On Wednesday, Democratic North Carolina Gov. Roy Cooper vetoed a trio of anti-trans bills passed by wide margins in the Republican-controlled state House and Senate. The three bills would ban gender-affirming care for minors, prohibit trans athletes in school sports, and limit classroom discussions about gender and sexuality.
Despite the governor’s vetoes, prospects for killing the legislation are poor. Republicans hold veto-proof majorities in both state chambers.
Cooper condemned the bills as “a triple threat of political culture wars” and accused Republicans of “scheming for the next election” at the expense of vulnerable children.
“A doctor’s office is no place for politicians,” said Copper, echoing a popular line of defense among Democrats defending trans minors. “North Carolina should continue to let parents and medical professionals make decisions about the best way to offer gender care for their children.”
“Ordering doctors to stop following approved medical protocols sets a troubling precedent and is dangerous for vulnerable youth and their mental health,” Cooper said, referring to H.B. 808, which would ban puberty blockers and hormone therapy for trans youth in the state.
Cooper also vetoed H.B. 574, a ban on athletes competing on middle school, high school, and college sports teams that align with their gender identity. A “student’s sex shall be recognized based solely on the student’s reproductive biology and genetics at birth,” the bill reads. Sports teams would be designated for males, men or boys; females, women or girls; or coed or mixed by those strict gender definitions.
The third bill vetoed by Cooper, S.B. 49, would ban instruction on “gender identity, sexual activity, or sexuality” in kindergarten through fourth grade and require parents to be notified “prior to any changes in the name or pronoun used for a student in school records or by school personnel.”
Cooper denounced that measure as hampering “the important and sometimes lifesaving role of educators as trusted advisers when students have nowhere else to turn.”
Conservatives in North Carolina were trailblazers, pioneering the transphobic moral panic that has swept red states in the last two years.
In 2016, the state’s notorious “bathroom bill,” which banned trans people from public restrooms and shut down local efforts to enact anti-discrimination measures, cost North Carolina millions in lost business and was a national embarrassment. The law was partly repealed in 2017.
While Cooper’s vetoes will likely be overridden, activists hold out hope the courts will intervene, as they did then, on at least some of the legislation.
More than 20 states have enacted bans on gender-affirming care for minors, but almost all face court challenges. In June, a federal judge struck down Arkansas’ ban as unconstitutional, and federal judges have temporarily blocked bans in Alabama, Indiana, Kentucky, and Tennessee. Plaintiffs in Florida won a reprieve when a federal judge there blocked enforcement for three minor children.
Max Adomat considers themself fortunate. Adomat, 26, who is nonbinary and uses they/them pronouns, has been on a steady regimen of feminizing hormones for the last six years. They also began their gender transition in New Jersey, a progressive state where clinics offering transition-related medical care are commonplace, and name changes are confidential, they said.
But Adomat still found themself obtaining and self-administering gender-affirming hormones from unregulated, and oftentimes illegal, overseas online pharmacies instead of licensed medical offices. The reason, Adomat said, was a lack of both health insurance and money: When they began transitioning, their low-paying job in the food service industry did not provide insurance, and they were unable to afford the steep cost of transition-related care — including hormone therapy and routine doctors appointments — without it.
Though they knew the risks — which, without supervised care, can include higher chances of blood clots, heart attacks and some cancers — Adomat felt their window for a successful transition was closing, they said.
“I just sort of decided, ‘I’m going to do it, and if and when I can see a doctor somewhere down the road, sure, but I would rather do it now and face those consequences,’” they recalled, adding that their alternative at the time was to continue to “live miserably.”
Interviews with health care providers and lawyers, as well as transgender individuals who use or have used a do-it-yourself approach to transitioning, suggest the reasons people opt for the nonprescription and self-administration route vary and include cost savings, health care accessibility, medical discrimination, and the desire to choose which hormones and dosages are involved in the process.
A DIY approach, however, is not without its health and legal risks. Despite the risks, some experts predict this approach will become even more common given the current political climate: Nearly 20states have already passed laws blocking access to gender-affirming care for minors, and other states have proposed measures that would restrict this type of care for some adults.
Out of pocket costs
A monthly supply of common feminizing hormones — including estrogen and anti-androgens — can cost patients up to $115, according to GoodRx, which tracks U.S. drug prices. Masculinizing hormones, including injectable testosterone, are typically cheaper, costing about $40 to $90 a month. Through unregulated online pharmacies, however, a monthly supply of these feminizing and masculinizing hormones can be purchased for as low as $8, plus shipping.
While price sensitivity to health care costs is not unique to transgender people, this community faces higher rates of economic hardship and poverty, with 1 in 3 trans adults reporting an annual household income under $25,000, according to a 2021 report from the liberal think tank Center for American Progress.
Samme Qandil, 28, was on a medically supervised hormone regimen for three years, but when she landed a new job and her health insurance changed, she was unable to pay her new provider’s $300 copay for a six-week supply of injectable hormones. Faced with both high copay fees and a nationwide shortage of injectable estrogen, she decided to begin purchasing her hormones from an unregulated online pharmacy recommended by her friends.
While Qandil, now a graduate student in Oregon, said she didn’t have many reservations about obtaining and administering hormones by herself, since she knew others who had gone through the process, she still undergoes regular blood tests to ensure her estrogen levels are within a safe range.
The prescription route cost her nearly $700 a year for medications and $400 in appointment copays, Qandil said — more than twice what she now pays for a two-year supply of hormones and related expenses like estrogen blood tests.
While hormone replacement therapy using a DIY approach is “cheaper and technically more accessible,” Qandil said, orders from overseas pharmacies can be unreliable, with some packages of unregulated hormones seized at the U.S. border. However, she added, DIY is cheaper even with the sunk costs, and she even has the ability to stock up on a yearly supply to ensure the hormones don’t run out during a shortage or customs confiscation.
“In an era when patients may have no option but to ‘DIY’ their transitions, just as it is happening with abortions in many states, it might be important for them to know that there are ways to do it that are overall less risky.”
DR. URI BELKIND, CALLEN-LORDE COMMUNITY HEALTH CENTER
Stephanie Coiro, a clinical social worker at Northwell Health’s Center for Transgender Care in New Hyde Park, New York, estimates about 10% of her transgender patients have tried acquiring hormones without a prescription at one time or another. She said this route can cut their costs by more than 50%. Though, she emphasized, those with a prescription, even if they do not have health insurance, can get testosterone or estrogen for $20 to $30 a month at stores like Target and Walmart with manufacturer coupons.
For those who do not have health insurance, anything out-of-pocket, including doctors appointments, is “incredibly expensive,” Coiro acknowledged. In addition to price concerns, she said recent shortages of hormones, like testosterone, could also drive patients to acquire medication through nonprescription means.
The cost of hormones is often one of many expenditures associated with a transition, according to experts and those receiving transition-related care. And a number of transition-related services and procedures are typically not covered by health insurance, including hair removal, which can be mandatory for some gender-affirming surgeries; therapy visits for referral notes, which are typically mandatory for prescriptions and surgeries; and gender-affirming facial and chest surgeries.
Dr. Uri Belkind, the associate director of adolescent medicine at Callen-Lorde Community Health Center, an LGBTQ-focused health clinic in New York City, called the long list of transition-related expenses a “transgender tax” that can cost trans people hundreds of thousands of dollars over their lifetime.
Across the pond, in the United Kingdom, Alicia Tuplin West, 19, has turned to unregulated online pharmacies for both cost and expedience. While England offers free gender-affirming care through a publicly funded health care system, West, a university student, said she faced a waitlist of up to several years through England’s National Health Service (joining around 26,000 others, according to The Guardian). Unwilling to wait and unable to afford a private health care alternative costing 1,000 pounds a year ($1,250), West bought hormones through an online pharmacy and cut the price by 90%, she said.
“The traditional way, it’s all socialized; it’s all paid for by my taxes,” West said. “However, I would argue that the traditional way is like a myth — the idea of getting treatment from the NHS — if you want to transition in this decade.”
Access to care
Most U.S. states still permit minors to obtain gender-affirming care with parental consent, and, for those over 18, this type of care is still legal in all 50 states. However, recent years have seen an unprecedented wave of state laws seeking to ban or restrict transition-related care, particularly for trans youths.
Eighteen states now have laws on the books banning or restricting the prescription of puberty blockers and hormones to minors, though a federal judge struck down Arkansas’ law last month, and judges have temporarily blocked laws in Alabama, Florida, Indiana, Kentucky, Oklahoma and Tennessee. At least two dozen other statesare considering such measures, and a few, like Tennessee and Oklahoma, have considered bills that would restrict this type of care for some adults.
This legislative push makes legal access to gender-affirming care nearly impossible for some people, three experts told NBC News, which could lead them to unregulated online pharmacies.
Belkind said this recent legislation “absolutely” has the potential to send more transgender people online to seek hormones. He also pointed to a recent request by Florida Gov. Ron DeSantis, a Republican, that asked state universities to send information to the governor’s office about students who sought or received treatment for gender dysphoria.
“People are not going to want to be on those lists for obvious reasons,” Belkind said. “They might not even disclose to their medical providers, if they seek medical care for other things, that they are on hormones.”
Dr. Danielle Brooks, an endocrinologist at Northwell Health’s Center for Transgender Care, said state legislation restricting transition-related care will likely drive more people, including minors, down the DIY path.
“I think more and more people are aware of the path,” Brooks said. “I do think that will be something that will increase over time, and it’s probably increasing now.”
Dr. Joshua Safer, director of the Center for Transgender Medicine and Surgery at Mount Sinai in New York City, said patients have historically self-medicated when they don’t have access to conventional medical care. While he doesn’t think most trans youths will be able to acquire gender-affirming hormones through the informal economy, he said parents may resort to seeking medical care in other states if they have the resources.
If these youths are unable to acquire hormones, Safer said, there are “going to be negative mental health implications.”
The data supports Safer’s assertion: Transgender and gender-nonconforming individuals are at an increased risk for mental illness and suicidality, according to a study published last year in JAMA Network Open, and receipt of transition-related care is associated with 60% decreased odds of moderate or severe depression and 73% decreased odds of suicidality.
Even for adults and minors who have health insurance and live in states not affected by restrictions on transition care, insurance companies may not approve coverage for such care.
Dale Melchert, a staff attorney at the Transgender Law Center, said he has seen most insurance companies oscillate gender-affirming health care coverage based on what’s required under federal regulation, such as individual presidential administrations’ interpretation of the Affordable Care Act. While Obama-era policies blocking widespread coverage exclusions have historically prompted insurers to adjust their plans to cover more gender-affirming care, Trump-era rollbacks of these policies have since barred many from affordable access to transition care, Melchert said.
“Most insurance companies will do anything they can to save money, and denials are a way to save money,” he said. “Technically, we still have Trump’s rollbacks on the books.”
Apart from the expenses associated with transitioning, unpleasant experiences with health care providers can also dissuade individuals from seeking supervised care.
“Doctors can also ask unnecessary questions that have nothing to do with the reason they came to seek care. That feels really invasive,” Melchert said. “A lot of times doctors don’t know how to provide competent care.”
A 2018 study of students at 10 medical schools found that approximately 80% of survey respondents felt “not competent” or “somewhat not competent” treating transgender patients. According to the same study, while 93% of respondents felt somewhat or very comfortable treating sexual minority patients, 68% felt comfortable treating gender minority patients.
Dr. Ricardo Correa, an associate professor at the University of Arizona College of Medicine-Phoenix, acknowledged that there’s a “high” amount of bias in the health care community against trans people, echoing a sentiment also expressed by Brooks. However, he added, even those who want to refer patients to practices where they can receive gender-affirming care may be unable to, because the patients are based in communities where there’s an absence of physicians who are able to provide adequate help.
“Instead of food deserts, there are medical deserts,” Correa said. “The patient just gets more traumatized [and] trusts the system less.” This, he said, can lead patients to pursue a DIY approach, until they are able to find the care they seek.
A desire for control
A., a postdoctoral fellow in life scienceat a Canadian university who requested that her name not be published due to safety concerns, sourced gender-affirming hormones through overseas online pharmacies for roughly a year. She wasn’t, however, prompted by a desire to save money or a lack of health insurance. Instead, she said, her driving factor was control over her own transition.
She said she received care from a Planned Parenthood clinic in the Midwest for nearly three years, followed by care at the LGBTQ nonprofit Howard Brown Health in Chicago for several years. Eventually, she grew dissatisfied after facing remasculinization and plateauing effects, she said. Her decision to take a DIY approach was the result of a conservative approach to hormone replacement therapy by her previous health providers and a general lack of information about trans care among doctors, she said.
“At first, everything seemed to be doing fine,” she said of her transition-related care. “You see breast growth, you see that your skin is getting smoother. … All of a sudden, for no reason whatsoever, you stall or you start regressing. Your facial and body hair come back in force, and you feel general discomfort in your body and mind.”
Following years of remasculinization — including “$3,000 of laser hair removal out the window” and persistent gender dysphoria — she grew desperate for a solution, she said. That’s when she decided to turn to online pharmacies, which enabled her to increase her hormone dosage.
She said the DIY process made her “feel empowered.”
“You feel very lost, but you feel that there’s the possibility of something moving forward,” she said. “You feel like you’re taking the reins of your care.”
After a year of ordering hormones through unregulated online pharmacies and self-administering, she said, she finally found a “good, private” clinic that was willing to listen to her concerns and address her needs. While she no longer personally uses a DIY approach, she continues to serve as a resource for others starting their DIY journeys through online forums, she said.
Health and legal risks
Obtaining and administering hormones without regulated pharmacies and licensed health care providers can expose individuals to serious health risks, including blood clots, stroke, liver damage and cardiovascular disease.
“We’re always worried about excess dosing if someone’s not being monitored, because the risks are real,” Brooks said. “There’s a possibility that medical history is not being taken into account or there is something being missed.”
Brooks said several patients have come to her office with a higher-than-normal concentration of red blood cells as a result of taking “very inappropriately” high levels of testosterone. This, she added, can cause vision problems, dizziness, fatigue, weakness, confusion and, of most concern, blood clots.
“The vast majority of products offered through online pharmacies are, at best, non-U.S. FDA-approved medicines and, more often, at worst, dangerous fakes.”
LIBBY BANEY, ALLIANCE FOR SAFE ONLINE PHARMACIES
Belkind, of Callen-Lorde, said his colleagues have seen patients who ended up with injection-site infections after self-administering hormones using the wrong technique, as well as blood clots due to using the incorrect hormone dosage.
On the flip side, Belkind said, he has had patients who, prior to seeking his care, used self-prescribed hormones and found helpful resources online, where they “learned what medications are safer.”
“In an era when patients may have no option but to ‘DIY’ their transitions, just as it is happening with abortions in many states, it might be important for them to know that there are ways to do it that are overall less risky and that there are resources created by the community where they can learn how,” he said.
Libby Baney, a partner at the law firm Faegre Drinker and a senior adviser to the Alliance for Safe Online Pharmacies, a nonprofit that combats illegal online drug sellers, cautioned that those who buy medication from unregulated online pharmacies may not actually be getting what they ordered.
“U.S. consumers buying medications from online pharmacies rarely, if ever, receive exactly what they think they are ordering,” she said. “The vast majority of products offered through online pharmacies are, at best, non-U.S. FDA-approved medicines and, more often, at worst, dangerous fakes.”
The National Association of Boards of Pharmacy’s 2022 “Rogue Rx Activity Report,” which Baney’s team shared with NBC News, cites a 2008 European Alliance for Access to Safe Medicines report that found 62% of medicines purchased online are substandard or counterfeit, and a 2010 Korean study that found 26% of medications tested from online pharmacies contained toxins like mercury, lead and arsenic, while 37% of samples tested didn’t have any active ingredients at all.
“Anytime that you have a product where people have either a legitimate medical need or perceived need, people will go online to find it outside the regulated supply chain,” Baney said.
Of the approximately 30,000 to 40,000 online pharmacies around the globe, 96% don’t require a valid prescription, 85% offer medicines that aren’t authorized by the FDA and more than 50% offer controlled substances, according to the 2022 National Association of Boards of Pharmacy report.
When it comes to the legal risks, enforcement efforts generally aren’t targeted at individual consumers, but rather the unregulated pharmacies selling the medication or the intermediaries helping to facilitate importation, according to Carrie Harney, vice president of government and regulatory affairs at United States Pharmacopeia, a nonprofit that annually publishes standards for prescription and over-the-counter drugs.
As for Adomat, they have recently scrapped the DIY method in favor of medically supervised care in Pennsylvania. This decision, they said, came after a career switch that included health insurance coverage. Still, Adomat said, they wouldn’t change their five-year DIY experience if given the opportunity.
“My attitude for a while was, ‘If it ain’t broke, don’t fix it,’” Adomat said. “Adding on to a general distrust of doctors, I decided to continue to put it off and shoulder the costs and risks myself.”
Now, with the right insurance and doctor, Adomat said, they “pay a fraction” of what they did using DIY methods. But, they added, those aren’t the only reasons why they’re currently content with the state of their care and their health: “I’m grateful I have a supportive family and legislature around me.”
If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.
A Kansas law will reverse gender markers on trans people’s birth certificates and driving licences, in a move deemed “disastrous” for those affected.
On Monday (26 June), state attorney general Kris Kobach confirmed to reporters that the new law – Senate Bill 180 – which takes effect from 1 July, will legally erase trans people’s gender identities.
Kobach said the law will also force public schools to record students as the gender assigned at birth, regardless of whether teachers and staff recognise gender identities of trans and non-binary students.
The legislation, described by the Kansas Senate as a “women’s bill of rights,” defines “sex” as “either male or female at birth” in state law, with no alternative definition for individuals who identify as trans, non-binary, gender fluid, or gender-non-conforming.
In addition, trans people will be forced to use toilets and other single-sex spaces corresponding to the gender they were assigned at birth.
Republican representative Brenda Landwehr, who voted for the bill, said it would “protect women’s spaces currently reserved for women and men’s spaces currently reserved for men”.
‘That does not make you a woman’
Senator Renee Erickson, one of three Republican lawmakers who joined Kobach during his news conference, said: “You can choose whatever name you want. You can choose to live however you want. That does not make you a woman.”
The law follows a 2019 ruling which saw a federal judge order Kansas to allow trans people to change their birth certificates to settle a lawsuit over a no-change policy. SB 180 would see the 2019 order cancelled.
Micah Kubic, the executive director of the American Civil Liberties Union of Kansas, accused Kobach of rushing to “impose his own stamp of extremism”. He added that state agencies are not required to adopt the attorney general’s views.
‘Disastrous and fraught with difficulty’
Trans activist and journalist Erin Reed, whose partner is trans Montana lawmaker Zooey Zephyr, said of the new law: “Rolling back transgender people’s legal markers would be disastrous and fraught with difficulty.”
Reed said enforcing incorrect gender markers could lead trans people to experience heightened “harassment and abuse”.
In May, Montana’s Senate Bill 458 was signed into law. The Republican-backed legislation defines “sex” as binary – excluding intersex, non-binary and trans people.
Zephyr has been vocal in opposing Republican’s anti-LGBTQ+ bills, which saw her banned from the floor of the state’s House of Representatives.
‘Calculated manoeuvre’
Reed added: “The calculated manoeuvre of redefining sex to systematically exclude transgender individuals is an attempt to sidestep legal challenges. These laws represent a clear attempt to move beyond targeting transgender youth and the beginning of the campaign to eradicate transgender adults from all legal protections.”
According to AP News, Omar Gonzalez-Pagan, a lawyer for Lambda Legal, said: “The attorney general must be off his rocker. This was a bunch of bombast by an attorney general engaging in politics.”
A Californian transgender man claims a pharmacist at a Walgreens chain in Oakland refused to hand over his hormone replacement medicine due to their “religious beliefs”.
In a Reddit post made on Tuesday (20 June), 30-year-old trans Oakland resident Roscoe Rike wrote that he had entered the pharmacy to pick up his prescription when he was asked by an employee what the medication was for.
“I told him I was pretty sure that it wasn’t any of his business,” he said in the post which has since been deleted.
Rike explained that he had been going to the Walgreens pharmacy on Telegraph Avenue for nearly a decade, and had been picking up his hormone prescription for three years, always without issue.
But the pharmacist, who Rike said he had never seen before, allegedly claimed he could not fill the prescription “due to his religious beliefs”.
Rike then said he immediately began recording a video that had also been uploaded to the post, in which he asks the pharmacist: “So you think you know better than my doctor, is that what’s going on?”
The clip then sees the pharmacist say: “I just need to know the diagnosis”, which Rike responds with: “That’s none of your f**king business.”
The pharmacist then allegedly told Rike, after making “some phone calls”, that he was still not going to give him his prescription.
“At this point, I completely lost my temper and demanded to speak to a manager,” Rike continued. “The pharmacist ignored me and walked away.”
After speaking to one of the employees Rike said was “familiar to me”, a manager was then called in who “apologised profusely” and issued his prescription.
“The whole experience was extremely distressing and caused me severe emotional pain,” he said. “I have reached out to the transgender law center, and plan on filing a formal complaint with the Walgreens corporate office.“
Rike finished by urging any local trans residents to make sure “this person isn’t working” when picking up their hormones, because, Rike said: “He will deny you care.”
PinkNews contacted Walgreens for comment on the alleged incident.
In a statement to the local news station KRON4, a spokesperson said: “Our policies are designed to ensure we meet the needs of our patients and customers while respecting the religious and moral beliefs of our team members.
“In an instance where a team member has a religious or moral conviction that prevents them from meeting a customer’s need, we require the team member to refer the customer to another employee or manager on duty who can complete the transaction. These instances, however, are very rare.”
A federal judge on Wednesday struck down Florida rules championed by Gov. Ron DeSantis restricting Medicaid coverage for gender dysphoria treatments for potentially thousands of transgender people.
“Gender identity is real” and the state has admitted it, U.S. District Judge Robert Hinkle wrote in a 54-page ruling.
He said a Florida health code rule and a new state law violated federal laws on Medicaid, equal protection and the Affordable Care Act’s prohibition of sex discrimination.
They are “invalid to the extent they categorically ban Medicaid payment for puberty blockers and cross-sex hormones for the treatment of gender dysphoria,” Hinkle wrote.
The judge said Florida had chosen to block payment for some treatments “for political reasons” using a biased and unscientific process and that “pushing individuals away from their transgender identity is not a legitimate state interest.”
An email seeking comment from the DeSantis’ office wasn’t immediately returned.
Hinkle’s harsh language echoed that in his ruling two weeks ago over a law that bans transgender minors from receiving puberty blockers. Hinkle, who was appointed by Democratic President Bill Clinton, issued a preliminary injunction so that three children could continue receiving treatment.
The DeSantis administration and the Republican-controlled Legislature had banned gender-affirming treatments for children and a law that DeSantis signed in May made it difficult — even impossible —for many transgender adults to get treatment.
The latest ruling involved a lawsuit filed last year on behalf of two adults and two minors, but advocacy groups estimate that some 9,000 transgender people in Florida use Medicaid to fund their treatments.
Hinkle also addressed the issue of whether gender-affirming treatments were medically necessary and noted that transgender people have higher rates of anxiety, depression and suicide than the general population.
Transgender medical care for minors is increasingly under attack — Florida is among 19 states that have enacted laws restricting or banning treatment. But it has been available in the United States for more than a decade and is endorsed by major medical associations.
The American College of Pediatricians, a small, right-wing extremist group of physicians who for two decades has struggled to gain traction finds itself for the first time with more power than it has ever had as the far-right takes greater hold on America.
But along with their new-found power comes a deep dive into at least 15 years worth of their internal documents, the result of the group reportedly publishing a link to its own unsecured Google drive in April, which WIRED uncovered and reported on back in May.
The Washington Post combed through 10,000 of the group’s documents, and on Thursday publishing its exposé on the American College of Pediatricians, which the Southern Poverty Law Center lists as an anti-LGBTQ hate group.
“The American College of Pediatricians (ACPeds) is a fringe anti-LGBTQ hate group that masquerades as the premier U.S. association of pediatricians to push anti-LGBTQ junk science, primarily via far-right conservative media and filing amicus briefs in cases related to gay adoption and marriage equality,” SPLC writes in its extensive report.
According to The Washington Post, the American College of Pediatricians is a “small group of conservative doctors” that “has sought to shape the nation’s most contentious policies on abortion and transgender rights by promoting views rejected by the medical establishment as scientific fact.”
The American College of Pediatricians promotes the discredited practice of “conversion therapy,” which has been called “torture” by some who have been subjected to it. Conversion therapy, which purports to change a human being’s sexual orientation or gender identity, is outlawed in several states, while most credible medical organizations have denounced it.
The group’s success comes at the expense of transgender youth.
“The organization’s quest to ban the use of puberty blockers and hormone therapy for transgender minors has culminated in a string of recent legislative wins following lobbying in at least eight states, internal documents show,” The Post reports. “Arkansas first enacted such a law in 2021, after Michelle Cretella, then executive director of the American College of Pediatricians, described such care as ‘experimental and dangerous‘ to legislators. A federal appeals court temporarily blocked it.”
“Versions of the law have since passed at least 20 other state legislatures, including Florida, Idaho, Indiana, West Virginia, Oklahoma, Missouri, Montana, Texas, North Dakota and Louisiana this spring alone; some face court challenges and one was vetoed by a governor. Similar bills are making their way through legislatures in North Carolina and Ohio.”
In other words, lawmakers in about half the country are working to harm transgender children, with the help of the American College of Pediatricians.
Also among the American College of Pediatricians’ more dangerous efforts over the years have been its attacks on homosexuality.
“Internal records from 2010 show how the group tied homosexuality to health risks — even death — in a letter campaignto educators, citing a 1991 study to demonstrate that for each year adolescents delay ‘self-labeling as ‘gay’,’ the risk of suicide decreases by 20 percent.”
That claim we know today is false.
“According to more recent research, suicide risk rises with therapy directed at changing sexual orientation. Lesbian, gay and bisexual people who experienced conversion therapy were almost twice as likely to think about suicide and to attempt suicide compared with peers who had not experienced conversion therapy, according to the Williams Institute at the UCLA School of Law,” The Post adds.
2010 may seem like light years ago, but LGBTQ rights were very much a large part of the national conversation back then.
In 2010, President Barack Obama directed the federal government to extend spousal benefits to same-sex couples. A critical portion of the anti-LGBTQ federal law, the Defense of Marriage Act, was ruled unconstitutional by a federal court. President Obama also signed into law the repeal of “Don’t Ask, Don’t Tell” that year. And a federal judge ruled California’s infamous Prop 8 was unconstitutional.
But also in 2010, just as LGBTQ people were starting to be able to access the rights and recognition they had always been denied, the American College of Pediatricians sent a letter, The Post reports, “to 14,800 public school superintendents [that] urged school officials not to affirm any student expressing homosexuality. It directed them to a website operated by the group that pushed ‘sexual reorientation therapy’ for those with ‘unwanted homosexual attractions.’”
The Heritage Foundation, a once-vaunted right-wing think tank that has succumbed to pro-Trump MAGA far-right extremism, is a big fan of the American College of Pediatricians.
“They have had the courage to take stands in court and to speak as medical professionals in relating their experience when it comes to questions of human dignity in unborn life, freedom of conscience, and the protection of children,” Roger Severino, Heritage’s vice president of domestic policy, told The Post.
Severino, a far-right religious extremist, served in the Trumpadministration as the head of the Department of Health and Human Services’ Office of Civil Rights.
In its report on Thursday, The Washington Post adds that Severino “said [he] relies on the American College of Pediatricians for scientific expertise.”
Amplifying far-right wing anger that the LGBTQ Pride flag was hanging from the White House during President Joe Biden’s historic Pride celebration over the weekend, the Heritage Foundation lashed out, attacking the entire LGBTQ community and the Biden administration.
On Wednesday the Heritage Foundation declared that the LGBTQ Pride flag “does not represent anything good and it certainly does not represent America.”
Missouri Gov. Mike Parson (R) signed two anti-trans bills targeting kids into law on Wednesday, one banning gender-affirming care for trans youth and one banning trans women and girls from playing on women’s sports teams.
S.B. 49, the “Missouri Save Adolescents from Experimentation (SAFE) Act”, is set to take effect on August 28 and bans all gender-affirming treatments (including reversible puberty blockers) until August 2027. Any healthcare providers who violate the law risk losing their license. Some states that have passed gender-affirming care bans have required trans youth already receiving this care to wean themselves off their medications and detransition, but this law allows those already undergoing care to continue.
“We support everyone’s right to his or her own pursuit of happiness,” Parson tweeted upon signing the bill. “However, we must protect children from making life-altering decisions that they could come to regret in adulthood once they have physically and emotionally matured.”
The anti-trans sports bill, S.B. 39, says both private and public schools all the way through college must require trans youth to play on sports teams according to their sex assigned at birth.
In his tweet about the bill, Parson declared that inclusivity was unjust “nonsense.”
“Women and girls deserve and have fought for an equal opportunity to succeed, and we stand up to the nonsense and stand with them as they take back their sport competitions. In Missouri, we support real fairness, not injustice disguised as social righteousness.”
LGBTQ+ advocates have roundly condemned the legislation.
“These bills represent a two-pronged approach to targeting trans youth and eliminating their stories, their perspectives, and their right to a happy, healthy childhood,” said Human Rights Campaign state legislative director and senior counsel Cathryn Oakley in a statement. “SB 49 tosses aside decades of scientific research and guidance from every major medical and mental health organization, representing over 1.3 million American doctors, in favor of the discriminatory whims of politicians in Jefferson City.”
Shira Berkowitz, senior director of public policy and advocacy for Missouri advocacy group PROMO said Parson has “showed just how little Missouri’s state government values LGBTQ+ lives and, in particular, transgender and gender-expansive youth. Berkowitz added that the laws are part of an “embarrassing history of elected leaders intentionally taking action to harm transgender Missourians.”
It’s a pivotal time for the trans community. Anti-trans lawmakers have rushed to restrict trans rights at every turn. By mid-May, 110 anti-trans bills had advanced for votes in state legislatures across the country.
NCTE helped to defeat 66 of them.
Pride is a time to celebrate these wins, to remember our collective strength, and to joyfully resist queer and trans oppression.
Trans people have always been here. We’ll always be here – no matter how hard our opposition tries to change that. In the face of threats to our rights and safety, we will protect each other.
This Pride month, we’re fundraising for trans rights in the lead up to Give OUT Day. This is a perfect opportunity to show your solidarity with the trans community.
Donate $10 or more to the National Center for Transgender Equality today. Your donation could help us win up to $10,000 from Horizons Foundation to protect trans rights!
Ready to go further?Click here to start your own fundraiser for NCTE andencourage your friends and family to donate. It only takes a few minutes to set up, and it will make a huge difference for trans rights, safety, and joy!
We truly appreciate your support. All of us at NCTE hope you have a powerful, fearless, and celebratory Pride!
The American Civil Liberties Union (ACLU) has filed a lawsuit challenging Idaho’s gender-affirming care ban for transgender youth.
The organization is suing alongside other groups and law firms on behalf of two families who believe the law violates the U.S. Constitution. It is the eighth lawsuit filed by the ACLU and its affiliates against trans health care bans, according to the Los Angeles Blade. Lawsuits have also been filed in Arkansas, Nebraska, Montana, Oklahoma, Indiana, Tennessee, and Kentucky.
“This law is a dangerous intrusion upon the rights and lives of Idaho families,” said Amy Dundon, a Legislative Strategist with the ACLU of Idaho. “Our state should be a safe place to raise every child, including transgender youth, and HB 71 threatens to deny them the safety and dignity they deserve. We welcome this opportunity to defend the transgender youth of Idaho and their families from this discriminatory political attack and we won’t stop defending them until each one has all the care and support they need to thrive.”
The lawsuit calls the legislation “an unprecedented intrusion into families’ fundamental autonomy” and says it “preempts Idaho parents’ (and doctors’) judgment about what is best for their own children.”
One of the anonymous plaintiffs, a 16-year-old trans girl, said it has been a “long journey” to living as her true self.
“My medical care has been an important part of that journey,” she said. “My family, my doctors, and I have worked together to make decisions about my medical care, and it’s shocking to have politicians take those decisions away from us. Trans people like myself deserve the same chance at safety and liberty as everyone else, but this law specifically targets us and our health care for no good reason. I’m 16 – I should be hanging out with my friends and planning my future instead of fighting my State for the health care I need.”
Idaho Gov. Brad Little (R) signed H.B. 71 in early April. It is considered one of the nation’s most punitive bans on gender-affirming care for trans youth. The bill made providing such care to a trans person under the age of 18 a felony with a maximum sentence of 10 years in prison.
Only one other state, Alabama, has made it a felony to provide gender-affirming care. The 11 other states that ban such care have imposed administrative penalties like the loss of a healthcare provider’s medical license.
The Idaho bill bans gender-affirming surgery from being performed on trans minors, though such surgeries aren’t performed on minors. The bill also bans doctors from prescribing puberty blockers and hormone replacement therapy to people under the age of 18.
Puberty blockers are reversible, life-saving medications that delay the permanent effects of puberty so that young people and their families have more time to understand their identities. Puberty blockers don’t work if they’re taken years after the onset of puberty.
“We are determined to protect the transgender youth of Idaho, their families, and their medical providers from this unjust and dangerous attack on their rights and lives,” said Li Nowlin-Sohl, a Senior Staff Attorney at the LGBTQ & HIV Project with the ACLU. “This health care is supported by every major medical organization in the U.S. and is critical for the futures of transgender youth across the state. We will not rest until this unconstitutional law is struck down.”
The legal team of a transgender woman incarcerated in Minnesota on Thursday announced she will be transferred to a women’s prison as part of a landmark settlement with the state’s Department of Corrections. The settlement also guarantees affirmative medical care and appropriate housing for other trans prisoners.
Christina Lusk, 57, sued the Minnesota Department of Corrections (DOC) last year when they denied her gender-affirming medical care and housed her in a men’s prison after she pled guilty to a drug charge in 2019. Lusk came out as transgender and started hormone replacement therapy in 2008, and legally changed her name in 2018. At the time of her arrest the following year, she was consulting with doctors regarding gender-affirming surgery at the time of her arrest.
As part of its settlement, the DOC agreed to move Lusk from MCF Moose Lake, a men’s prison facility to MCF Shakopee, a women’s facility. The DOC also agreed to provide Lusk with an objective third-party medical provider to determine Lusk’s suitability for gender-affirming surgery. If deemed suitable, the DOC agreed to pay for the treatment and cover out-of-pocket expenses after her release from prison if certain conditions are met, such as obtaining health insurance. The DOC also agreed to abide by the World Professional Association for Transgender Health’s (WPATH) standards of care for other trans inmates, and contract with a WPATH certified health care provider to provide training and support.
Lusk was in represented in her suit by lawyers from Gender Justice and Robins Kaplan LLC.
“As part of settling the lawsuit and in accordance with the DOC’s new transgender policy, the DOC has agreed to provide [Lusk] access to a transgender healthcare specialist to determine if gender-affirming surgery is medically necessary,” the DOC said in a statement. “The DOC will also assist her in obtaining surgery if the specialist determines it is necessary.”
“With this settlement, the Department of Corrections takes an important and necessary step toward fulfilling its responsibilities to the people in its care,” Jess Braverman, legal director for Gender Justice, said in a statement. “Thanks to Christina Lusk’s willingness to speak out, transgender people in custody will now have expanded access to the housing and health care they need, and the legal protections they deserve.”