Transgender healthcare becomes target for broad GOP-led rollback

In May, Alabama had the toughest anti-transgender law in the US for about a week. Any doctor who prescribes puberty blockers or hormone therapy for anyone under 18 can face a felony charge, serve up to 10 years in prison, and pay a $15,000 fine. Physicians scrambled to refill their patients’ prescriptions before the law went into effect; Parents began to consider plans to move their families abroad.

A federal judge has since issued an injunction banning the drug. But it was a brief preview of what conservative lawmakers across the country are increasingly pushing for. An analysis by Bloomberg News found at least 40 similar bills being proposed in around two dozen Republican-controlled states that would severely restrict or outright ban gender-affirming and transitional healthcare, often specifically for minors.

A draft law in Georgia would sentence any doctor who prescribes puberty blockers to a minor to up to 10 years in prison; Another in North Carolina would fine doctors $1,000 per incident for doing the same. In Mississippi, a bill would limit health insurance coverage for transgender health services.

“We’re seeing a tsunami of these laws,” said Michael Bronski, a Harvard University professor who studies LGBTQ history and culture.

anti-LGBTQ legislation ascending in recent years, with a slew of bills designed to restrict which bathrooms transgender people can use and which sports teams they can play on. But in the past year, anti-trans health regulations have really picked up steam. In the 2022 legislature, about 60% of all proposed LGBTQ health legislation aimed to ban or restrict transgender-related health care. It’s a reversal from the last decade, when pro-LGBTQ lawmakers passed progressive legislation like banning conversion therapy discredited practice attempting to change a person’s sexual orientation or gender identity.

“They throw everything at the wall to see what sticks,” Bronski said.

“Part of the goal is getting rid of foster care, but getting rid of trans people is just one of the stops along the way,” said Chase Strangio, an attorney with the American Civil Liberties Union who has done so sued several states for anti-trans laws that argue they violate the 14th Amendment’s equal protections clause.

Strangio has had some success in convincing judges that these laws are not legal, at least for now. In Arkansas, he obtained a drug ban injunction similar to that in Alabama, and in Texas he received another injunction by order of the governor directing state agencies to investigate parents or physicians who provide gender-affirming care to minors.

The judge who eventually blocked the Alabama law said, “Parents — not the state or federal courts — play the primary role in raising and caring for their children.” He also said the state had failed to provide credible evidence that the Treatments are “experimental” and therefore dangerous, as politicians in Alabama have argued. The American Academy of Pediatrics and nearly two dozen other major medical associations support the treatments that clinics offer to transgender youth.

Conservative groups believe both the public and healthcare will return to their positions. “We’re not there yet, but I think we’re going to get to a point where this will be seen as a totally inappropriate way of intervening,” said Jay Richards, a research fellow at the Heritage Foundation, a conservative think tank working on providing model laws for legislators on the subject.

Proponents say extremism is part of the strategy. “Each of these calculations is a test,” said Nikita Shepard, a researcher at Columbia University who studies gender and sexuality. “How far can it go? How far can rhetoric go?”

They liken it to the anti-abortion crusade that ultimately led to the overthrow of Roe v. Wade led. State legislatures for more than a decade Passed hundreds of laws Restrict or prohibit abortion. Many never went into effect until a more conservative Supreme Court picked one up and voted this year to overturn federal protections on abortion. Now doctors in a dozen states face felony charges for providing abortion services.

Physicians who see transgender patients fear their future leads there, said Kellen Baker, executive director of the Whitman-Walker Institute, an LGBTQ health research and advocacy group. “We see a lot of confusion, a lot of fear and a lot of fear,” he said.

Chase Strangio, an attorney for the American Civil Liberties Union, in New York, USA.

Photographer: Amir Hamja/Bloomberg

Clinics are also reporting an increase in violence and harassment. Last month, doctors at Boston Children’s Hospital, home of the nation’s first transgender pediatric and adolescent health program, were the target of a campaign of harassment; The hospital also received a bomb threat a few weeks later.

Despite the legal hurdles they have faced so far, the laws are not expected to ease up.

Promise to America’s Children, an anti-LGBTQ advocacy group, is asking lawmakers to sign a pledge supporting measures that ban “physical interventions on children’s bodies” such as puberty blockers and hormone therapy. The coalition is supported by the Heritage Foundation, the Family Policy Alliance and the Alliance Defending Freedom, conservative groups that have also been instrumental in the fight against abortion. The group will offer model legislation and awareness campaigns, Richards said.

“We are dealing with a fundamental disagreement: Can children be born in the wrong body and should their bodies be altered to match an assumed inner state, or should we try to help children feel comfortable in their bodies ?” said Richards of the Heritage Foundation. “There’s a chasm between these two different views of reality and we think one is right and one is wrong.”

–Supported by Linly Lin and TaylorJohnson.

To contact the authors of this story:
Kelsey Butler in New York at [email protected]

Andre Tartar in New York at [email protected]

To contact the publisher responsible for this story:
Rebekah Grunfeld at [email protected]

Sarah McGregor

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