US presidential candidate Vivek Ramaswamy has caused uproar among the public after describing being transgender as a “mental health disorder.”
The comment, which came during Wednesday night’s (27 September) second GOP debate, completely disregards official guidance from all major medical and mental health associations.
As transphobic rhetoric continues to sweep across the United States, it was likely that the topic of LGBTQ+ rights was going to crop up at some point during the presidential election run, but those tuned into the debate were disgusted to hear the Republican candidate’s views.
Candidates were asked their opinions on the contentious parental rights debate, which has seen a growing number of school districts debate whether to introduce policies that would inform parents if a student goes by a gender identity that doesn’t match the gender on their birth certificate.
When it came Ramaswamy’s turn to speak, he said: “Transgenderism, especially in kids, is a mental health disorder… It is not compassionate to affirm a kid’s confusion. That is not compassion, that is cruelty.”
This comment directly contradicts guidance from the American Psychiatric Association which says diverse gender expressions “are not indications of a mental disorder.”
The Republican candidate also made baseless claims that a lack of a parental notification policy in schools would increase the risk of suicide among young people.
LGBTQ+ advocacy groups have warned that introducing parental notification policies would be more likely to put young people at risk, particularly if their parents are not supportive of their wishes to transition.
Ramaswamy then claimed to have spoken with two young women who said they regretted undergoing gender-affirming surgeries and promised the “ban genital mutilation and chemical castration.”
In fact, it is incredibly rare for gender-affirming surgeries, when made available to transgender and gender non-conforming individuals, to result in feelings of regret.
According to a 2021 review of 27 studies involving almost 8,000 teenagers and adults across Europe, the US, and Canada who had gender-affirming surgeries found that an average of just one per cent expressed regret.
Those tuned in to the debate were devastated to see baseless anti-trans rhetoric being spread on such a public platform and took to X (formerly Twitter) to condemn Ramaswamy and other candidates who expressed similar beliefs.
“We will stand up for trans people every day,” commented one viewer. “Absolutely disgusting to hear Vivek Ramaswamy call it a mental health disorder.”
Both Tennessee and Kentucky have been given the go-ahead by a federal appeals court to outlaw gender-affirming care for minors.
Earlier in 2023, both states passed legislation to restrict a number of rights for transgender youth, including access to gender-affirming care.
Both were challenged in court by the families of transgender children in each state and the American Civil Liberties Union, who had argued that bans on gender-affirming care discriminated on the basis of sex.
Bans on gender-affirming care have been upheld in both states. (Getty Images)
On Thursday (28 September), the 6th US Circuit Court of Appeals voted 2-1 to honour both states’ appeals, allowing the restrictive bans to go ahead, Reuters reports.
In both states, these bans will prohibit medical providers from treating transgender minors with gender-affirming care, including puberty blockers, hormones and, in rare cases, surgery.
Gender-affirming care for minors has been backed by all major medical associations, including the American Medical Association (AMA) which reaffirmed this summer that they “unequivocally support the health and welfare of people who identify as LGBTQ+, which includes trans and gender diverse people seeking and undergoing gender-affirming care.”
Such treatment can often be life-saving for people suffering from gender dysphoria, and young people will be put at serious risk by having their access blocked.
Despite the overwhelming evidence in favour of gender-affirming care for minors, Chief Judge Jeffrey Sutton wrote in his ruling: “This is a relatively new diagnosis with ever-shifting approaches to care over the last decade or two.
“Under these circumstances, it is difficult for anyone to be sure about predicting the long-term consequences of abandoning age limits of any sort for these treatments.”
A crowd of people, many of whom are young, gather to protest the passing of SB 150 on 29 March 2023 at the Kentucky state capitol. (Getty)
Judge Sutton was joined by Judge Amul Thapar in his vote to allow the bans to go ahead.
In opposition was Judge Helene White, who had argued that neither Tennessee nor Kentucky should pass “constitutional muster” or “intrude on the well-established province of parents to make medical decisions for their minor children.”
Commenting on the ruling, the ACLU of Tennessee said: “This is a devastating result for transgender youth and their families in Tennessee and across the region.”
“Denying transgender youth equality before the law and needlessly withholding the necessary medical care their families and their doctors know is right for them has caused and will continue to cause serious harm. “
Meanwhile, the ACLU of Kentucky said in a separate statement: “Today’s decision is heartbreaking for trans youth across the state. It ignores evidence from medical experts & the trial court who agree that this care is necessary, effective, appropriate, & banning it undermines parents’ right to direct the upbringing of their children.”
“No one should have to decide between their health care and their home.”
Both ACLU chapters pledged to take further action in defence of their clients and the rights of all transgender people in their respective states.
A Montana law banning gender-affirming medical care for transgender minors is temporarily blocked, a state judge ruled Wednesday, just four days before it was to take effect.
District Court Judge Jason Marks agreed with transgender youth, their families and healthcare providers that a law passed by the 2023 Montana Legislature is likely unconstitutional and would harm the mental and physical health of minors with gender dysphoria.
The preliminary injunction blocking the law will remain in effect until a full trial can be held on the issue, but Marks has said he expects his decision will be appealed to the Montana Supreme Court.
“Today’s ruling permits our clients to breath a sigh of relief,” Akilah Deernose, executive director of the ACLU of Montana, said in a statement. “But this fight is far from over. We look forward to vindicating our clients’ constitutional rights and ensuring that this hateful law never takes effect.”
Montana is one of at least 22 states that have enacted bans on gender-affirming medical care for minors and most face lawsuits. Some bans have been temporarily blocked by courts, while others have been allowed to take effect.
All the laws ban gender-affirming surgery for minors. Such procedures are rare, with fewer than 3,700 performed in the U.S. on patients ages 12 to 18 from 2016 through 2019, according to a study published last month. It’s not clear how many of those patients were 18 when they underwent surgery.
In Montana’s case, transgender youth argued the law would ban them from continuing to receive gender-affirming medical care, violating their constitutional rights to equal protection, the right to seek health and the right to dignity.
Their parents said the law would violate their constitutional rights to make medical decisions for their children and two medical providers said it would prevent them from providing effective and necessary care to their patients.
“Montana’s ban is a direct assault on the freedom and well-being of transgender youth, their families, and their medical providers,” Malita Picasso, staff attorney for the American Civil Liberty Union, said in a recent statement.
The law sought to prohibit the use of puberty blockers, cross-sex hormones and surgical treatments for gender dysphoria, while still allowing cisgender minors to receive puberty blockers to treat early puberty or surgical procedures to treat intersex conditions.
Allowing the ban to take effect would cause irreparable harm to transgender minors who are receiving treatment, in part by exacerbating the anxiety and depression they feel because their body is incongruent with their gender identity, Picasso argued during a Sept. 18 hearing for the preliminary injunction.
The state countered that beginning the treatments put transgender children on a “path of no return.”
“A child cannot possibly consent to the treatment that permanently and irreversibly changes secondary sex characteristics, nor can a child consent to future infertility and sterilization, future sexual dysfunction and a lifetime of hormone treatments and other forms of medicalization and resulting complications,” Assistant Attorney General Russell argued.
As Republican-led states have rushed to ban gender-affirming care for minors, some families with transgender children found a bit of solace: At least they lived in states that would allow those already receiving puberty blockers or hormone therapy to continue.
But in some places, including Missouri and North Dakota, the care has abruptly been halted because medical providers are wary of harsh liability provisions in those same laws — one of multiple reasons that advocates say care has become harder to access even where it remains legal.
“It was a completely crushing blow,” said Becky Hormuth, whose 16-year-old son was receiving treatment from the Washington University Gender Center at St. Louis Children’s Hospital until it stopped the care for minors this month. Hormuth cried. Her son cried, too.
“There was some anger there, not towards the doctors, not toward Wash U. Our anger is towards the politicians,” she said. “They don’t see our children. They say the health care is harmful. They don’t know how much it helps my child.”
Since last year, conservative lawmakers and governors have prioritized restricting access to transgender care under the name of protecting children. At least 22 states have now enacted laws restricting or banning gender-affirming medical care for transgender minors. Most of the bans face legal challenges and enforcement on some of them has been put on hold by courts.
All the laws ban gender-affirming surgery for minors, although it is rare, with fewer than 3,700 performed in the U.S. on patients ages 12 to 18 from 2016 through 2019, according to a study published last month. It’s not clear how many of those patients were 18 when they received the surgeries.
There’s more variation, though, in how states handle puberty-blockers and hormone treatments under the new bans. Georgia’s law does not ban those for minors. The others do. But some states, including North Carolina and Utah, allow young people taking them already to continue. Others require the treatments to be phased out over time.
These treatments are accepted by major medical groups as evidence-based care that transgender people should be able to access.
James Thurow said the treatment at the Washington University center changed everything for his stepson, a 17-year-old junior at a suburban St. Louis high school who is earning As and Bs instead of his past Cs, has a girlfriend and a close group of friends.
“His depression, his anxiety had pretty much dissipated because he was receiving the gender-affirming care,” Thurow said. “He’s doing the best he’s ever done at school. His teachers were blown away at how quickly his grades shot up.”
For its part, the center said in a statement that it was “disheartened” to have to stop the care. Its decision followed a similar one from University of Missouri Health Care, where the treatment for minors stopped Aug. 28, the same day the law took effect.
Becky Hormuth holds boxes containing testosterone in Wentzville, Mo., on Sept. 20, 2023. Jeff Roberson / AP
Both blamed a section of the law that increased the liability for providers. Under it, patients can sue for injury from the treatment until they turn 36, or even longer if the harm continues past then. The law gives the health care provider the burden of proving that the harm was not the result of hormones or puberty-blocking drugs. And the minimum damages awarded in such cases would be $500,000.
Neither state Sen. Mike Moon, the Republican who was the prime sponsor of the Missouri ban, state Sen. Justin Brown nor state Rep. Dale Wright, whose committees advanced the measure, responded immediately to questions left Thursday by voicemail, email or phone message about the law’s intent.
In North Dakota, the law allows treatment to continue for minors who were receiving care before the law took effect in April. But it does not allow a doctor to switch the patient to a different gender dysphoria-related medication. And it allows patients to sue over injuries from treatment until they turn 48.
Providers there have simply stopped gender-affirming care, said Brittany Stewart, a lawyer at Gender Justice, which is suing over the ban in the state. “To protect themselves from criminal liability, they’ve just decided to not even risk it because that vague law doesn’t give them enough detail to understand exactly what they can and cannot do,” Stewart said.
Jasmine Beach-Ferrara, the executive director of the Campaign for Southern Equality, said it’s not just liability clauses that have caused providers to stop treatment.
Across the South, where most states have adopted bans on gender-affirming care for minors, she said she’s heard of psychologists who wrongly believe the ban applies to them and pharmacists who stop filling orders for hormones for minors, even in places where the laws are on hold because of court orders.
“It’s hard to overstate the level of kind of chaos and stress and confusion it’s causing on the ground,” she said, “particularly … for people who live in more rural communities or places where even before a law went into effect, it still took quite a bit of effort to get this care.”
Her organization is providing grants and navigation services to help children get treatment in states where it’s legal and available. That system is similar to networks that are helping women in states where abortion is not banned get care.
But there’s one key difference: gender-affirming care is ongoing.
For 12-year-old Tate Dolney in Fargo, North Dakota, continuing care means traveling to neighboring Minnesota for medical appointments. “It’s not right and it’s not fair,” his mother, Devon Dolney, said at a news conference this month, “that our own state government is making us feel like we have to choose between the health and well-being of our child and our home.”
Hormuth’s son is on the waiting list for a clinic in Chicago, at least a five-hour drive away, but is looking at other options, too. Hormuth, a teacher, has asked also her principal to write a recommendation in case the family decides to move to another state.
“Should we have to leave?” she asked. “No one should have to have a plan to move out of state just because their kid needs to get the health care they need.”
In the meantime, the family did what many have: saving leftover testosterone from vials. They have enough doses stockpiled to last a year.
A Texas church has chosen a radically different path from many denominations nationwide. Instead of demonizing LGBTQ+ people, the Galileo Church in Fort Worth has opted to support and welcome the community.
The congregation is particularly disturbed by the state legislature’s recently enacted law that bans healthcare providers from treating trans kids and has launched a program to help families get their children the healthcare they need.
“Health care is a human right, and withholding necessary care for trans kids is state-sponsored cruelty. As neighbors to one another, we seek ways to help each other’s families flourish,” the church says on the website for the new program, the North Texas TRANSportation Network.
The church will assist families who need to travel out of state to get treatment for their children with a $1000 grant. Individual donors and organizations fund the group; no public money is used.
The not-for-profit doesn’t require religious beliefs or church participation from applicants. The only qualification is that families must live in the 19-county northern Texas area and have a trans or gender-diverse child.
“I’m a mother, I have three kids so and I have always been able to get the healthcare for my kids that they desperately needed,” Executive Director Cynthia Daniels told CBS News. “So to me it’s just being a good neighbor to a group of people who have been selected to not be able to receive their healthcare and to me that’s devastating.”
Grants are distributed as the funds become available.
Findings from 40 years of the British Social Attitudes (BSA) survey, which was published by the National Centre for Social Research (NatCen) on Thursday (21 September), revealed insights into cultural and moral views in the UK.
Although the BSA was founded in 1983, questions regarding transgender people were first asked only seven years ago.
The BSA 2022 survey consisted of 6,638 interviews, conducted between 7 September and 30 October, and results showed a sharp rise in prejudice against trans people, with only 64 per cent saying they’re “not at all prejudice”, falling from 82 per cent since 2019.
Also according to the data, on average, almost four in every 10 people disagreed that trans people should have the right to change the sex recorded at birth on their birth certificate, if desired. Only three in every 10 people felt transgender men and women should be allowed to do so – a fall of 23 percentage points since 2019. Three in 10 also neither agree or disagree.
Elsewhere, the research brought better news: the British public has definitely become more liberal in its attitudes towards non-traditional family forms, sexual relationships and abortion.
Forty years ago, only 17 per cent of people felt same-sex relationships were “not wrong at all”, while 67 per cent feel that way now. Over the same period, those who believed that same-sex relations were “always wrong” has fallen from 50 per cent to just nine per cent.
Meanwhile, there is almost universal support for abortion being allowed when the woman’s health is seriously endangered by the pregnancy – backed by of 95 per cent of those surveyed – while 89 per cent said they were who are in favour when there was a strong chance of the baby having a serious health condition.
‘Shift that benefits no one’
Gillian Prior, NatCen’s deputy chief executive, said of the findings: “In the case of transgender people, the recent public debate about the law on gender recognition has appeared to have resulted in attitudes becoming less liberal than they were just a few years ago.”
Stonewall were more blunt, saying the decline in trans acceptance were a “shift that benefits no one”.
The LGBTQ+ charity blamed the results on the “inevitable human impact of a manufactured moral panic”, in a post on X, formerly known as Twitter.
“The only way society has moved on from previous moral panics is by political and societal leaders standing strong against hatred and misinformation. This is what we all need to do now to get the UK back on track.”
The data is the result of “the press-driven moral panic bearing fruit”, according to Nancy Kelley, Stonewall’s chief executive.
“Shame on every institution and individual that has driven this and is profiting from it,” she said.
A federal appeals court is considering cases out of North Carolina and West Virginia that could have significant implications on whether individual states are required to cover health care for transgender people with government-sponsored insurance.
The Richmond-based 4th U.S. Circuit Court of Appeals heard oral arguments in cases Thursday involving the coverage of gender-affirming care by North Carolina’s state employee health plan and the coverage of gender-affirming surgery by West Virginia Medicaid.
During the proceedings, at least two judges said it’s likely the case will eventually reach the U.S. Supreme Court. Both states appealed separate lower court rulings that found the denial of gender-affirming care to be discriminatory and unconstitutional. Two panels of three Fourth Circuit judges heard arguments in both cases earlier this year before deciding to intertwine the two cases and see them presented before the full court of 15.
Tara Borelli, senior attorney at Lambda Legal — the organization representing transgender people denied services in both states — said excluding the coverage is a clear example of discrimination outlawed by the 14th Amendment.
“The exclusion here is actually quite targeted, it’s quite specific,” Borelli said in court, arguing that a faithful interpretation of the U.S. Constitution and the equal protection clause ensures transgender people coverage.
“One of the most important things that a court can do is to uphold those values to protect minority rights who are not able to protect themselves against majoritarian processes,” she said.
Attorneys for the state of North Carolina said the state-sponsored plan is not required to cover gender-affirming hormone therapy or surgery because being transgender is not an illness. Attorney John Knepper claimed only a subset of transgender people suffer from gender dysphoria, a diagnosis of distress over gender identity that doesn’t match a person’s assigned sex.
Knepper said North Carolina’s insurance plan does not discriminate because it does not allow people to use state health insurance to “detransition,” either.
In updated treatment guidelines issued last year, the World Professional Association for Transgender Health said evidence of later regret is scant, but that patients should be told about the possibility during psychological counseling.
West Virginia attorneys said the U.S. Centers for Medicare & Medicaid Services has declined to issue a national coverage decision on covering gender-affirming surgery.
Caleb David, attorney for the state defendants, said West Virginia’s is not a case of discrimination, either, but of a state trying to best utilize limited resources. West Virginia has a $128 million deficit in Medicaid for the next year, projected to expand to $256 million in 2025.
“West Virginia is entitled to deference where they’re going to take their limited resources,” he said. “They believe that they need to provide more resources towards heart disease, diabetes, drug addiction, cancer, which are all rampant in the West Virginia population.”
Unlike North Carolina, the state has covered hormone therapy and other pharmaceutical treatments for transgender people since 2017. “That came from a place of caring and compassion,” he said.
In June 2022, a North Carolina trial court demanded the state plan pay for “medically necessary services,” including hormone therapy and some surgeries, for transgender employees and their children. The judge had ruled in favor of the employees and their dependents, who said in a 2019 lawsuit that they were denied coverage for gender-affirming care under the plan.
The North Carolina state insurance plan provides medical coverage for more than 750,000 teachers, state employees, retirees, lawmakers and their dependents. While it provides counseling for gender dysphoria and other diagnosed mental health conditions, it does not cover treatment “in connection with sex changes or modifications and related care.”
In August 2022, a federal judge ruled that West Virginia’s Medicaid program must provide coverage for gender-affirming care for transgender residents.
U.S. District Judge Chuck Chambers in Huntington said the Medicaid exclusion discriminated on the basis of sex and transgender status and violated the equal protection clause of the 14th Amendment, the Affordable Care Act and the Medicaid Act.
Chambers certified the lawsuit as a class action, covering all transgender West Virginians who participate in Medicaid.
An original lawsuit filed in 2020 also named state employee health plans. A settlement with The Health Plan of West Virginia Inc. in 2022 led to the removal of the exclusion on gender-affirming care in that company’s Public Employees Insurance Agency plans.
Olivia Hill is the first openly transgender person ever elected to Nashville’s Metro Council. According to LGBTQ+ Victory Fund, Hill is the first transgender woman elected in Tennessee history.
Hill secured one of the Council’s five at-large seats in Thursday’s runoff election with 12.9% of the vote, as of 10 p.m. Thursday night. She joins a historic number of women elected to the Council. All five at-large members will be women, as well as 17 district councilmembers. That adds up to 22 women — a majority of the 40-member council.
“I want to say that I am elated,” Hill told The Tennessean after the historic win. A Nashville native, Hill graduated from Hillwood High School in 1983. She then served in the U.S. Navy from 1986-1995 and saw combat overseas during Desert Storm.
Read the full article. Per Wikipedia: The Metropolitan Council (officially the Metropolitan Council of Nashville and Davidson County) is the legislative body of the consolidated city-county government of Nashville, Tennessee and Davidson County.
A U.S. Justice Department lawsuit against the American Samoa Government (ASG) over allegations that the ASG unfairly treated a former employee because she was transgender has been settled.
According to Title VII of the Civil Rights Act, it is illegal to discriminate based on sex or gender identity at one’s workplace.
In a consent decree approved by the court, ASG agreed to pay Simeonica Tuiteleleapaga $125,000 as compensation for the harassment she suffered at the hands of her supervisor during her employment at ASG, a DOJ press release said.
In addition, the consent decree mandates that ASG implement comprehensive policies and procedures to address complaints of sex-based discrimination and provide training to its employees, ensuring that they are well-equipped to handle such matters with sensitivity and adherence to the law.
According to the lawsuit, Tuiteleleapaga’s supervisor, Meki Solomona, the ASG’s Department of Human and Social Services director, consistently harassed Tuiteleleapaga and another transgender colleague despite numerous employee complaints.
Solomona once asked Tuiteleleapaga, in front of other employees, whether she was a “girl or a boy” and told her to “take it off” and “let us see if you are a woman.”
Solomon berated her for nearly an hour after she departed the meeting.
The ASG failed to do anything to intervene.
Tuiteleleapaga’s discrimination claim was referred to the Justice Department for enforcement after the EEOC’s Hawaii District Office investigated and tried to resolve it.
Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division said, “Discrimination against transgender employees is discrimination based on their sex, and no employee should have to tolerate a supervisor’s hostile comments about their gender identity.”
She continued, “Transgender employees must be free from discrimination, harassment or derision in the workplace.”
The case serves as a stark reminder of the importance of proactive measures to prevent and address discrimination in the workplace.
Gender Justice on Thursday announced the state district court lawsuit in a news conference at the state Capitol in Bismarck. The lawsuit against the state attorney general and state’s attorneys of three counties seeks to immediately block the ban, which took effect in April, and to have a judge find it unconstitutional and stop the state from enforcing it.
State lawmakers “have outlawed essential health care for these kids simply and exclusively because they are transgender,” Gender Justice attorney and North Dakota state director Christina Sambor told reporters. “They have stripped parents of their right to decide for themselves what’s best for their own children. They have made it a criminal offense for doctors to provide health care that can literally save children’s lives.”
The bill that enacted the ban passed overwhelmingly earlier this year in North Dakota’s Republican-controlled Legislature. Republican Gov. Doug Burgum, who is running for president, signed the ban into law in April. It took effect immediately.
“Going forward, thoughtful debate around these complex medical policies should demonstrate compassion and understanding for all North Dakota youth and their families,” Burgum said at the time.
Tate Dolney, a plaintiff and 12-year-old transgender boy from Fargo, said gender-affirming care helped his confidence, happiness, school work and relationships with others.
“I was finally able to just be who I truly am,” the seventh-grader told reporters. “It has hurt me all over again to know that the lawmakers who have banned the health care don’t want this for me and want to take it all away from me and every other transgender and nonbinary kid who just wants to be left alone to live our lives in peace.”
Mother Devon Dolney said Tate was previously severely depressed and angry, but with the care “went from being ashamed and uncomfortable with who he is to being confident and outspoken,” a “miraculous” change.
North Dakota’s ban has led the family to travel farther for Tate’s appointments, now in neighboring Minnesota, she said. The family has considered moving out of North Dakota, she said.
Politicians “have intruded on our lives and inserted themselves into positions that they have no business being involved in,” father Robert Dolney said.
The law exempts minors who were already receiving gender-affirming care, and allows for treatment of “a minor born with a medically verifiable genetic disorder of sex development.”
But the grandfather clause has led providers “to not even risk it, because that vague law doesn’t give them enough detail of exactly what they can and cannot do” — an element of the suit, Gender Justice Senior Staff Attorney Brittany Stewart said.
North Dakota Attorney General Drew Wrigley told The Associated Press he hadn’t seen the lawsuit’s filing, but his office “will evaluate it and take the appropriate course.”
Bill sponsor and Republican state Rep. Bill Tveit told the AP that he brought the legislation to protect children.
“I’ve talked to a number of people who are of age now and would transform back if they could, and they’re just really upset with their parents and the adults in their life that led them to do this, to have these surgeries,” Tveit said. He declined to identify the two people he said he talked to, but said one is a college student in Minnesota that he became acquainted with while working on the bill.
North Dakota’s law criminalizes doctors’ performance of sex reassignment surgeries on minors with a felony charge, punishable up to 10 years’ imprisonment and a $20,000 fine.
The law also includes a misdemeanor charge for health care providers who prescribe or give hormone treatments or puberty blockers to minors. That charge is punishable up to nearly a year’s incarceration and a $3,000 fine.
Opponents of the bill said sex reassignment surgeries are not performed on minors in North Dakota, and the ban on gender-affirming care would harm transgender youth, who are at increased risk for depression, suicide and self-harm.
At least 22 states have now enacted laws restricting or banning gender-affirming medical care for transgender minors, and most of those states face lawsuits. A federal judge struck down Arkansas’ ban as unconstitutional, and a federal judge has temporarily blocked a ban in Indiana.
