Transgender America Fights Back

Democratic-led states are establishing sanctuaries for those seeking gender transitions, part of a broad legal effort to resist Republican restrictions on medical interventions for transgender youth. 

The playbook is one used by U.S. cities that have provided sanctuary from federal authorities to migrants lacking permanent legal status, a custom dating to medieval times when fugitives took refuge in churches.

In the case of transgender youth, Democratic-run states are offering parents and doctors protection from enforcement by other states that have outlawed medical treatments that involve puberty blockers, hormones and surgeries for gender transition.

Governors in 14 states, from New York to California to Hawaii, have signed legislation or executive orders allowing transgender families to take sanctuary in their states. Details vary, but range from noncompliance with subpoenas to blocking extradition for providing services banned in GOP states. Most of these measures have yet to be tested in court. 

Jennifer Harris Dault, 40, just sold her house and left her job as a pastor in St. Louis after Missouri’s governor signed a bill in June banning gender-transitioning care for minors. Those already receiving such treatments are exempt, but the state will revoke the license of any doctor or clinician who violates the ban on new cases.

Harris Dault has two daughters, ages 8 and 6, one of whom transitioned to her current gender identity. The law prompted her to fear for her children’s future, she said.

“It’s so hard emotionally to continuously be in fight mode and wondering what comes next,” Harris Dault said of living in Missouri. She is renting a home in Rochester, N.Y., with her husband and is looking for work.

A central tenet of the gender transitioning of minors, widely accepted among transgender allies, holds that gender lies on a spectrum between male and female, distinct from sex, and can only be identified by the individual. The role of a clinician, according to this tenet, is to assess and affirm an individual’s expressed identity along that spectrum, provide therapeutic relief, and to intervene medically in some cases in which the identity differs from sex at birth. 

Republicans disagree and say their bans are a response to the rapid acceptance of this approach, known as gender-affirming care, by key medical and educational institutions. 

Conservatives justify their restrictions by saying children are too young for such a self diagnosis that has lasting repercussions and often refer to the use of medical treatments for transgender minors as a form of child abuse. 

“Who wants the government stepping in between doctors, parents and children? But when there’s something that’s so wrong that’s going on, then I think we have to,” said Miriam Grossman, a child psychologist and expert witness for Republicans during congressional hearings in June. 

Democrats say medical interventions provide necessary relief to youth struggling to manage deep distress. Such issues should be left to families and their doctors, they say.

“In Minnesota, we’re protecting rights, not taking them away,” Democratic Gov.

Both sides claim science is on their side. Transgender allies say treating gender-diverse youth with puberty blockers or hormones reduces suicide risk, and has the support of associations such as the American Academy of Pediatricians and the Endocrine Society, both medical trade groups.

Conservatives respond by saying the U.S. medical authorities are out of step, noting European countries, including Finland, Sweden and Britain, now urge caution over such treatments after rigorous reviews of existing studies found a lack of evidence that the benefits outweigh the risks. Some European countries, as a result, are restricting medical interventions to clinical trials.

The American Civil Liberties Union, the Human Rights Campaign, an LGBTQ advocacy group and other nonprofits have challenged state bans in court, recording some early victories in Arkansas, Alabama, Florida, Indiana, and Kentucky. In Tennessee, a similar victory was overturned on appeal in July after a tribunal found the medical community is divided on the issue. The legal contests are expected to eventually reach the Supreme Court. 

The Republicans are “trying to erase trans people from every nook and cranny of public life,” said James Esseks, director of the LGTBQ & HIV Project at the American Civil Liberties Union Foundation, which helps with the legal effort. “So we are trying to respond to that full range of attacks.”

Corporations have proven big donors to the Democratic-led effort. Foundations, meanwhile, have donated $252 million to LGTBQ nonprofits in 2021, with donations more than doubling over the past decade, a significant portion of which supported transgender causes, according to Funders for LGTBQ issues, a nonprofit that tracks donations. 

Polling consistently shows clear majorities oppose discrimination against transgender Americans. But a majority of Americans, 65%, also say they believe in only two genders, while 34% say a range of genders is possible, according to a June survey by the nonpartisan PRRI polling firm. 

Kandice Baker, a 35-year-old transgender woman, was worried a Texas law aimed at curbing minors’ access to drag shows could lead to prosecution if she wore dresses in public. She said she feared Texas, which bans transition care for minors, may try to do so for adults. 

She left Dallas and moved to Baltimore in January. “They’re trying to ban all HRT treatment,” Baker said, referring to hormone treatment. “In order to get hormones, to people there, I’m a joke. My life is a joke.”

The number of youth who say they identify as transgender or gender fluid has grown, although the numbers still remain small. About 1.6 million people ages 13 and above identify as transgender, according to University of California Los Angeles Williams Institute.

Twenty-one states have enacted a ban on certain medical interventions for at least some transgender youth, according to Movement Advancement Project, a nonprofit that supports LGBTQ rights.

Lisa Stanton said her family felt intimidated in Houston because Texas passed a law barring transgender youth from getting puberty blockers and hormone therapies. She and her husband are moving this month to Colorado with their son and transgender daughter. Both are 12 years old. Colorado has passed legislation to shield transgender care for minors. 

When the Texas welfare agency in 2022 began investigating parents who provide gender-affirming care to their children, Stanton said she began sending her children to school with the name and number of their family lawyer on a laminated card just in case child protection services showed up.  

“This shouldn’t be happening to us,” she said.

Write to Stephanie Armour at [email protected] and Jathon Sapsford at [email protected]