell case and was outside the Supreme Court the day the decision came down. He thought about his younger self, and how impossible such a ruling would have seemed just years before — when state marriage bans were sweeping the country. But he didn't have much time to dwell on the victory, he said, as it became clear "within minutes" that anti-LGBTQ+ forces were already regrouping and preparing for the next fight. One of their first targets was transgender people's use of public bathrooms. Within months of the Obergefell decision, voters in Houston rejected an anti-discrimination measure after opponents falsely claimed that the ordinance's gender-identity protections would allow sexual predators to enter women's bathrooms. In 2016, North Carolina passed the nation's first law barring transgender people from using bathrooms aligned with their identities. The measure sparked huge backlash and statewide boycotts, led in part by corporate America — and the bill was rolled back in 2017. LGBTQ+ activists were jubilant, viewing North Carolina's embarrassment as a clear sign that history was on their side and that expanded transgender rights and protections were inevitable. And there would be big wins to come — including the 2020 Supreme Court ruling that the historic Civil Rights Act of 1964 protects LGBTQ+ employees from workplace discrimination nationwide. However, the tide was already beginning to shift, including as right-wing groups began to identify specific transgender issues that resonated with voters more than bathrooms, and as Trump — in his first term — began taking aim at transgender rights. Terry Schilling, president of the American Principles Project, said his organization "poll tested all of these issues, the bathrooms, the showers, the locker rooms," and found that many were "incredibly unpopular to voters" — but some more than others. One of the issues that resonated the most, Schilling said, was kids' healthcare and competition in girls sports. So his group ran with that, including in the 2019 race for governor in Kentucky, when it ran an ad suggesting the Democratic candidate and ultimate victor — Andy Beshear — supported boys competing in girls' wrestling competitions, when in fact Beshear supported policies barring discrimination based on kids' gender identity. Schilling said it was "the left's insistence that we need to start trans'ing kids" that made the issue a political one. But his group's strategy in Kentucky helped wake conservatives up to the political value of highlighting it. "We're really just tapping into a real vulnerability that Democrats started for themselves," Schilling said. Trump had pursued various anti-transgender policies during his first term, including a ban on transgender service members. But during his campaign for reelection, he centered transgender issues like never before, dumping millions of dollars into anti-transgender ads that cast his opponent, Vice President Kamala Harris, as an extreme progressive on such issues. "Kamala is for they/them; President Trump is for you," one ad said. Once in office, Trump moved even more aggressively against transgender rights than the community had feared — prompting various lawsuits from LGBTQ+ organizations that are still pending. He issued an executive order declaring there are only two genders, and suggesting transgender people don't actually exist. He again banned transgender people from serving in the military. He threatened the funding of states such as California with trans-inclusive school policies. He ordered transgender athletes out of youth sports. He said federal law enforcement would target those who provide gender-affirming care to minors. And his administration said it would stop providing transgender people with passports reflecting their identities. Harrison Fields, a White House spokesman, said the American people "voted for a return to common sense," and Trump was "delivering on every campaign promise." "President Trump's historic reelection and the overall MAGA movement is a big tent welcome for all and home to a large swath of the American people," Fields said. Reggie Greer, who served as a senior advisor on LGBTQI+ Persons at the State Department in the Biden administration, remembers being in North Carolina during the 2016 bathroom bill fight. While local Democrats were pleased with how it had backfired on Republicans, it was clear to him that "hate is lucrative," Greer said — with the anti-rights groups raising hundreds of millions of dollars. He now sees the episode as an early warning of what was to come. Nick Hutchins handled public affairs around the Obergefell case before joining the Human Rights Campaign, where he worked on state affairs and communications. Traveling through conservative states, he watched as more Republicans began seizing on LGBTQ+ issues after Trump's 2016 victory. "It was a moment when Republicans saw an opening and wanted to chip away at LGBTQ rights in any way they could," Hutchins said. "That's where you began to see a spaghetti-against-the-wall approach from their end, pursuing the bathroom bills that evolved into various education-focused bills, and healthcare." Inside the HRC during Trump's first term, leadership felt confident that public opinion remained on their side. LGBTQ+ rights organizations had secured victories in statehouses on bathroom and healthcare issues, and were buoyed by Trump's electoral defeat in 2020. Yet, several warning signs emerged. Internal state polling by the HRC found large majorities of Americans supported trans rights, but a plurality opposed allowing transgender athletes to compete in sports. One former HRC staffer, granted anonymity to speak candidly, said the organization had not paid much attention to the issue until a series of political attacks in conservative states. The governor's race in Kentucky was one, followed by a statehouse push in Louisiana. Still, other battles — including "confronting whiteness in the movement" — took precedent, the former staffer recalled. "There were significant generational divides within the organization between the older teams and their younger staff that were more diverse on these issues," the staffer said. "It was a distraction." Hutchins said LGBTQ+ organizations today are having "autopsy conversations" to take stock of how things have played out in recent years and identify lessons to be learned. Among the most prominent leaders of the modern LGBTQ+ movement, there is consensus on many things. It's a scary time for LGBTQ+ people and other vulnerable groups, including immigrants and women. Trump represents an existential threat to American democracy. The LGBTQ+ rights movement needs more resources to continue fighting back. Nobody is going to throw transgender people under the bus just because some Democrats have suggested it would help them rebound politically. "No one person, no one community, is expendable. End of story," said Jim Obergefell, the lead plaintiff in the marriage case. The actor Laverne Cox, one of the most recognizable transgender women in the country, said the marriage victory in 2015 left the right in need of "a new boogeyman," and they picked transgender people — a tiny portion of the U.S. population, at around 1%. They further picked on transgender people in sports — an even tinier group — in order to focus the conversation on "hormones and physical ability," which is "a great way to objectify trans people, to reduce us to our bodies, and thus dehumanize us," Cox said. The best way to fight back, she said, is to refocus the conversation on transgender people's humanity by allowing them to tell their own stories — rather than allowing their narratives to be "hijacked by propaganda." "We're just like everybody else in terms of what we want, need, desire, our hopes and fears," she said. "Living authentically and being able to be oneself is where the focus should be." Evan Wolfson, an attorney and founder of the advocacy group Freedom to Marry, which is widely credited with securing the 2015 victory in the Obergefell case, said there are "three significant factors" that got the country to where it is today on transgender issues. The "most important factor by far," he said, "is the right-wing attack machine and the political agenda of some who are trying to attack and scapegoat and divide" the country around transgender issues. A second factor, he said, is that transgender identities are still a "relatively new" concept for many Americans, and "that conversation is just not as far along as the very long conversation about who gay people are." A third and far less significant factor, he said, are the "missteps" by LGBTQ+ advocates in the last decade, including some vocally renouncing anyone who is not 100% supportive of trans rights. "We worked hard in the Freedom to Marry campaign to bring people along and to distinguish between those who were our true opponents, those who were really anti-gay, anti-rights, anti-inclusion on the one hand, and those who I called the 'reachable but not yet reached' — people who weren't with us, but weren't our true opponents, people who were still wrestling with the question," Wolfson said. Allowing people a bit more time and space to be brought along on transgender issues will be necessary moving forward, he said — though he stressed that does not mean that advocates should slow down or pull back. Wolfson rejected the idea that the LGBTQ+ community is moving too fast on transgender rights, which was also argued about marriage, and the idea that transgender rights should be abandoned as a political liability. "There is no reason to believe that we would profit from selling out our principles and doing the wrong thing just to avoid this tough moment," Wolfson said. Strangio said the fight for LGBTQ+ rights today cannot be viewed in a vacuum, and that zooming out, "there are a lot of reasons to be concerned about basic constitutional principles and civil rights protections" for all sorts of vulnerable people under the Trump administration. Still, he said, he believes in the queer community's "ability to move through setbacks" and come out on ahead of the "billion-dollar global campaigns to undermine equality protections" that began after the Obergefell decision. "Fighting back was the right course," he said, "and continuing to assess how we can effectively build support for the entire community is going to be a critical part of this next decade." Get the L.A. Times Politics newsletter. Deeply reported insights into legislation, politics and policy from Sacramento, Washington and beyond, in your inbox twice per week. This story originally appeared in Los Angeles Times.
Los Angeles Times
26-06-2025
- Politics
- Los Angeles Times
A decade on from Obergefell, setbacks prompt a reckoning among LGBTQ+ groups
When the Supreme Court ruled in the landmark Obergefell vs. Hodges case 10 years ago that same-sex couples have a right to marry nationwide, the sense of triumph was palpable. Celebrations broke out in the streets, and courthouses were flooded with newlyweds. But that wasn't the only response. Opponents of LGBTQ+ rights immediately began implementing new strategies to limit the decision's reach and reverse the broader momentum toward LGBTQ+ acceptance, including by casting a small, less understood subset of the queer community — transgender people — as a growing threat to American families and values. 'Right after Obergefell, every effort to advance any equality measure was met with an anti-trans backlash,' said Chase Strangio, a transgender attorney with the American Civil Liberties Union and one of the nation's leading voices on LGBTQ+ legal rights. In statehouses and governors' mansions across the country, the number of bills targeting LGBTQ+ rights have increased year after year, with 800 being introduced this year alone. The Trump administration also has embraced the shift, with federal agencies aggressively investigating California and threatening its funding over its trans-inclusive policies. Last week, the Supreme Court ruled that states may ban gender-affirming care for transgender minors. The strategy has delighted many conservatives. But it has also frightened a community that had seen itself as being on a path toward progress, reviving discussions about the legacy of the Obergefell decision and igniting a fierce debate within the community about the wisdom of its political strategy over the past decade. Some have questioned whether the efforts since Obergefell to broaden transgender rights were pursued too fast, too soon, playing into the hands of the movement's political foes. Others say those concerns sound strikingly similar to ones raised during the fight for marriage equality, when some argued that same-sex couples should settle for civil unions to avoid alienating religious moderates. The conversation is not a comfortable one. Nerves are raw and fear is palpable. Some worry that pointing the finger will further embolden those working to dismantle LGBTQ+ rights. But others argue that a strategic reassessment is necessary after years of setbacks. 'This can be an inflection point for how we move forward — whether we galvanize resources in [an] aligned effort to push back, [or] continue to let ourselves be divided by campaigns and movements and strategies that seek to divide us,' Strangio said. 'That's the real question for this moment.' Strangio, now co-director of the ACLU's LGBT & HIV Project, had worked on the Obergefell case and was outside the Supreme Court the day the decision came down. He thought about his younger self, and how impossible such a ruling would have seemed just years before — when state marriage bans were sweeping the country. But he didn't have much time to dwell on the victory, he said, as it became clear 'within minutes' that anti-LGBTQ+ forces were already regrouping and preparing for the next fight. One of their first targets was transgender people's use of public bathrooms. Within months of the Obergefell decision, voters in Houston rejected an anti-discrimination measure after opponents falsely claimed that the ordinance's gender-identity protections would allow sexual predators to enter women's bathrooms. In 2016, North Carolina passed the nation's first law barring transgender people from using bathrooms aligned with their identities. The measure sparked huge backlash and statewide boycotts, led in part by corporate America — and the bill was rolled back in 2017. LGBTQ+ activists were jubilant, viewing North Carolina's embarrassment as a clear sign that history was on their side and that expanded transgender rights and protections were inevitable. And there would be big wins to come — including the 2020 Supreme Court ruling that the historic Civil Rights Act of 1964 protects LGBTQ+ employees from workplace discrimination nationwide. However, the tide was already beginning to shift, including as right-wing groups began to identify specific transgender issues that resonated with voters more than bathrooms, and as Trump — in his first term — began taking aim at transgender rights. Terry Schilling, president of the American Principles Project, said his organization 'poll tested all of these issues, the bathrooms, the showers, the locker rooms,' and found that many were 'incredibly unpopular to voters' — but some more than others. One of the issues that resonated the most, Schilling said, was kids' healthcare and competition in girls sports. So his group ran with that, including in the 2019 race for governor in Kentucky, when it ran an ad suggesting the Democratic candidate and ultimate victor — Andy Beshear — supported boys competing in girls' wrestling competitions, when in fact Beshear supported policies barring discrimination based on kids' gender identity. Schilling said it was 'the left's insistence that we need to start trans'ing kids' that made the issue a political one. But his group's strategy in Kentucky helped wake conservatives up to the political value of highlighting it. 'We're really just tapping into a real vulnerability that Democrats started for themselves,' Schilling said. Trump had pursued various anti-transgender policies during his first term, including a ban on transgender service members. But during his campaign for reelection, he centered transgender issues like never before, dumping millions of dollars into anti-transgender ads that cast his opponent, Vice President Kamala Harris, as an extreme progressive on such issues. 'Kamala is for they/them; President Trump is for you,' one ad said. Once in office, Trump moved even more aggressively against transgender rights than the community had feared — prompting various lawsuits from LGBTQ+ organizations that are still pending. He issued an executive order declaring there are only two genders, and suggesting transgender people don't actually exist. He again banned transgender people from serving in the military. He threatened the funding of states such as California with trans-inclusive school policies. He ordered transgender athletes out of youth sports. He said federal law enforcement would target those who provide gender-affirming care to minors. And his administration said it would stop providing transgender people with passports reflecting their identities. Harrison Fields, a White House spokesman, said the American people 'voted for a return to common sense,' and Trump was 'delivering on every campaign promise.' 'President Trump's historic reelection and the overall MAGA movement is a big tent welcome for all and home to a large swath of the American people,' Fields said. Reggie Greer, who served as a senior advisor on LGBTQI+ Persons at the State Department in the Biden administration, remembers being in North Carolina during the 2016 bathroom bill fight. While local Democrats were pleased with how it had backfired on Republicans, it was clear to him that 'hate is lucrative,' Greer said — with the anti-rights groups raising hundreds of millions of dollars. He now sees the episode as an early warning of what was to come. Nick Hutchins handled public affairs around the Obergefell case before joining the Human Rights Campaign, where he worked on state affairs and communications. Traveling through conservative states, he watched as more Republicans began seizing on LGBTQ+ issues after Trump's 2016 victory. 'It was a moment when Republicans saw an opening and wanted to chip away at LGBTQ rights in any way they could,' Hutchins said. 'That's where you began to see a spaghetti-against-the-wall approach from their end, pursuing the bathroom bills that evolved into various education-focused bills, and healthcare.' Inside the HRC during Trump's first term, leadership felt confident that public opinion remained on their side. LGBTQ+ rights organizations had secured victories in statehouses on bathroom and healthcare issues, and were buoyed by Trump's electoral defeat in 2020. Yet, several warning signs emerged. Internal state polling by the HRC found large majorities of Americans supported trans rights, but a plurality opposed allowing transgender athletes to compete in sports. One former HRC staffer, granted anonymity to speak candidly, said the organization had not paid much attention to the issue until a series of political attacks in conservative states. The governor's race in Kentucky was one, followed by a statehouse push in Louisiana. Still, other battles — including 'confronting whiteness in the movement' — took precedent, the former staffer recalled. 'There were significant generational divides within the organization between the older teams and their younger staff that were more diverse on these issues,' the staffer said. 'It was a distraction.' Hutchins said LGBTQ+ organizations today are having 'autopsy conversations' to take stock of how things have played out in recent years and identify lessons to be learned. Among the most prominent leaders of the modern LGBTQ+ movement, there is consensus on many things. It's a scary time for LGBTQ+ people and other vulnerable groups, including immigrants and women. Trump represents an existential threat to American democracy. The LGBTQ+ rights movement needs more resources to continue fighting back. Nobody is going to throw transgender people under the bus just because some Democrats have suggested it would help them rebound politically. 'No one person, no one community, is expendable. End of story,' said Jim Obergefell, the lead plaintiff in the marriage case. The actor Laverne Cox, one of the most recognizable transgender women in the country, said the marriage victory in 2015 left the right in need of 'a new boogeyman,' and they picked transgender people — a tiny portion of the U.S. population, at around 1%. They further picked on transgender people in sports — an even tinier group — in order to focus the conversation on 'hormones and physical ability,' which is 'a great way to objectify trans people, to reduce us to our bodies, and thus dehumanize us,' Cox said. The best way to fight back, she said, is to refocus the conversation on transgender people's humanity by allowing them to tell their own stories — rather than allowing their narratives to be 'hijacked by propaganda.' 'We're just like everybody else in terms of what we want, need, desire, our hopes and fears,' she said. 'Living authentically and being able to be oneself is where the focus should be.' Evan Wolfson, an attorney and founder of the advocacy group Freedom to Marry, which is widely credited with securing the 2015 victory in the Obergefell case, said there are 'three significant factors' that got the country to where it is today on transgender issues. The 'most important factor by far,' he said, 'is the right-wing attack machine and the political agenda of some who are trying to attack and scapegoat and divide' the country around transgender issues. A second factor, he said, is that transgender identities are still a 'relatively new' concept for many Americans, and 'that conversation is just not as far along as the very long conversation about who gay people are.' A third and far less significant factor, he said, are the 'missteps' by LGBTQ+ advocates in the last decade, including some vocally renouncing anyone who is not 100% supportive of trans rights. 'We worked hard in the Freedom to Marry campaign to bring people along and to distinguish between those who were our true opponents, those who were really anti-gay, anti-rights, anti-inclusion on the one hand, and those who I called the 'reachable but not yet reached' — people who weren't with us, but weren't our true opponents, people who were still wrestling with the question,' Wolfson said. Allowing people a bit more time and space to be brought along on transgender issues will be necessary moving forward, he said — though he stressed that does not mean that advocates should slow down or pull back. Wolfson rejected the idea that the LGBTQ+ community is moving too fast on transgender rights, which was also argued about marriage, and the idea that transgender rights should be abandoned as a political liability. 'There is no reason to believe that we would profit from selling out our principles and doing the wrong thing just to avoid this tough moment,' Wolfson said. Strangio said the fight for LGBTQ+ rights today cannot be viewed in a vacuum, and that zooming out, 'there are a lot of reasons to be concerned about basic constitutional principles and civil rights protections' for all sorts of vulnerable people under the Trump administration. Still, he said, he believes in the queer community's 'ability to move through setbacks' and come out on ahead of the 'billion-dollar global campaigns to undermine equality protections' that began after the Obergefell decision. 'Fighting back was the right course,' he said, 'and continuing to assess how we can effectively build support for the entire community is going to be a critical part of this next decade.'
Spectator
25-06-2025
- Politics
- Spectator
‘Trans rights' has never been a civil rights issue
Indisputably a nutjob, Chase Strangio is the soul of nominative determinism. The lawyer for the American Civil Liberties Union is a 'trans man' – meaning a woman, of course; one of the trans movement's lesser impositions is forcing consumers of pliant media to keep translating wishful thinking into real life, much as the unhip once had to keep remembering that 'super-bad' means 'super-good'. Strangio is a rare example of sexual disguise that is reasonably persuasive. The 42-year-old woman passes for a certain kind of man: weedy, slight and very short, with narrow shoulders, Marx Brothers eyebrows, just-credible facial hair, a tight fade over the ears bursting into a cocky skywards coiffure, and a chronically smarmy, self-satisfied expression. Strangio comes across as nerdy, weak and perplexingly vain. Plenty of bona fide males out there fit that general description while to all appearances failing to embody the once-prized attributes of traditional masculinity. At a glance, Strangio belongs to that benighted class of weirdos, wimps and wusses – the ultimate swipe-left. So much trouble and expense lavished on passing as a male sissy, when the lawyer might have made a respectable broad. Is it perversity or hypocrisy? Strangio resents that alphabet land is dominated by the 'gay white men' whose appearance she is aping, decries the Supreme Court – before which she has just appeared – as a 'vile institution', believes as a lawyer that law is 'not a dignified system' and, typically, is highly invested in the alchemy of having changed sex yet does not believe in the existence of sex. 'A penis is not a male body part,' she claims. 'It's just an unusual body part for a woman.' Behold, Exhibit B for the Democrats' foisting of crackpots into positions of responsibility (granted, Donald Trump has form in that regard as well). Naturally, Exhibit A is Admiral 'Rachel' Levine, who may single-handedly have convinced Vladimir Putin to invade Ukraine, because the US military was then apparently a joke. Before the Supreme Court, Strangio headed the ACLU case against Tennessee, which had banned puberty blockers, cross-sex hormones and sex-change surgeries for minors. Last week's 6-3 decision in Tennessee's favour rescues similar laws in 26 other states, which prevent doctors from neutering, mutilating and disrupting the maturation of underage patients suffering under the contagious misapprehension that they are not the sex they are. Just like the UK Supreme Court's recent decision that in law biological sex trumps an imaginary 'gender identity', this is a big win for sanity, physical reality and common sense. The ACLU argued that because puberty blockers are occasionally prescribed to arrest precocious puberty, banning their use to make sexual fancy dress more convincing in future amounts to discrimination. The logic is skewed. The world is full of things that are good for one purpose and bad for another. Nothing against picking crops, but if I used a combine harvester to vacuum your sitting-room carpet, I'd expect you to sue. There's a night-and-day medical difference between a double mastectomy to cure breast cancer and the linguistically sanitised 'top surgery' that lops healthy breasts off bamboozled girls who will never breastfeed their children in the unlikely event they can still reproduce. From the start, this whole trans business has been sold as a civil rights issue. But there is no movement in the West to deny transgender people equal access to housing or employment, much less to 'kill trans people', as Strangio asserts. There are no water fountains or lunch counters from which trans people are banished. This is a medical issue – specifically, a mental health issue – slyly packaged as a campaign against bigotry. We don't let children get tattoos, because they're too young to understand the concept of permanence and they could come to regret covering their limbs in dinosaurs. It's therefore just sensible safeguarding for the state to keep kids from opting to take powerful drugs that prevent their bodies from maturing or from opting to get their genitals carved up just because some poor excuses for grown-ups planted this fanciful notion that one can play swapsies with biological sex. This movement's 'trans rights' decode as the rights to: compel other people to mouth lies that contradict what they see with their own eyes; impose the widespread adoption of dehumanising language such as 'menstruators' and 'birthing people'; force the well-adjusted to finance costly elective plastic surgery through taxation and insurance premiums; walk around women's changing rooms with one's wang hanging out; turn women's sports into a farce; and most importantly, it seems, coax children and mixed-up teenagers to make drastic, irreversible medical decisions which may well result in infection, reduced bone density, lifelong reliance on pharmaceuticals, poor ability to form relationships, sexual dysfunction, impotence and infertility. Perhaps also in searing regret – especially once this sick societal obsession finally subsides and its victims no longer constitute sacralised members of the avant-garde but the awkward residue of an old mistake. We're making progress, but this festishistic ideology is perniciously entrenched. Children are still butchered in American blue states. Let's relieve insurance companies and the NHS of the obligation to provide gender-denying care. It's past time we restored the conviction you're really the opposite sex to being a mental illness, and one not necessarily that is best treated by humouring the delusion. Sure, men can wear dresses and women tuxes, but doctors who mangle fully functional body parts violate the Hippocratic oath. Aren't we all to some degree 'born in the wrong body'? I'm an abysmal 5ft 2in, yet I identify as 6ft 7in. I also identify as 23, so that I expect you all to ignore my skin's telltale crenulation and to ask eagerly whether I'm planning to attend graduate school. I identify as beautiful, so watch the mouth. I identify as immortal, too, so that on my deathbed I am sure to identify like fury as an alive person, and if anyone makes a move to call an undertaker I will see them in court. Apologies to the jury in advance, for the smell is apt to be unpleasant.
USA Today
18-06-2025
- Politics
- USA Today
Supreme Court upholds state ban on transgender minors using puberty blockers, hormone therapy
Supreme Court upholds state ban on transgender minors using puberty blockers, hormone therapy In her dissent, Justice Sotomayor said the Supreme Court 'abandons transgender children and their families to political whims." Show Caption Hide Caption Families speak out for transgender youth at Supreme Court Families of transgender youth tells how their lives could change if Supreme Court bans gender-affirming care. WASHINGTON − An ideologically divided Supreme Court on June 18 upheld Tennessee's ban on gender-affirming care for minors, a major setback for transgender Americans who have increasingly become targets of conservative states and the Trump administration. The court's six conservative justices upheld the ban and the three liberals dissented. The decision − one of the court's biggest this year − came about five years after the court ruled that transgender people, as well as gay and lesbian people, are protected by a landmark civil rights law barring sex discrimination in the workplace. But in this case, the court said that preventing minors from using puberty blockers and hormone therapy does not violate the equal protection clause of the 14th Amendment, which requires the government to treat similarly situated people the same. "Having concluded it does not, we leave questions regarding its policy to the people, their elected representatives, and the democratic process," Chief Justice John Roberts wrote for the majority. In her dissent, Justice Sonia Sotomayor said the court retreated 'from meaningful judicial review exactly where it matters most,' and 'abandons transgender children and their families to political whims.' Tennessee Attorney General Jonathan Skrmetti called the decision a "landmark defense of America's children." "A bipartisan supermajority of Tennessee's elected representatives carefully considered the evidence and voted to protect kids from irreversible decisions they cannot yet fully understand," he said in a statement. Chase Strangio, a lawyer with the American Civil Liberties Union who represented the Tennessee families challenging the law, called the decision is a 'painful setback.' But Strangio, who was the first openly transgender person to argue before the court, noted the opinion didn't revisit past decisions protecting transgender people from discrimination. 'We are as determined as ever to fight for the dignity and equality of every transgender person,' Strangio said in a statement. The Biden administration and the Tennessee families that challenged the law argued it discriminated against transgender people because a teenager whose sex assigned at birth is male may be given testosterone to treat delayed puberty. But a teenager assigned female at birth who wants testosterone to treat gender dysphoria may not have it. Tennessee countered that the treatments have different risks and benefits when used by transgender youth, who need to be protected from life-altering consequences. The Supreme Court agreed, saying the law is removing one set of diagnoses − gender dysphoria − from the range of treatable conditions, not excluding people from treatment because they're transgender. After the case was argued in December, the Justice Department under President Donald Trump told the court it was no longer challenging Tennessee's law. Trump made opposition to transgender rights a central theme of his campaign. The issue, a major flashpoint in the culture wars, gained prominence with startling speed, despite the tiny – though increasing – fraction of Americans who are transgender. Since 2022, the number of states taking steps to limit access to gender-affirming care for minors grew from four to about half. States have also taken steps to restrict the bathrooms transgender students can use, what sports teams they can join. and whether they can change the sex designation on their birth certificates. When families with transgender children challenged bans on gender-affirming care, district courts largely sided with them and blocked enforcement. But three appeals courts upheld the laws, including the Cincinnati-based 6th U.S. Circuit Court of Appeals. Tennessee's law was the first to reach the Supreme Court. More: Transgender lawyer makes history, takes case on puberty blockers and hormone therapy to Supreme Court During the December oral arguments, several of the conservative justices voiced support for taking a similar approach to what the court did when it overturned Roe v. Wade, finding there's no constitutional barrier to the issue at hand and leaving it up to state and federal legislatures to decide. 'My understanding is the Constitution leaves that question to the people's representatives, rather than to nine people, none of whom is a doctor,' Chief Justice John Roberts said during December's debate. The court's liberal justices had argued that the court can't ignore constitutional protections, particularly for the vulnerable. 'That's a question for the court,' Justice Ketanji Brown Jackson said. Sotomayor wrote in her dissent that the law 'plainly discriminates on the basis of sex,' tying it to the 2020 decision barring employment discrimination for transgender people. Roberts responded that the court didn't decide in 2020 whether the reasoning could be applied outside of the civil rights law at issue in that case. And the court didn't need to now, he said, because neither the teen's sex nor transgender status is the reason he can't get puberty blockers under Tennessee's law. Gender-affirming care for minors is supported by every major medical organization, including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association. But the court's conservative justices focused more on the fact that some European countries have tightened restrictions on the treatments. England's National Health Service, for example, stopped prescribing the drugs outside of clinical trials after a review concluded more data is needed to help doctors and their patients make informed decisions. Tennessee concluded that there's an ongoing debate among medical experts about the risks and benefits of the treatments, Roberts wrote. "Recent developments," he said, "only underscore the need for legislative flexibility in this area." The case is U.S. v. Skrmetti.
