South CarolinaRepublican U.S. Rep. Nancy Mace’s latest attack on transgenderrights has hit a wall. Her proposal to bar transgender people from using bathrooms aligned with their gender identity in House-controlled spaces didn’t make the cut in the rules package for the 119th Congress. Leaving the measure out of the package marks a setback for Mace’s culture war efforts, even as other anti-LGBTQ+ priorities remain front and center.
Mace introduced her bathroom resolution last November, admittedly targeting Delaware Rep. Sarah McBride, the first out trans member of Congress. LGBTQ+ advocates and Democratic lawmakers slammed the proposal as not only discriminatory but also unenforceable. House Speaker Mike Johnson, the Louisiana Republican, has previously stated that transgender women must use the men’s bathroom. McBride said at the time that she would comply with House rules.
The Advocate reached out to Johnson’s office for clarification on why the measure wasn’t included.
The rules package, which largely mirrors policies from the last Congress, did include one significant anti-trans provision: a measure redefining Title IX compliance in athletics to base eligibility solely on sex assigned at birth. This codification, a key Republican priority, was coupled with the first bill in the package, which explicitly targets transgender athletes.
“It is not surprising to me that an anti-trans bill will be the first, if not one of the first bills they put forward,” McBride told The Advocate. “It’s going to be important for us to acknowledge the harm that anti-LGBTQ legislation presents, but also to pull back the curtain on what these attacks are attempting to do, which is to distract from issues that impact our economy and worker protections. These policies harm not just LGBTQ people but everyone who believes the federal government should improve lives rather than wage culture wars.”
The U.S. House voted on the new rules package after electing Mike Johnson speaker again and swearing in legislators.
While opponents of gender-affirming care for trans youth often act as if such care is common and undertaken thoughtlessly, it’s actually quite rare, according to a new study.
The study, published Monday in JAMA Pediatrics, found that “fewer than 1 in 1,000 U.S. adolescents with commercial insurance received gender-affirming medications — puberty blockers or hormones — during a recent five-year period,” the Associated Press reports.
Other studies have looked at gender-affirming surgery for transgender minors and concluded it is rare, but the use of medications for gender confirmation is not well-documented, the study’s authors note.
“Because age and experience of puberty onset varies by sex assigned at birth and dictates the course of care, it is important to analyze these rates by age and sex assigned at birth,” says an abstract of the study (the full research paper is behind a paywall). “This study filled this gap by using private insurance data across all 50 states.”
“We are not seeing inappropriate use of this sort of care,” lead author Landon Hughes, a researcher at Harvard University,” told the AP. “And it’s certainly not happening at the rate at which people often think it is.”
The authors examined insurance data for more 5 million patients aged 8 to 17, covering the years 2018 to 2022, so it as before many of the state bans were enacted. Only 926 of these patients received puberty blockers and 1,927 received hormones, coming out to 0.1 percent. Puberty blockers were not administered to anyone under age 12.
“I hope that our paper cools heads on this issue and ensures that the public is getting a true sense of the number of people who are accessing this care,” Hughes said.
The new study “adds to the growing evidence base about best practices when serving transgender and gender-diverse youth,” Dr. Scott Leibowitz, who has helped develop the adolescent standards of care for the World Professional Association for Transgender Health, told the AP.
Twenty-six states have passed laws banning some or all gender-affirming procedures for trans youth. The U.S. Supreme Court heard a case in Decemberseeking to overturn Tennessee’s ban, and a decision is expected in the spring or summer. Donald Trump has vowed to ban such care nationwide through an executive order when he becomes president again, something that would undoubtedly lead to more court cases, and during his campaign he falsely claimed that young people are receiving gender-affirming medical care at school. He has promised to enact other anti-trans policies as well.
After a record-breaking year for anti-trans legislation, 2025 is shaping up to be even more challenging for transgender and queer people across the United States. A legislative tracker maintained by Erin In The Morning and other volunteers has found that nearly 120 anti-trans and anti-LGBTQ+ bills have already been filed in states nationwide ahead of the 2025 legislative season. This far surpasses the 80 bills filed by this time in 2023, signaling another historic wave of legal attacks on the ability of transgender people to move, live, and exist freely as themselves in public.
The bulk of the bills so far come from Texas and Missouri, two of the earlier states that release prefilled legislation ahead of the 2025 session. However, states like South Carolina, New Hampshire, Georgia, Wyoming, and Montana all feature multiple anti-LGBTQ+ bills, with more being added every day. Thirteen states in all have seen anti-trans bills filed: Alabama, Arizona, Georgia, Indiana, Missouri, Montana, Nevada, New Hampshire, Ohio, South Carolina, Texas, Washington, and Wyoming.
This year, several state bills aim to strip legal recognition from transgender people entirely. Between 2022 and 2024, ten states passed such legislation or enacted similar policies, with devastating consequences for affected communities. In Kansas, Florida, and Texas, transgender individuals are now unable to update their driver’s licenses, and in some cases, states have begun reverting gender marker changes that were made years or even decades ago. Transgender people who have lived as their legal gender for years may face forced reversion of their identification documents if these new bills are enacted. Similar legislation has already been introduced in Texas, Missouri, South Carolina, and Wyoming.
In many states that have passed such legislation, bathroom bans have also been attached. Indeed, in the initial rush of bills, several bathroom bans can be found that target transgender adults. Two Texasbills would allow lawsuits if transgender people are encountered in bathrooms. One bill in Montana would bar transgender people from publicly owned bathrooms of their gender identity. One bill in Missouri would even make it “unlawful public discrimination” to allow a transgender person in bathrooms of their gender identity.
Book bans are seeing a resurgence in the prefiled bills. In 2024, PEN America found 10,046 instances of individual books banned, affecting 4,231 unique titles. Banned books include the Handmaids Tale, Flamer, The Perks of Being a Wallflower, Gender Queer, and more. Texas features severalsuchbillsthisyear, despite the state being rebuked by higher courts for book bans in 2024.
Another common type of anti-trans legislation that is common is sports bans. Many bills aim to expand existing restrictions to even broader contexts. In Texas, one proposed bill seeks to deny private sporting events access to the state’s Events Trust Fund—a source of professional funding for major sporting events—if they allow trans athletes to compete. Other bills aim to extend sports bans to new age groups. For instance, a bill in Wyoming would expand its current ban, which applies to students in grade 7 and above, to include kindergarteners.
Several other categories of bills have seen activity, such as drag bans, forced outing of transgender students, “don’t say gay” bills, birth certificate gender change bans,drivers license gender change bans, and more.
According to the ACLU, legislative attacks on transgender people grew “exponentially” over 2023 and 2024. These anti-trans laws have directly causedan increase in suicide attempts in some states by up to 72%. According to the Centers for Disease Control, one in four transgender youth have attempted to take their own life in the last year, with many of those attempts requiring medical treatment.
In the coming months, a landmark Supreme Court decision will determine the constitutional fate of bills targeting transgender people. While the case centers on a law restricting transgender medical care, its broader implications go far deeper—addressing whether discrimination against transgender people qualifies as sex discrimination warranting heightened scrutiny. The Court may also weigh whether transgender individuals are granted equal protection around their transgender status. This ruling has the potential to either shut the door on many of these bills and laws or swing it wide open, unleashing a flood of legislative attacks that could make 2025 a historically devastating year for transgender rights.
These bills will continue to be tracked by Erin In The Morning and other volunteers and can be found here.
Restrictions on gender-affirming care proposed by Republicans in Congress and President-elect Donald Trump could be devastating for transgender youths, doctors say, especially for teens with eating disorders.
Gender-affirming care — which includes mental health counseling and sometimes puberty-suppressing medication and hormone therapy — is a critical part of care for trans teens with eating disorders, said Jessie Menzel, a psychologist and vice president of development at Equip Health, which provides virtual mental health care for people with eating disorders.
Yet transition-related care is increasingly out of reach for minors struggling with gender dysphoria, the acute distress that results from a mismatch between one’s sex assigned at birth and one’s gender identity. Most U.S. medical associations consider transition-related care to be essential for minors struggling with gender dysphoria.
Public opinion polls show that Americans are divided over transition-related care for minors. A Gallup survey published in June found that 51% of respondentsagreed that “changing one’s gender is morally wrong,” although 60% also oppose laws banning transition-related care.
Many people who oppose such care say that minors are too young to understand the risks of hormonal therapies and that they are concerned about the lack of long-term data on potential side effects. Although the effects of puberty-blocking medications are largely reversible, they can cause a temporary reduction in bone density. Taking the hormones estrogen or testosterone, which many trans teens eventually receive, restores most of that bone loss. Gender-affirming surgery is rarely performed on patients under 18, and hospitals require parental consent before they provide any transition-related care.
But forbidding that type of care can also cause harm, and state bans have been linked to increased suicide attempts by trans youths. Additional restrictions could lead more kids to develop eating disorders and make it harder for people with eating disorders to recover, Menzel said.
“We are absolutely going to see an increase in eating disorders amongst these individuals,” Menzel said.
Carsen Rhys Beckwith, 27, of Kansas City, Missouri, said they developed an eating disorder around age 14, as they began developing the curves typically associated with female bodies.
But Beckwith didn’t feel female. They wanted to look muscular and more masculine.
“My body was developing in a way that didn’t match how my identity was developing,” said Beckwith, who identifies as nonbinary and transmasculine.
Carsen Rhys Beckwith, now 27, said they developed an eating disorder around age 14, as they began developing the curves typically associated with female bodies.Carsen Beckwith
Beckwithbegan trying to change their body the only way they could: by losing weight and constantly working out at the gym.
“It started with counting calories,” said Beckwith. After a while, Beckwith was subsisting on a single piece of fruit a day. “I would give most of my lunch away to my friends and think, ‘I don’t need to eat until dinner.’”
Feeling more at home in their bodies
For trans teens with eating disorders, receiving gender-affirming care — a comprehensive approach that validates a young person’s feelings, provides psychological support and, in many cases, includes hormonal therapies — can reduce their need to lose weight, Menzel said.
“It’s life-changing for them to be able to have access to somebody who is willing to listen to them,” Menzel said. “Just having someone who is willing to affirm who they are can make such a big difference.”
Puberty-blocking hormones can give trans teens a temporary reprieve from developing more adult bodies, giving them time to explore their gender identities with therapy, Menzel said. Other hormonal therapies, such as estrogen and testosterone, typically taken later in the teen years, can help children grow into bodies that match their gender identities.
Dr. Ellen Rome, a pediatrician and head of the center for adolescent medicine at Cleveland Clinic Children’s Hospital, said gender-affirming care can help teens feel better about their bodies and their relationships with food.
“When a kid is living as who they want to be,” Rome said, “often the eating disorder symptoms are relatively easy to eradicate.”
Although Ohio’s ban allows children currently receiving gender-affirming care to continue the treatments, doctors are no longer allowed to prescribe the medications for new patients under 18.
“They have taken that tool out of our toolbox,” Rome said.
Starvation as a coping strategy
Gender-affirming care — like trans rights in general — has become a hot-button political issue.
Tiffany Justice, a co-founder of the influential conservative group Moms for Liberty, dismisses gender-affirming care for minors as “child abuse” and “snake oil,” and she said her organization is working to ban gender-affirming care for minors in every state.
Children who are desperately unhappy — and unable to delay puberty in any other way — may take matters into their own hands, said Dr. Jason Nagata, an associate professor of pediatrics at the University of California, San Francisco.
Trans boys, for example, sometimes avoid eating, because they know that without enough daily calories, they won’t begin menstruation, Nagata said.
“Some people will intentionally restrict their food intake to get rid of their periods,” Nagata said. “We have seen that a lot, particularly when people can’t get gender-affirming care.”
Trans girls also sometimes try to delay the effects of puberty through starvation, Nagata said. “If they really restrict their food intake, they can prevent themselves from developing facial hair or Adam’s apples.”
Eating disorders can be life-threatening, Nagata said.
Anorexia, a condition in which people severely restrict their calorie intake, has the second-highest mortality rate of any psychiatric disorder, behind only opioid addiction. It can cause abnormal heart rhythms, anemia, bone loss and brain damage. About 5% of people die within four years of anorexia diagnoses. Even with intensive treatment, relapse rates are high. Fewer than half of people with anorexia make full recoveries.
Research shows such state bans on gender-affirming care heighten the stress and anxiety with which many trans people already live. Calls to a mental health crisis line run by The Trevor Project, a nonprofit organization that works to prevent suicide in LGBTQ youths, rose 700% the day after the November election. A recent study in Nature found that suicide attempts among trans youths increased 72% in states that outlawed gender-affirming care for minors.
Both trans children and those with eating disorders have elevated rates of self-harm and suicide, Menzel said. If lawmakers ban puberty-blocking hormones, Menzel predicts, more trans teens will look for ways to stop the process themselves.
Finding peace
Beckwith said they owe their recovery to transition-related health care and the support of other trans people.
Eight years ago, Beckwith began taking testosterone, which they describe as “lifesaving.” Although they still sometimes need to be reminded to eat more, Beckwith said they are much healthier than they were in college, when they contemplated suicide.
“I still have days when I have thoughts that creep back in,” said Beckwith, a program director at Project HEAL, an advocacy group that aims to increase access to treatment for eating disorders. Thanks to mental health counseling, “I have so much more practice now in rewiring those thoughts and leaning on the people around me who can affirm me and lift me up.”
The ACLU of Florida is suing the state’s Department of Corrections over a new anti-transgender policy that will restrict trans prisoners’ access to gender-affirming medical care as well as their ability to express their gender identity.
According to a report from The Marshall Project and theTampa Bay Times, a federal judge in Tallahassee held a preliminary hearing in the case on December 9. The ACLU of Florida has asked the judge to block enforcement of the policy, calling it an unconstitutional ban on gender-affirming care. A ruling is expected in the weeks ahead.
Under the new policy, Florida prisons will only provide inmates diagnosed with gender dysphoria with therapy. Trans inmates will not have access to gender-affirming hormone therapy except “in rare instances” when it is deemed “necessary to comply with the U.S. Constitution or a court decision.”
“Unaddressed psychiatric issues and unaddressed childhood trauma could lead to a misdiagnosis of gender dysphoria,” the policy claims. Gender-affirming hormone therapy, it continues, “may be requested by persons experiencing short-termed delusions or beliefs which may later be changed and reversed.”
Daniel Tilley, lead attorney from the ACLU of Florida, compared the policy’s therapy requirements to so-called “conversion therapy.”
In court documents, Danny Martinez, the state prison system’s medical director, said he based the department’s new policies on a 2022 report commissioned by Florida’s Agency for Health Care Administration (AHCA). The report focused primarily on the effects of gender-affirming care on children and its findings contradicted the overwhelming consensus of all major medical organizations, which hold that gender-affirming healthcare is necessary and frequently lifesaving for transgender individuals suffering from gender dysphoria.
The 2022 report resulted in the state banning healthcare providers from billing the state’s Medicaid program for gender-affirming care. But in June 2023, a federal judge struck down the Florida Medicaid ban, finding that the AHCA report was “a biased effort to justify a predetermined outcome, not a fair analysis of the evidence,” and its conclusion was “not supported by the evidence and was contrary to generally accepted medical standards.”
The Florida Department of Corrections’ new policy was announced in September during meetings in which incarcerated transgender women were told that trans inmates would be “reevaluated” to determine whether they would still be allowed access to gender-affirming healthcare and other accommodations that they were already receiving. According to the Tampa Bay Times, inmates said they were not told how prison officials would determine whether they would still be allowed access to care. While so far no inmates reported being taken off hormone therapy, more than a dozen incarcerated trans women told the paper they had already been forced to cut their hair short.
In court filings and interviews, incarcerated trans women in Florida prisons also reported being subjected to breast examinations to determine whether or not they would still be allowed access to bras.
“It felt like I was being treated less than human,” Josie Takach, a trans inmate at a Florida men’s facility, said of the examination. Takach said her undergarments, now considered contraband, were confiscated. “I feel like I’m 12 years old again, sneaking around wearing a bra.”
Sara Maatsch, who is also incarcerated in a Florida men’s prison, said that her gender dysphoria diagnosis was now considered a serious psychiatric illness. She was told she would have to be moved to a more restrictive facility with fewer work and programming opportunities to continue receiving treatment.
Mariko Sundwall told The Marshall Project that after spending 10 days in solitary confinement for refusing to cut her hair, a prison barber buzzed her hair short while she was handcuffed.
“I’m very sad and depressed. I feel like they’re taking away my identity,” Jada Edwards, another trans inmate, said of the buzz cut she was forced to receive.
As The Marshall Project notes, previous court decisions have held that prisons in the U.S. are required under the Constitution to provide gender-affirming care as needed.
University of California San Francisco psychiatrist Dan Karasic, who helped develop international standards for treatment of transgender people, told The Marshal Project that Florida’s new anti-trans prison policies were “a fig leaf on [the state’s] efforts to ban gender-affirming care.”
“They are really trying to skirt the law, as determined by multiple courts, that gender-affirming medical and surgical care must be provided when medically necessary,” Karasic said.
The battle over Florida’s anti-trans prison policies follows the 2024 presidential campaign, which saw Donald Trump’s campaign target Democratic nominee Kamala Harris with ads claiming the Vice President “supports taxpayer-funded sex changes for prisoners.”
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The U.S. Supreme Court heard oral arguments yesterday in the case of U.S. v. Skrmetti, a significant case that may profoundly affect the accessibility of health care for transgender youth and their families across the country, as well as the autonomy of health care providers to deliver such care.
The plaintiffs, families of transgender youth and a medical provider, are challenging Tennessee’s law banning health care such as hormone therapy and puberty-pausing medications for transgender youth under 18, even when that treatment is medically warranted and sanctioned by their parents. The same treatments are not banned for cisgender (non-transgender) youth.
Following oral arguments, CNN’s Brianna Keilar hosted Alliance Defending Freedom (ADF) president Kristen Waggoner. ADF was described as a Christian legal organization that is representing other states with similar cases. In fact, ADF is an anti-LGBTQ hate group, as designated by the Southern Poverty Law Center, and has a history of funding and representing cases targeting LGBTQ people, youth and protections. ADF has fought alongside the first Trump administration’s Justice Department to legalize discrimination against LGBTQ people:
at work (Bostock)
against same-sex couples trying to buy a wedding cake (Masterpiece)
couples looking to adopt children (Fulton)
303 Creative, a case that the Washington Post reported included “manufacturing lawsuits” to find plaintiffs to sue, ending up with a website designer who was never asked to perform services for LGBTQ clients.
No transgender people appeared to challenge Waggoner’s claims, including the baseless assertion that patients are incapable of understanding the consequences of medical care. Transgender youth seeking care must have parental consent to receive it.
ADF is among several groups with a long history of activism against LGBTQ Americans that filed amicus briefs in the Skrmetti case. Media reporting on the case and support for the bans that are supported by every major medical association can report on the records of the groups and their longstanding animus against LGBTQ people. GLAAD has documented these records on the GLAAD Accountability Project, including:
—Advocated for President Trump’s ban on transgender people in the military and bragged of White House connections just prior to the ban.
—Publishes brochures, videos, and other materials for parents and other school anti-trans activists, such as the 2016 “Parents Guide to the Transgender Movement in Education,” which misgenders trans people and encourages parents to oppose gender-affirming care backed by every major medical association as best practice, lifesaving care
—Supports so-called “conversion therapy,” and encourages children to ignore classmates’ pronouns, despite research showing that using accurate pronouns improves mental health.
—Describes the Equality Act, which would provide comprehensive protections from discrimination for LGBTQ people as “unequal, unfair, and unjust.”
—Filed an amicus brief to the Supreme Court against marriage equality in support of California’s Proposition 8 and the Defense of Marriage Act, both since nullified.
—Baselessly claimed that “one of the primary goals of the homosexual rights movement is to abolish all age of consent laws and to eventually recognize pedophiles as the ‘prophets’ of a new sexual order.”
—Promotes the “ex-gay” movement as a way to combat LGBTQ civil rights measures and refutesthe claims of victims of abusive, so-called “conversion therapy.”
—Fringe medical group that split with the mainstream American Academy of Pediatrics to protest its support of LGBTQ couples adopting children
—Colluded with the Alliance Defending Freedom (ADF) using junk science to propagate anti-transgender policy
—Made false claims about evidence-based gender-affirming care to support Texas authorities targeting families of transgender children
—Sued the Department of Health and Human Services with Alliance Defending Freedom objecting to gender-affirming care for any patient including children
—Made false claims about LGBTQ people’s mental health and fitness as parents, claims debunked by the American Academy of Pediatrics, American Psychological Association, and the American Medical Association
—Colluded with the American College of Pediatricians (ACP) to shore up anti-transgender policy efforts and legal arguments with junk science
—Multiple lawsuits, including false claims, to prevent transgender students from participating in sports
—Represented multiple educators who refused to use accurate pronouns and names of transgender students. Research shows using accurate pronouns and names reduces suicide risk for vulnerable youth.
—Testified in the Ohio legislature to spread misinformation about gender affirming care for youth, which is supported by every major medical association
—Argued in court for the criminalization of homosexuality in amicus briefs for the U.S. Supreme Court case Lawrence v. Texas
—As early as 2010 began sending letters threatening libraries to ban books with LGBTQ inclusive content and characters
—Represented “conversion therapy” practitioners in lawsuits, a practice discredited by mental health and medical professionals as harmful and ineffective.
—Helped draft bills in Idaho, Montana, and other states targeting trans youth participation in school sports
—Drafted the model “Student Privacy Act” legislation that led to a wave of “bathroom bills” in 2017
—Defended state-enforced sterilization for transgender Europeans
—For years has promoted the idea of “homosexual agenda,” a purportedly evil plan to abolish Christianity and, eventually, civilization through LGBTQ people’s efforts to secure legal equality
—Falsely declared that LGBTQ people are more likely to engage in pedophilia
—Multiple efforts to legalize discrimination against LGBTQ couples by businesses
—Advised Ohio lawmakers on strategies to advance bills banning transgender students from using bathrooms matching their gender identity, and prohibiting transgender health care for youth.
—Created the “Women’s Bill of Rights,” legislation that defines sex strictly as the biological sex assigned at birth, and excludes transgender identities. Versions of this bill have been introduced in multiple states (and have reached the U.S House and Senate) to restrict the rights of transgender individuals.
—In an amicus brief to the Supreme Court, misgendered the plaintiff writing, “Simply, Aimee Stephens is a man.”
—Opposes the Equality Act
—Filed a joint brief in opposition to a lower court ruling in favor of Gavin Grimm, a trans boy who desired to use the boys’ restroom at his high school.
These organizations’ so-called “concerns” about trans kids are not new, and their anti-LGBTQ actions represent a longheld pattern. These groups have a long history of promoting discrimination against queer and transgender people.
The media have a responsibility to do their homework on their guests including researching and including the history of groups advocating against LGBTQ people. The GLAAD Accountability Project has profiles of public figures and groups and their records of targeting LGBTQ people. Journalists should challenge any unfounded and baseless claims. Media coverage of the issues facing transgender people should include the voices of transgender people.
Every major medical association and world health authority supports healthcare for transgender people. Accurately report there is widely-held consensus about the safety and efficacy of this mainstream care. Statements from medical associations and world health authorities here.
The House passed a massive defense spending bill Wednesday with a provision that bars the military’s health care program from covering transition-related care for minors. If it passes, some families said it would be devastating and could force them out of the military.
The National Defense Authorization Act, a must-pass $895 billion bill, sets Pentagon and defense policies for the next year. Speaker Mike Johnson, R-La., pushed to add the new provision regarding trans care, which states that “affirming hormone therapy, puberty blockers, and other medical interventions for the treatment of gender dysphoria that could result in sterilization may not be provided to a child under the age of 18” under Tricare, the military’s health program.
The bill passed the House 281-140 Wednesday, with 200 Republicans and 81 Democrats voting yes, while 124 Democrats and 16 Republicans voted no. The Senate will vote on the bill next week, and then it will be sent to President Joe Biden — who would need to veto the entire package if he wanted to block the trans care element.
If the NDAA is signed into law, it would mark one of the first times Congress has aggressively attempted to pass a federal statute targeting trans people.
Johnson called the bill’s passage in the House “an important win for our troops,” noting that it would provide pay increases to about half of enlisted servicemembers and improve military housing, among other investments.
“We also believe it’s important to refocus the Pentagon on military lethality, not radical woke ideology,” he said in a statement Wednesday. “This legislation permanently bans transgender treatment for minors, prohibits critical race theory in military academies, ends the DEI bureaucracy, and combats antisemitism.”
However, some military families with trans children disagree that the provision regarding trans care will improve the military.
One active duty member of the Air Force, who has served for more than two decades and has a trans daughter who is receiving treatment for gender dysphoria through Tricare, said the bill sends a “mixed message,” because it could help some military families while harming others.
“The reason why the military has some of the amazing benefits that we do is so that when we are called to action or we are called to war, we can focus entirely on the mission and the task at hand, because we know that our family and our home life is secure and safe,” said the service member, who requested anonymity out of fear of facing repercussions at work for speaking to the press. “If you want to ensure we remain the world’s most effective fighting force, you should not take away care for our military members and their dependents.”
The service member and his spouse said their teenage daughter came out to them about four years ago. About two years ago, she underwent at least six months of psychological evaluations and received other doctors’ opinions before beginning hormone therapy.
“Once she was able to receive the gender-affirming care, it was like the puzzle pieces fell into place,” the service member’s spouse said. “We could see her, she was happy, her grades got better, she started to make so many more friends. It was beautiful. It was a veil that got removed, and then you could fully see your kid and celebrate them.”
The service member said that if the NDAA passes with the provision regarding trans care for minors, he would consider finding supplemental insurance or paying out of pocket for his daughter’s care, but that doing so would strain his family’s budget. He said the out-of-pocket costs would vary depending on whether they can get supplemental insurance. The average cost of estrogen without insurance can fall between $20 to $200 per month depending on the dose and delivery method.
The restriction and its associated out-of-pocket costs, his spouse added, would put some military families “into survival mode instead of being ready for the mission ahead.”
The service member said that the restriction would definitely “affect my decision whether we continue to serve.”
“I have a strong desire and propensity to continue to serve and to continue to give back to the military, but if I lose access to care for my family, my family’s got to come first,” he said.
Johnson did not return a request for comment regarding the potential effects of the provision on some military families.
It’s unclear how many families would be affected by the provision. But Rep. Adam Smith, D-Wash., the former Armed Services chairman who is now the panel’s ranking member, said on the House floor Wednesday that there are about 4,000 minors currently within the military health system whose care would be taken away by the restriction.
“[B]lanketly denying health care to people who need it — just because of a biased notion against transgender people — is wrong,” Smith said in a statement Tuesday. “The inclusion of this harmful provision puts the lives of children at risk and may force thousands of service members to make the choice of continuing their military service or leaving to ensure their child can get the health care they need.”
Cathy Marcello, the deputy director of the Modern Military Association of America, an organization that advocates for LGBTQ members of the military and veterans, said hundreds of the families the organization supports are frightened by the potential restriction. She added that Modern Military estimates that there are currently about 10,000 trans youth between 6 and 22 with parents who are in the military, based on the Defense Department’s estimate that there are 1.6 million military children.
“Families are deciding right now if they will be able to afford care on their own, or if they can get out, or if they should live apart,” Marcello said.
She added that 95% of the group’s membership reported altering their military career in some way because of state laws targeting LGBTQ people, according to a recent small internal poll of about 300 member families. She said the Tricare restriction would further affect where service members can live and how long they serve.
“Military families with trans kids have been serving for decades and it’s never been an issue,” she said. “To say to these many thousands of families that your sacrifice isn’t good enough, that your multiple combat deployments aren’t good enough and we don’t want you is unconscionable.”
The Montana Supreme Court on Wednesday affirmed a lower court ruling that temporarily blocked a state law prohibiting transition-related health care for minors.
The suit, which was filed by two transgender teens and their families, as well as two providers of transition-related care, will now go to trial before Missoula County District Court Judge Jason Marks, who initially blocked the law in September 2023.
The American Civil Liberties Union and Lambda Legal, an LGBTQ legal advocacy group, which are representing the teens and providers, said the decision was a victory for the state’s trans youths.
“Fortunately, the Montana Supreme Court understands the danger of the state interfering with critical healthcare,” Kell Olson, an attorney for Lambda Legal, said in a statement. “Because Montana’s constitutional protections are even stronger than their federal counterparts, transgender youth in Montana can sleep easier tonight knowing that they can continue to thrive for now, without this looming threat hanging over their heads.”
Chase Scheuer, press secretary for Montana Attorney General Austin Knudsen, said the office looks forward to “defending the case on its merits, which will include recent scientific developments ignored by this court.”
“The Supreme Court has abandoned Montanans once again to rule in favor of their out-of-state political allies,” Scheuer said in an emailed statement. “In upholding the district court’s flawed decision to temporarily block a duly enacted law, the Supreme Court put the wellbeing of children — who have yet to reach puberty — at risk by allowing experimental treatments that could leave them to deal with serious and irreversible consequences for the rest of their lives to continue.”
Doctors treat gender dysphoria — the distress that results when a person’s gender identity is in conflict with their gender assigned at birth — on a case-by-case basis, but minors who do pursue medical transition begin puberty blockers, which temporarily stop puberty, at its onset.
Montana’s Republican-controlled Legislature passed a law in April 2023 prohibiting health care providers from using puberty blockers, hormone therapy and surgery to treat minors with dysphoria. The law also prohibits Medicaid from covering such treatments for trans minors.
When Marks issued a preliminary injunction against the law last year, he wrotethat it was likely unconstitutional and that “barring access to gender-affirming care would negatively impact gender dysphoric minors’ mental and physical health.”
He also noted that the same Legislature, which described puberty blockers and hormone therapy as “experimental,” had passed a law giving patients, including minors, the right to receive treatment with experimental drugs if they consent and the treatment is recommended by a health care provider, The Associated Press reported.
In upholding the injunction, Montana Supreme Court Justice Beth Baker wrote in the majority opinion that the Legislature “did not make gender-affirming care unlawful,” nor “did it make the treatments unlawful for all minors,” as minors can still receive the treatments for other reasons.
“Instead, it restricted a broad swath of medical treatments only when sought for a particular purpose,” Baker wrote, adding that the law “puts governmental regulation in the mix of an individual’s fundamental right ‘to make medical judgments affecting her or his bodily integrity and health in partnership with a chosen health care provider.’”
All seven state Supreme Court justices agreed with the decision to uphold the injunction. Two issued a separate concurring opinion, arguing that the court should have made clear that discrimination based on transgender status is a type of sex discrimination prohibited by the equal protection clause of Montana’s Constitution. One issued a partial dissent, arguing that the court should’ve allowed the portion of the law prohibiting Medicaid coverage of trans care for minors to take effect, because “there is no current federal mandate for Medicaid funding of gender-affirming care.”
Montana is one of 26 states that has passed a law restricting transition-related care for minors, according to the Movement Advancement Project, an LGBTQ think tank. Montana garnered international headlines last year when state lawmakers were debating the law. State Rep. Zooey Zephyr, the first trans woman elected to Montana’s Legislature, was censured in a party-line vote after telling her colleagues that they would have blood on their hands if they supported the restriction on trans care.
The U.S. Supreme Court took up such restrictions for the first time last week, when it heard arguments over a similar law in Tennessee. It is expected to issue a decision this summer.
A 28-year-old trans woman in China has won her lawsuit against the hospital and doctor that subjected her to three months of traumatic and painful electroshock conversion therapy treatments, the Guardian reports.
The woman, a performance artist who goes by the name Ling’er, said she hoped the victory would help others in the LGBTQ+ community protect their rights.
“In China, the situation for transgender people is not very optimistic,” she said. “There’s a lack of protection for this group.”
Ling’er asserted in her suit that the enforced conversion therapy treatments had violated her personal rights. Her victory came with a small award of about $8,000 U.S.
Ling’er was taken to a hospital in Qinhuangdao City in 2022 after coming out to her parents as transgender the previous year. They were “very opposed” to her gender identity, Ling’er said, and “felt that I wasn’t mentally stable. So they sent me to a mental hospital.”
There, she was tied to a bed with restraints and diagnosed with “anxiety disorder and discordant sexual orientation.” Ling’er identifies as heterosexual.
She was kept in hospital for 97 days over her objections and subjected to seven sessions of electroshock therapy.
“It caused serious damage to my body,” Ling’er said. “Every time I underwent the treatment, I would faint … I didn’t agree to it, but I had no choice.”
Chinese law dictates patients can’t be forcibly subjected to psychiatric treatment barring a threat to their safety or others’.
Ling’er’s hospital physician said in testimony that she might pose a risk to the safety of her parents if they killed themselves because of her gender identity, according to a report in Chinese media.
The night before the electroshock treatments, Ling’er was restricted to a diet of bread and milk. During the treatments, her arms and legs were fixed and something was taped to her hands, Ling’er recalled. With each session, “as soon as the power was turned on, I fainted.” She says she suffers from heart arrhythmias in the aftermath.
During her internment, Ling’er was forced to cut her long hair and conform to a male gender identity.
“For three months, they forced me to wear men’s clothes step by step. It was painful and helpless for me,” she said.
There are a few precedents for Ling’er’s legal victory.
In 2017, a gay man in Henan province was awarded a small settlement after he was forced to stay in a psychiatric hospital for 19 days and take medications to “treat” his homosexuality.
In 2014, a judge ruled a facility falsely claimed it could “cure” a man’s homosexuality when he was subjected to hypnosis and electroshock therapy without consent.
While China removed homosexuality from an official list of psychiatric disorders in 2001, it retained a diagnosis for “sexual orientation distress,” leaving the door open for therapies claiming to cure it.
After she was discharged and returned home, Ling’er discovered that her parents had removed her women’s clothes and cosmetics and prepared a men’s wardrobe for her.
Months later, after Ling’er’s parents confiscated her hormone pills, she decided to leave her hometown. She packed a small pink suitcase, she said, found a place to stay for one night, and left by car the next day.
Ohio Gov. Mike DeWine signed a bill Wednesday banning transgender students from using school restrooms that align with their gender identities. The Republican-majority state Senate pushed forward SB 104, also known as the “Protect All Students Act,” in a 24-7 party-line vote.
“No school shall permit a member of the female biological sex to use a student restroom, locker room, changing room, or shower room that has been designated by the school for the exclusive use of the male biological sex,” and vice versa, the bill reads.
The bill defines “biological sex” as the “biological indication of male and female, including sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth, without regard to an individual’s psychological, chosen, or subjective experience of gender.” The bill adds that a birth certificate may be used as proof of biological sex if it was “issued at or near the time of the individual’s birth.”
The bill also mandates that Ohio schools cannot have restrooms or locker rooms that are open to all genders, excluding family facilities or single-occupancy facilities. Exceptions to the bill include children under 10 who are being assisted by family members, school employees whose job duties require them to enter all restrooms or people with disabilities who are being assisted.
DeWine, a Republican, conducted a legal review before he signed the bill, according to The Associated Press.
The American Civil Liberties Union condemned SB 104 in a statement after it passed in the state Senate, deeming it “anti-trans” and urging DeWine not to sign it.
“If allowed to go into effect, SB 104 will create unsafe environments for trans and gender non-confirming individuals of all ages. This bill ignores the material reality that transgender people endure higher rates of sexual violence and assaults, particularly while using public restrooms, than people who are not transgender,” Jocelyn Rosnick, policy director for the ACLU of Ohio, said in a statement.
Senate Democratic leader Nickie J. Antonio urged DeWine to veto the bill in a letter published Nov. 15.
“Sponsors of the legislation declare that the bill is about safety. However, this bill does nothing to make anyone safer. Instead, it will make trans people less safe and fail to increase the safety of all students,” Antonio wrote. “There’s a line between being passionate and understanding and being concerned about safety. Given that trans kids already face discrimination and bullying in schools, this bill could exacerbate the issue.”
The Center for Christian Virtue, which describes itself as Ohio’s largest Christian public policy organization, had called on DeWine to sign the bill, hailing it as preserving privacy.
“Today is a huge victory for children and families in Ohio. Amended SB104 is common-sense legislation that will guarantee the only people entering young ladies’ private spaces are female, not men claiming to be female,” the organization’s policy director, David Mahan, said in a statement after the Senate passed the bill.
Mahan did not specify whether a man claiming to be female has ever entered a women’s restroom in Ohio, and he did not respond to requests for comment.
There is no evidence that letting transgender people use public facilities, like restrooms, that align with their gender identities increases assaults or privacy violations, according to a 2018 study published in the journal Sexuality Research and Social Policy. Another study, published in the journal Pediatrics in 2019, found that transgender youths are at higher risk of sexual assault when they are not allowed to use restrooms that fit their gender identities.
Ohio House Republicans attached the legislation about restrooms to proposals regarding report card data for Ohio’s college credit program for high school students.
Melanie Willingham-Jaggers, the executive director of GLSEN, which advocates for LGBTQ students, condemned the law in a statement following DeWine’s signature.
“Extremist politicians are panicking because transgender students exist,” Willingham-Jaggers said. “Bathroom bans do not work: they isolate transgender youth, exacerbate harassment and unsafe conditions, and encourage schools to engage in harmful and stigmatizing gender-policing at the bathroom door.”
