An alarming 81% of transgender adults have considered suicide, according to a new studyfrom the Williams Institute at UCLA School of Law. Comparatively, it found 35% of cisgender adults have considered suicide.
The first-of-its-kind study, which appeared in this month’s edition of the journal Psychiatry Research, examined the prevalence of serious drug use, psychological distress, and suicidality among a nationally representative sample of trans and cisgender adults. The study took its data from the U.S. Transgender Population Health Survey (TransPop).
The study found that 42% of trans adults have attempted suicide, compared to just 11% of cis adults. It also found that 56% of trans adults have engaged in non-suicidal self-injury, compared to 12% of cis adults.
Overall, trans people said they were significantly more likely to experience poor mental health during their lifetimes than cis people. However, 82% of trans adults said they had sought mental health treatment at some point, compared to just 47% of cis adults.
While trans and cis adults both reported similar rates of hazardous drinking and problematic drug use, trans nonbinary adults reported the highest rates of substance use.
For example, while 17% of trans women and 25% of trans men reported hazardous drinking, 45% of trans nonbinary people reported the same. While 33% of trans women and 18% of trans men reported problematic drug use, 42% of trans nonbinary people reported the same.
Trans nonbinary adults also reported more problematic drug use, more psychological distress, more suicidal ideation, and more non-suicidal self-injury than trans men, with rates of three to six times greater than that of trans men.
One of the study’s authors, Ilan H. Meyer, said, “A lack of societal recognition and acceptance of gender identities outside of the binary of cisgender man or woman and increasing politically motivated attacks on transgender individuals increase stigma and prejudice and related exposure to minority stress, which contributes to the high rates of substance use and suicidality we see among transgender people.”
Sadly, the study’s findings seem to back up a May 2023 study from The Trevor Project, an LGBTQ+ youth anti-suicide organization. In that study, 66% of queer youth said that anti-LGBTQ+ legislation had negatively affected their mental health, and 41% of LGBTQ+ youth in the U.S. said they’d seriously considered suicide in the last year.
Among suicidal survey respondents, those who identified as transgender, nonbinary, and/or people of color reported higher rates of suicidal ideation than their peers. Rates of anxiety and depression were, on average, 18.5% higher among trans, nonbinary, and questioning youth than among cisgender youth.
In addition to the mental distress, 64% of trans and nonbinary young people reported feeling discriminated against in the past year due to their gender identity, and 27% of trans and nonbinary young people reported being physically threatened or harmed in the past year due to their gender identity.
If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. The Trans Lifeline (1-877-565-8860) is staffed by trans people and will not contact law enforcement. The Trevor Project provides a safe, judgment-free place to talk for youth via chat, text (678-678), or phone (1-866-488-7386). Help is available at all three resources in English and Spanish.
More than 100 transgender men have entered the Miss Italy pageant this week, according to an activist leading a protest against recent comments by the pageant’s organizer, who said trans women wouldn’t be allowed to compete.
The comments came after another European pageant, Miss Netherlands, crowned its first transgender winner, Rikkie Valerie Kollé, this month. About a week later, Patrizia Mirigliani, the official organizer of Miss Italy, told an Italian radio station that Miss Italy wouldn’t allow trans women to compete.
“Lately, beauty contests have been trying to make the news using strategies that I think are a bit absurd,” Mirigliani said, according to the Italian news outlet Il Primato Nazionale.
She added that Miss Italy has historically allowed only people who were assigned female at birth to enter, “probably because, even then, it was foreseen that beauty could undergo modifications, or that women could undergo modifications, or that men could become women,” according to Il Primato Nazionale.
Trans activist Federico Barbarossa, who lives in Bari, a town in southern Italy, said that he became angry when he saw Mirigliani’s comments but that he was “also kind of amused by it, because I was like, ‘Yeah, well, I was assigned female at birth, but they would reject me because I look like a boy, and they would consider me as a boy,’” he said in an interview with NBC News.
Barbarossa decided to enter the pageant under his deadname, or the name he was given at birth, as a form of protest in solidarity with trans women. Barbarossa shared a screenshot of an email he received confirming his registration on Instagram, and then the local LGBTQ nonprofit group he works with, Mixed LGBTQIA+, shared his entry on Facebook with a statement encouraging other trans men to do the same.
The campaign went viral online, Barbarossa said, and he estimates that more than 100 trans men have entered the pageant so far. He said some told him they haveeven been called to selections, which is the next step in the process to find contestants across the country.
Miss Italy organizers “really have to go through every single application,” Barbarossa said. He hopes the protest will “maybe lead them to think better next time.”
“I like to think I’m a little part of Italy’s progress in this sense,” Barbarossa said.
Mirigliani and Miss Italy organizers didn’t immediately respond to requests for comment.
More beauty pageants have started to include trans women in recent years. In 2018, Angela Ponce became the first trans woman to compete in the Miss Universe pageant. Then, in 2021, Kataluna Enriquez became the first trans woman to compete in the Miss USA pageant after she was crowned Miss Nevada. Some countries, such as Mexico and Thailand, have held separate beauty pageants for trans women.
Federico Barbarossa.Courtesy Federico Barbarossa.
Barbarossa said he thinks beauty pageants try to exclude trans women in part because they simply don’t understand them or have false ideas about what it means to be trans.
For his decision, Durán cited federal court decisions, Title IX of the Education Amendments of 1972, and the Equal Protection Clause of the Fourteenth Amendment.
Virginia’s Department of Education introduced policies last week that would force students to use bathrooms, pronouns, and names that align with their sex assigned at birth. The guidelines went into effect immediately.
“I reaffirm our unwavering support for our LGBTQIA+ students, staff, and community. I want our transgender, non-binary, and gender fluid students to hear loud and clear that you belong here, you are valued, and we stand with and support you,” Durán said.
“I oppose any policy that infringes upon the rights of our students and threatens the safety and well-being of our LGBTQIA+ students. APS will continue to uphold our core mission and follow our policies to ensure that every child receives equal educational access and opportunities. We fully support our transgender and LGBTQIA+ students and value the many diverse identities within our schools, where every student can authentically express themselves, feel valued and have a genuine sense of belonging.”
Youngkin’s 2022 election campaign highlighted “parents’ rights” in opposition to so-called “woke” anti-racist education and trans-inclusive school policies. The VDOE’s new policies will affect the estimated 4,000 transgender students in Virginia among the state’s 1.2 million public school students.
The state’s previous governor enacted policies allowing students to use school facilities and participate in programs matching their gender identities. The earlier policies also required schools to accommodate students’ chosen names and pronouns.
“We will continue to model and live our values in support of inclusion, belonging, well-being, and access to quality education,” Durán told parents. “To this end, our current policies and procedures that protect, affirm, and celebrate transgender, non-binary, and gender-fluid students are of paramount importance in adhering to these ideals.”
Two patients sued Monday in Nashville Chancery Court, saying they were among more than 100 people whose records were sent by Vanderbilt to Attorney General Jonathan Skrmetti. His office has said it is examining medical billing in a “run of the mill” fraud investigation that isn’t directed at patients or their families. Vanderbilt has said it was required by law to comply.
The patients say Vanderbilt was aware that Tennessee authorities are hostile toward the rights of transgender people, and should have removed their personally identifying information before turning over the records.
Tennessee has stood out among conservative-led states pushing myriad laws targeting transgender people, enacting some of the nation’s most anti-LGBTQ restrictions, even as families and advocates have voiced objections that such policies are harmful. The lawsuit seeks class-action status on behalf of everyone at the clinic whose private medical records were released to Skrmetti.
“Against that backdrop, its failure to safeguard the privacy of its patients is particularly egregious,” the lawsuit says.
The attorney general’s office has said the hospital has been providing records of its gender-related treatment billing since December 2022, and that the records have been kept confidential. Elizabeth Lane Johnson, an attorney general’s office spokesperson, noted Tuesday that the office isn’t a party to the lawsuit, and directed questions to Vanderbilt.
VUMC spokesperson John Howser said Tuesday that it’s common for health systems to get such requests in billing probes and audits, and “the decision to release patient records for any purpose is never taken lightly, even in situations such as this where VUMC was legally compelled to produce the patient records.”
Many of the patients involved are state workers, or their adult children or spouses; others are on TennCare, the state’s Medicaid plan; and some were not even patients at the transgender clinic, according to the lawsuit. It says that records for more than 100 current and former patients were sent without redacting their identities.
The lawsuit says that since the patients learned that their information was shared, they’ve been “terrified for their physical safety, have had significant anxiety and distress that has impacted their ability to work, has caused them to increase home security measures, and drop out of activities in which they normally would participate.”
The lawsuit accuses Vanderbilt of negligence that inflicted emotional damage and violated patient privacy protection and consumer protection laws. It seeks monetary damages, improved security procedures, an injunction blocking further release of their records without notice, an acknowledgement by Vanderbilt that it violated its own privacy policy, and an admission that the policy inadequately informs patients of their rights regarding disclosures.
The hospital waited months before telling patients their medical information was shared, acting only after the existence of the requests emerged as evidence in another court case. Howser said that at that point, hospital officials thought patients should hear it from them instead of media reports or other ways.
The attorney general also requested a slew of additional information, including the names of everyone referred to the transgender clinic who made at least one office visit, as well as people who volunteer for the hospital’s Trans Buddy initiative, which aims to increase access to care and improve outcomes by providing emotional support for the clinic’s patients.
Howser said Vanderbilt’s lawyers are in discussion with the attorney general’s office “about what information is relevant to their investigation and will be provided by VUMC.”
The attorney general’s office made the requests several months after conservative commentator Matt Walsh surfaced videos last September that include a medical center doctor saying gender-affirming procedures are “huge money makers” for hospitals. Vanderbilt paused all gender-affirming surgeries for minors the next month under pressure from Republican lawmakers and Gov. Bill Lee, who demanded an investigation.
Vanderbilt said it had provided about five gender-affirming surgeries to minors each year since its clinic opened in 2018, all to people over 16 who had parental consent. None received genital procedures.
When the U.S. Supreme Court revoked the national guarantee of abortion rights last year, there were warnings that the ruling would endanger other rights involving bodily autonomy. And indeed, it’s now being weaponized against gender-affirming care.
The ruling, from the U.S. Court of Appeals for the Sixth Circuit, isn’t the final word on the case; it simply lets the law go into force while the suit against it is heard. But it’s raising concern that other courts might buy the argument or, if federal appellate circuits disagree on the question, the issue of gender-affirming health care could be decided by the Supreme Court — where conservatives currently outnumber liberals by six to three. Vox senior correspondent Ian Millhiser raised this possibility in a recent article.
Representatives of LGBTQ+ organizations, however, say the jury is out, so to speak.
“There’s a high likelihood that these organization and states [behind the care bans] want to push this all the way to the Supreme Court,” Sarah Warbelow, vice president of legal at the Human Rights Campaign, tells The Advocate. Whether they’ll manage to do so, though, “is really hard to say,” she adds.
Sixth Circuit Chief Judge Jeffrey Sutton wrote the opinion placing a hold on the injunction against the Tennessee ban, and he mentioned the Dobbs ruling several times. “If a law restricting a medical procedure that applies only to women does not trigger heightened scrutiny, as in Dobbs, a law equally appliable to all minors, no matter their sex at birth, does not require such scrutiny either,” he wrote in one instance. When a court considers the constitutionality of a law, heightened scrutiny, also known as strict scrutiny, means that the government must prove it has a compelling interest behind the law and that the statute is tailored as narrowly as possible to achieve its goals.
But Judge Helene White, who dissented from Sutton’s ruling, pointed out that the Tennessee ban does treat minors differently based on their sex at birth. It bans gender-affirming procedures for minors who do not identify as the gender assigned at birth but allows them for those who do. “To illustrate, under the law, a person identified male at birth could receive testosterone therapy to conform to a male identity, but a person identified female at birth could not,” she wrote.
Until Sutton wrote his ruling, every federal court that had considered the constitutionality of these laws reached the conclusion that they discriminated based on sex, White observed. Such laws have been temporarily blocked (while cases are heard) in Alabama, Florida, Indiana, and Kentucky because federal judges believed that those who are challenging them are likely to prove such discrimination, and a judge in Arkansas has gone further by striking down that state’s law, the first ruling on such a law’s merits. In a suit in Oklahoma, the state and the challengers have agreed that the law will not be enforced while the case proceeds.
Jennifer Levi, senior director of transgender and queer rights at GLBTQ Legal Advocates and Defenders, says this shows the Sixth Circuit’s ruling is off base. “The states have been citing Dobbsall along, and the courts have rejected that,” Levi says.
On whether there will be a rash of such rulings or the Supreme Court will eventually get involved, she says, “I think it’s really premature to speculate at this point.” GLAD is representing clients challenging the Alabama law and the Florida one; the Alabama trial is scheduled for next spring, while there’s not a definite timetable for the Florida case.
HRC is co-counsel in the Alabama and Florida cases, plus one in Georgia that’s in a very early stage. The Alliance Defending Freedom, an anti-LGBTQ+ legal nonprofit that has won cases at the Supreme Court, including the recent “right to discriminate” case out of Colorado, is working with Alabama officials to defend that state’s ban, and it’s pushing the use of Dobbs, Warbelow notes.
Ultraconservative Justice Samuel Alito, who wrote the Dobbs majority opinion, was very specific that it applied only to abortion, although that didn’t keep fellow conservatives like Justice Clarence Thomas from saying the court should use the same reasoning to strike down marriage equality and other rights. But still, in cases involving gender-affirming care, judges across the political spectrum are blocking or striking down the bans, Warbelow observes.
Ash Orr, press relations manager at the National Center for Transgender Equality, agrees that it’s “premature to form a definitive opinion” about what will happen with the gender-affirming care cases. But the situation bears watching, he says.
If the reasoning used in the Sixth Circuit decision continues to be applied, Orr says, “it could result in significant regression regarding numerous rights.” Beyond the question of whether these bans discriminate, courts must consider whether rights are “deeply rooted in this nation’s history and traditions,” he points out. Judge Sutton asserted that those challenging the Tennessee law had not demonstrated that the right to new medical treatments was deeply rooted.
As various courts rule on the constitutionality of gender-affirming care bans, “it is probable that they will eventually necessitate a comprehensive review by the Supreme Court,” Orr adds. One factor in whether the high court takes a case is whether there is a so-called circuit split — that is, appeals courts in different circuits have ruled differently on an issue.
In the meantime, there are things that not only lawyers and organizations but ordinary citizens can do, beyond supporting the organizations bringing these cases. Warbelow recommends becoming informed about what gender-affirming care for youth consists of and then sharing that information with others.
“Have that conversation with the people in your life,” she says. “We need more people who can spread the word.”
As a 7-year-old, Adelyn Vigil believed death was the way to be able to live as a girl.
Adelyn’s nightly prayer to God was to become a bird to be able to fly, then die and then be made into a girl.
“I was crying and I told her: ‘Oh, but mom, it’s going to take a long time, because first I have to die as a boy and then as a bird and then be a girl,” Adelyn, 14, told Noticias Telemundo about the conversation with her mother years earlier.
As a child “I knew I was in the wrong body,” Adelyn Vigil said, once telling her mom she prayed she would she would “die as a boy” so she could become a girl. Courtesy Vigil family
“The only thing I could say without crying was: ‘You know you don’t have to die,’” the trans teen’s mother, Adamalis Vigil, said in an interview, recalling the conversation. “I said, ‘If that’s what’s going to make you happy, you can do that. You don’t have to die.’”
Adelyn usually speaks with a smile, except when she starts talking about what makes her afraid: The estrogen hormone treatment she started a year ago is running out and she was left without a doctor after Republican Texas Gov. Greg Abbott signed state Senate Bill14 at the beginning of June. The law bans medical professionals from prescribing drugs to block puberty, hormonal therapies and gender transition surgeries on minors under 18.
The law “is going to be the toughest battle we’re going to face,” Adelyn’s mother said. The advice of a team of specialists and specialized medical care “is what has kept my daughter alive,” she added.
Adelyn is one of nearly 30,000 people ages 13 to 17 who identify as transgender in Texas, according to data from the Williams Institute at the University of California, UCLA. It’s the largest young transgender population of the nearly 20 conservative states that have passed similar laws in recent months.
Adelyn, who wants to be an attorney like Elle Woods (Reese Witherspoon) in “Legally Blonde” when she grows up, wants to move to Washington, D.C., work in human rights and someday be a mom.
Trans teen Adelyn Vigil, who’s turning 15 on July 24, in the quinceañera dress she bought in Mexico and will wear at her birthday party. Guidalty Photography
“It’s crazy what these legislators are trying to do, someone has to stop them,” Adelyn said about the state bill.
At least 64 bills against trans people have been introduced in Texas and four have passed, according to a count by Trans Legislation Tracker, an advocacy group that tracks these pieces of legislation around the country.
Those who promote and support laws banning gender-affirming care for minors, including puberty blockers and hormones, believe they are too young to make these kinds of decisions about their bodies and that the care is too experimental.
Adelyn spoke to Noticias Telemundo before her 15th birthday on July 24. She was emotional when talking about her quinceañera party — a tradition in Latino families when a young woman turns 15 — and she was excited about her dress, which had crystals, sequins, a bow and a layer of tulle. She bought it in Mexico, where her family is from.
According to Adamalis, the first signs regarding her child’s gender identity came early, when Adelyn was 3 years old. One day, Adamalis was sorting clothes in her closet and Adelyn saw a fuchsia party dress with crystals and asked her mom not to donate it. “When I grow up,” Adelyn told her mom, “I’m going to be a woman and I’m going to wear it.”
Adamalis told the child, “It doesn’t work like that, when you are born and you are a boy, you grow up and become a man,” she said. “And when you are born and you are a girl, you grow up and become a woman. It doesn’t work any other way.”
Adamalis said she tried to get information to understand what was happening and after much searching, she came across articles about trans people. “I had a word for what was happening to Adelyn,” she said.
“I knew I was in the wrong body,” Adelyn said. For Adelyn, there was first a social transition: buying girl’s clothes and shoes, growing her hair, changing her name and telling her family, friends and staff at her school who she was.
“My first instinct was to take her to the doctor,” her mother said. A pediatrician “examined her physically and he was the one who told me: ‘Your first step is going to be to take her to a counselor, a psychologist and talk to the school.’”
Transgender people like Adelyn often experience “a true disconnect between their birth-assigned sex and their inner sense of who they are,” according to the Human Rights Campaign. The anxiety caused by this disconnection has been referred to by doctors as gender dysphoria, since it can cause severe pain and anguish in the lives of trans people.
Adamalis Vigil and her child, Adelyn. Adamalis Vigil
She was “very sad all the time and would come home and cry,” Adamalis said.
Medical treatments, then a law banning them
For Adelyn, puberty blockers weren’t an option until she was 13 years old; then, after intense and prolonged medical care and assessments, she started hormone therapy with estrogen for a year. The treatments allow her to maintain a finer voice and prevent her from developing masculine features such as a prominent Adam’s apple.
Adelyn said that Texas’ ban on this kind of treatment for minors is “as if the lawmakers are telling you: ‘No, you can’t be you anymore’; ‘wait, wait.’ But if I wait, I will see myself as a man — I don’t want that,” she said, adding that is one of her biggest fears.
Puberty blockers “temporarily stop this process of change and give the adolescent and their family members the opportunity to explore a little more what their options are in the future,” said Dr. Uri Belkind, associate medical director of Adolescent Medicine at the Callen-Lorde Community Health Center in New York.
There are a series of protocols and medical criteria that must be followed before prescribing hormones and they’re not recommended for children who have not yet started puberty, according to the Mayo Clinic.
Puberty blockers, according to the Mayo Clinic, “do not cause permanent physical changes” but may affect growth, bone density and fertility, “although it depends on when the medication is started.” That is why they recommend that each case be evaluated specifically and that patients have a specialized medical team.
“We have enough evidence to say very clearly that these drugs are medically necessary, that they produce benefits, that the benefits outweigh the risks, and that, in one way or another, they improve quality of life and even save lives,” Belkind said.
That’s why the bill worries Adamalis.
“Of all the battles, I think this is the worst, because this kind of help is what has kept my daughter alive,” Adamalis said about her daughter. “When I found her [medical] team, she was happy. Her anxiety went away, her panic attacks went away,” Adamalis said.
Laws like the one in Texas, said Belkind, prevent medical professionals like him from providing patients the care they need, and by not having access, “they see their body getting further and further and further away from the idea that they have of themselves.”
This is dangerous because it generates anxiety, depression and stress. “We know that suicide rates increase in patients who don’t have access to this type of medication,” Belkind said.
Adelyn and her family would drive eight hours for appointments with the endocrinologist who was supervising her transition along with a team of experts. A few days ago, they got a letter from the endocrinologist saying that they could no longer treat her. The doctor was moving to California, the doctor confided to the family, because of the situation in Texas.
As a family, they’re considering traveling to New Mexico or Mexico to seek medical advice that is being denied at home. Adelyn doesn’t want to live in Texas but her mother said that, unfortunately, moving is currently not a possibility.
Adamalis said that the medical treatment they were able to get up to now “has given us the best years of Adelyn,” but that now she feels afraid and helpless.
She asks politicians to “educate themselves on the issue, but more than anything, to focus on what the problem really is: immigration reform, getting better health insurance, gun reform.”
Trans children and adolescents “are not the problem,” Adamalis said.
‘It has saved our entire family’
Juan is going to be 10 years old and identifies as trans. Due to his age, he’s only experienced a social transition with the support of his family, who is of Mexican origin, and a medical team that includes psychologists and counselors. The family lives in California, a state that, unlike Texas, has passed legislation to protect the legal and medical rights of LGBTQ+ people.
Juan’s transition began three years ago, although “from a very young age, from a very young age, around 2 years old — he always identified himself as a masculine,” his mother, Grisel Soriano, told Noticias Telemundo.
The process, she said, hasn’t been easy. “We went through a very complex emotional situation … because we didn’t really understand what was happening,” Soriano said.
“It’s difficult to understand a trans child when you do not have one at home,” said Grisel Soriano, with her son, Juan, who identifies as trans. Telemundo
For two years, the family tried to find alternatives, such as taking refuge in religion, but “we really started the transition out of survival,” Soriano said, adding that at the age of 6 “Juan had already had thoughts of death.”
His clothes, his hair, his name, made him suffer, Soriano said. “He didn’t like the gender that we were forcing him to live in at all.”
The family, guided by a team of medical experts, has supported Juan, although his mother feels that as parents they are judged and recriminated by a society that doesn’t understand them.
“It’s difficult to understand a trans family. It’s difficult to understand a trans child when you do not have one at home … until we hear our children say that they would be better off dead,” Soriano said.
Soriano believes that there are many myths surrounding trans children and their families. “They judge us as if one day our children decided to be trans children and we say happily, we are going to help them … We went through a difficult process and we do it from affection, from love,” she said.
Families, especially parents, go through a process similar to the stages of grief: shock, denial, anger, negotiation and acceptance, wrote Jason Rafferty, a pediatrician and psychiatrist at the American Academy of Pediatrics.
Rejecting and suppressing trans minors won’t make them change their gender identity, Rafferty wrote, but it harms the child’s emotional health and development and possibly contributes to high rates of depression, anxiety and other mental health problems.
Supporters of transgender rights protest outside a federal courthouse in Houston on June 24. Reginald Mathalone / NurPhoto via AP file
Nearly 600 anti-trans bills have been promoted across the country in 2023, according to the Trans Legislation Tracker‘s count. By contrast, only 19 bills were promoted in 2015.
Juan’s transition — he chose his name — “has been happiness for him,” his mother said. “After we started the transition, I saw him comfortable, I saw him happy, I saw him content … The transition has saved not only Juan, it has saved our entire family.”
Juan, whose favorite sport is American football, wants to be a doctor when he grows up. “I want to help children who are trans too,” he said.
He wanted to tell his story so that other children like him know that “everything will be fine.”
A federal judge has blocked a Wisconsin school district from requiring transgender students to use bathrooms and locker rooms that match the sex they were assigned at birth while a lawsuit plays out against the school.
U.S. District Judge Lynn Adelman said Thursday that the Mukwonago Area School District must allow a transgender student to use facilities that align with their gender identity, temporarily blocking a policy approved last month by the school board, the Milwaukee Journal Sentinel reported.
The order comes in a lawsuit brought anonymously by an 11-year-old transgender student and her mother. The judge ruled that the school’s policy was causing emotional and mental harm to the student, who was described as a boy at birth but has identified as a girl since she was three years old.
Mukwonago Area School District offices in Mukwonago, Wisc.Google maps
According to court documents, school officials have monitored which bathrooms the student uses and forced her to go to boys’ bathrooms or gender-neutral bathrooms at Mukwonago High School, where she is enrolled in summer school classes.
Adelman ruled that the student’s case was likely to succeed at trial, citing a similar case in Kenosha in 2017, in which a judge held that a school could not block a transgender student from using bathrooms that matched their gender identity.
The Village of Mukwonago is located in conservative Waukesha County, a Milwaukee suburb that has been key to Republican victories in the state. Across the country, Republican lawmakers have passed measures in recent years to restrict which bathrooms transgender students can use in public schools and universities.
On an early morning in June, Flower Nichols and her mother set off on an expedition to Chicago from their home in Indianapolis.
The family was determined to make it feel like an adventure in the city, though that wasn’t the primary purpose of the trip.
The following afternoon, Flower and Jennilyn Nichols would see a doctor at the University of Chicago to learn whether they could keep Flower, 11, on puberty blockers. They began to search for medical providers outside of Indiana after April 5, when Republican Gov. Eric Holcomb signed a law banning transgender minors from accessing puberty blockers and other hormone therapies, even after the approval of parents and the advice of doctors.
At least 20 states have enacted laws restricting or banning gender-affirming care for trans minors, though several are embroiled in legal challenges. For more than a decade prior, such treatments were available to children and teens across the U.S. and have been endorsed by major medical associations.
Indiana Gov. Eric Holcomb in Indianapolis on Jan. 10.Darron Cummings / AP file
Opponents of gender-affirming care say there’s no solid proof of purported benefits, cite widely discredited research and say children shouldn’t make life-altering decisions they might regret. Advocates and families impacted by the recent laws say such care is vital for trans kids.
On June 16, a federal judge blocked parts of Indiana’s law from going into effect on July 1. But many patients still scrambled to continue receiving treatment.
Jennilyn Nichols wanted their trip to Chicago to be defined by happy memories rather than a response to a law she called intrusive. They would explore the Museum of Science and Industry and, on the way home, stop at a beloved candy store.
Preserving a sense of normalcy and acceptance, she decided — well, that’s just what families do.
Navigating new laws
Families in Indiana, Mississippi and other states are navigating new laws that imply or sometimes directly accuse them of child abuse for supporting their kids in getting health care. Some trans children and teens say the recent bans on gender-affirming care in Republican-led states send the message that they are unwelcome and cannot be themselves in their home states.
For parents, guiding their children through the usual difficulties of growing up can be challenging enough. But now they are dealing with the added pressure of finding out-of-state medical care they say allows their children to thrive.
In the Nichols family alone, support took many forms as they traveled to Chicago: a grandmother who pitched in to babysit Flower’s 7-year-old brother, Parker, while their father Kris worked; a community of other parents of trans kids who donated money to make the trip more comfortable.
“What transgender expansive young people need is what all young people need: They need love and support, and they need unconditional respect,” said Robert Marx, an assistant professor of child and adolescent development at San José State University. Marx studies support systems for LGBTQ and trans people aged 13 to 25. “They need to feel included and part of a family.”
In Indiana, rancorous legislative debates, agitated family relationships and exhaustive efforts to find care have drawn families to the support group GEKCO, founded by Krisztina Inskeep, whose adult son is transgender. Attendance at monthly meetings spiked after the state legislature advanced bills targeting trans youth, she said.
“I think most parents want to do best by their kids,” Inskeep said. “It’s rather new to people, this idea that gender is not just a binary and that your kid is not just who they thought at birth.”
The perceptions of most parents, Marx said, don’t align neatly with the extremes of full support or rejection of their kids’ identities.
“Most parents exist in a kind of gray area,” Marx said. “Most parents are going through some kind of developmental process themselves as they come to understand their child’s gender.”
‘This is just like who I am’
On June 13, Flower and Jennilyn set off on their trip, unsteady but hopeful. They brought a care plan from Indiana University’s Riley Children’s Hospital, the Hoosier State’s only gender clinic.
At the time, the pair worried whether Chicago providers could meet their request for full-time support or as a backup if Indiana’s ban went on hold. They considered whether they could make the drive every three months, the necessary interval between Flower’s puberty blockers.
The decision for Flower to start puberty blockers two years ago wasn’t one the family took lightly.
Jennilyn recalled asking early on whether her daughter’s gender expression was permanent. She wondered if she had failed as a mom, especially while pregnant — was it an incorrect food? A missed vitamin?
Ultimately she and Kris dismissed those theories, ungrounded in science, and listened to their daughter, who recalled the euphoria of wearing princess dresses at an early age. Flower cherished a Little Red Riding Hood cape and felt certain of her identity from the start.
Flower Nichols in Chicago on June 13.Teresa Crawford / AP file
“I remember that I really disliked my name,” Flower said of her birth name. “This is just like who I am. It’s all that I have a memory of.”
Conversations between Flower and her mother are often marked by uncommon candor, as when discussing early memories together at an Indianapolis park.
“Before I knew you and before I walked this journey with you,” Jennilyn told her, “I would not have thought that a kid would know they were trans or that a kid would just come out wired that way. I always thought that that was something adults figured out, and so there were times that it was really scary because I didn’t know how the world would accept you. I didn’t know how to keep you safe.”
Now, Jennilyn said, her worries have shifted to Flower’s spelling skills and how she’ll navigate crushes.
Flower, for her part, appreciates being heard. She said she and her parents make medical decisions together because, “of course, they can’t decide on a medicine for me to take.”
“At the same time, you can’t pick a medicine that we can’t afford to pay for or that, you know, might harm you,” Jennilyn responded.
“That’s what I really like about her,” Flower said, of her mother. “She leaves a lot of my life up to me.”
‘They’re ripping our lives apart’
In Mississippi, a ban on gender-affirming care became law in the state on Feb. 28 — prompting a father and his trans son to leave the state at the end of July for Virginia. There, he can keep his health care and continue to see doctors.
“We are essentially escaping up north,” said Ray Walker, 17.
Walker lives with his mother, Katie Rives, in a suburb of Jackson, the state capital. His parents are divorced, but his father also lived in the area. Halfway through high school, Walker is an honors student with an interest in theater and cooking. He has a supportive group of friends.
When Mississippi Republican Gov. Tate Reeves signed the bill banning hormone therapy for anyone younger than 18, he accused “radical activists” of pushing a “sick and twisted ideology that seeks to convince our kids they’re in the wrong body.”
Mississippi Republican Gov. Tate Reeves signs Mississippi House Bill 1125 to ban gender-affirming care in the state for anyone younger than 18 on Feb. 28 in Jackson.Rogelio V. Solis / AP file
The state’s largest hospital halted hormone treatments for trans minors months before Reeves signed the ban. That hospital later closed its LGBTQ clinic.
After that clinic stopped offering its services, Walker and other teenagers received treatment at a smaller facility in another city, but those services ended once the ban took effect.
As access to gender-affirming dwindled and was later outlawed, Walker’s father, who declined to be interviewed, accepted a job in Virginia, where his son could keep his health care. Walker plans to move in with his father this month. Rives, however, is staying in Mississippi with her two younger children.
Walker’s memories of the anguished period when he started puberty at 12 still haunt him. “My body couldn’t handle what was happening to it,” he said.
After a yearslong process of evaluations, then puberty blockers and hormone injections, Walker said his self-image improved.
Then the broad effort in conservative states to restrict gender-affirming care set its sights on Mississippi. The path toward stability that Walker and his family forged had narrowed. It soon became impassable.
Ray Walker, 17, left, and his mother, Katie Rives, discuss his moving to Virginia for continued gender-affirming care on June 28 in Madison County, Miss.Rogelio V. Solis / AP file
“I was born this way. It’s who I am. I can’t not exist this way,” Walker said. “We were under the impression that I still had two years left to live here. The law just ripped all of that up. They’re ripping our lives apart.”
The family sees no alternative.
“Mississippi is my home, but there are a lot of conflicting feelings when your home is actively telling you that it doesn’t want you in it,” Walker said.
As Walker’s moving date approaches, Rives savors the moments the family shares together. She braces for the physical distance that will soon be between them. Her two younger sons will lose Ray’s brotherly presence in their daily lives.
She still feels lucky.
“We know that’s an incredibly privileged position to be in,” Rives said of her son moving to Virginia. “Most people in Mississippi cannot afford to just move to another state or even go to another state for care.”
‘She belongs’
Flower, initially dispirited by the debates at the Indiana Statehouse, brightened after her parents took her to her first Pride march on June 10 in Indianapolis.
She tied a transgender pride flag around her shoulders and covered her pink shirt in every rainbow heart-shaped sticker she could find. She gripped a sign that read: “She belongs.”
Her favorite activities are often less inflected with politics than her status as a soon-to-be teenager. She’s a Girl Scout who enjoys catching Pokemon with her brother. Before the trip, she zipped around an Indianapolis park on a pink scooter, her hair tangled by the wind.
Flower Nichols and her mother, Jennilyn, in front of the Museum of Science and Industry in Chicago on June 13.Teresa Crawford / AP file
Prior to entering Chicago’s Museum of Science and Industry, Flower used a women’s bathroom. At a diner in the city, she ordered a mint chocolate chip milkshake and a vegan grilled cheese. Jennilyn created an itinerary to make their experience as joyful and uncomplicated as possible.
“First of all, we’re going be able to chill at the hotel in the morning,” Flower said. “Second of all, there’s a park nearby that we can have a lot of fun in. Third of all, we might have a backup plan, which is really exciting. And fourth of all: Candy store!”
The doctor’s appointment the following day, initially intimidating, soon gave them another reason to celebrate: If care was not available in Indiana, they could get it in Chicago.
“Indiana could do whatever the hell they’re going to do,” Jennilyn said, “and we can just come here.”
Kansas Attorney General Kris Kobach (R) has filed a lawsuit to force the state government to discriminate against trans people on their driver’s licenses and birth certificates.
The suit asks the court to demand the Department of Revenue’s Division of Vehicles comply with S.B. 180, a sweeping new anti-trans law that, among other things, bans trans people from updating the gender marker on their birth certificates and driver’s licenses.
This is Kobach’s latest move in an ongoing battle between himself and the state’s Democratic Gov. Laura Kelly.
In April, Kelly vetoed S.B. 180, but the state’s Republican-led legislature overrode her veto to pass the bill. Once the bill took effect on July 1, Kelly directed state agencies to continue to allow transgender citizens to change the gender markers on their birth certificates and driver’s licenses in defiance of Kobach.
A banner at the top of the Department of Revenue’s website declares that the “enactment of Senate Bill 180 on July 1 will not impact the longstanding procedures for obtaining, renewing, and updating a Kansas driver’s license as they pertain to gender markers.”
Kobach – who also lost to Kelly in the 2018 gubernatorial race – also filed a motion in June to end a 2019 consent decree settling a 2018 lawsuit brought by four transgender residents who claimed that the state’s refusal to correct birth certificates violated their constitutional right to equal protection.
In conjunction with that motion, Kobach announced that trans people who already had a birth certificate or license changed could keep the documents but that the state’s data would revert back to their sex assigned at birth.
Prior to Kobach’s announcement, legal experts had assumed that the state would not move to change gender markers that had already been updated under the 2019 consent decree, leading many transgender Kansans to rush to update their documents before the law was scheduled to take effect.
Kobach’s current lawsuit against the Department of Revenue blasts Kelly, declaring she “cannot pick and choose which laws she will enforce and which she will ignore.”
“She does not possess the power that English monarchs claimed prior to the ‘Glorius Revolution’ of 1688,” the suit continues, “namely, the power to suspend the operation of statutes.”
Yet Kobach has also been accused of failing to enforce the law in his attempt to retroactively remove gender markers from the documents of trans citizens who received their licenses before the law took effect.
American Civil Liberties Union of Kansas executive director Micah Kubic told KMUW that S.B. 180 does not require the measures Kobach has announced. “These are of his own volition and interpretation, driven by his own extreme ideological perspective, not by requirements of the law, the constitution, or the best interests of Kansans.”
“The laws should not be considered retroactive,” UMKC Law School professor Steve Leben told KCTV5 News. “The law itself says it’s effective July 1, takes effect and it’s enforced from that date.”
Kobach also argues in the lawsuit that the state has already been using sex and gender synonymously since state statute says driver’s licenses must reflect an individual’s “gender” but the actual documents issued use the word “sex.”
Today, only three days after Kobach filed the lawsuit, District Judge Teresa Watson ordered the Kansas Department of Revenue to immediately stop allowing gender changes. The order will last up to two weeks but can be extended as the hearing goes on.
S.B. 180 has been characterized as a “women’s bill of rights” by Republican supporters who claim it is necessary to keep transgender women and girls out of women’s restrooms and locker rooms. In addition to legally defining “sex” in terms of reproductive biology, the law also bans trans people from accessing facilities that correspond with their gender identity in schools, prisons, women’s shelters, rape crisis shelters, and locker rooms.
A transgender woman and former inmate who was held in solitary confinement for six years is suing the Missouri Department of Corrections (MODOC) for what is described as its “unconstitutional and discriminatory policy against people living with HIV.”
The plaintiff, identified only as Jane Roe, claims in the lawsuit filed last week she was held in solitary confinement between 2015 and 2021 at the Jefferson City Correctional Center (JCCC) because she was living with HIV. She is represented by Lambda Legal, the MacArthur Justice Center, and the law firm Shook, Hardy & Bacon
“No person should be subjected to the inhumane and devastating effects of long-term solitary confinement, conditions that Ms. Roe faced every day for more than six years,” Richard Saenz, Lambda Legal senior attorney, criminal justice and police misconduct strategist, said in a statement. “We filed this lawsuit to hold the Missouri Department of Corrections accountable for its use of an unconstitutional and discriminatory policy that singles out people living with HIV.”
“Ms. Roe was trapped in isolation with no way to challenge her conditions,” MacArthur Justice Center attorney, Shubra Ohri, said. “Six years of that led Ms. Roe to self-harm, suicidal ideation, and actual suicide attempts. This tracks with widespread consensus among the human rights experts, psychologists, physicians, and mental health authorities who say solitary confinement is torturous and should be abolished.”
“We seek justice for our client who endured six years of unwarranted solitary confinement. We will work to prevent this from ever happening to another human being,” Gregory Woo, a Shook partner, said in a statement.
The lawsuit, Roe v. Precythe, et. al., was filed in the U.S. District Court for the Western District of Missouri, and claims “MODOC’s policy on incarcerated people living with HIV lacks any consideration of modern medicine and does not engage in individualized assessments.”
The lawsuit alleges that MODOC’s policies and actions violated Roe’s Eighth and Fourteenth Amendments, the Americans with Disabilities Act, and Section 504 of the Rehabilitation Act. Roe claimed she was denied the services, programs, and activities offered to other inmates because of her HIV status. Roe is seeking policy changes by MOCOD, monetary damages, and other unspecified relief.
If you are having thoughts of suicide or are concerned that someone you know may be, resources are available to help. The 988 Suicide & Crisis Lifeline at 988 is for people of all ages and identities. Trans Lifeline, designed for transgender or gender-nonconforming people, can be reached at (877) 565-8860. The lifeline also provides resources to help with other crises, such as domestic violence situations. The Trevor Project Lifeline, for LGBTQ+ youth (ages 24 and younger), can be reached at (866) 488-7386. Users can also access chat services at TheTrevorProject.org/Help or text START to 678678.
