That is a very good point to make, because so much of the analysis of this anti-trans, anti-LGBTQ legislative push has focused on the badness of the laws. And that’s important — these laws are horrific in many states.

But it’s also important to recognize that it’s not a uniform movement. At least fourteen states have passed laws that protect people on the basis of gender identity, that offer sanctuary from states that criminalize their care.

So, it is a hardening. We see half of the country moving in the positive direction, and half of the country banning care and banning people from bathrooms.

It is. I would also add that this is both a positive and a negative. These states do protect the rights of people. They have public health programs, they tend to have higher-end school systems, etc.

But a lot of the protective states are not super affordable to live in. And so you have this situation where many of the states that are criminalizing care have people who cannot move from those states because they don’t have the resources to get up and leave.

I have also spoken to people that have left places like Tennessee and Alabama who are now living out of vans in Massachusetts, for instance. Passing laws that protect transgender people who are fleeing persecution in the criminalizing states is a necessary and important first step. But we also need to ensure that we are ready to take care of the people who are leaving their home state.

I’ve done a lot of research on this topic myself. The Associated Press just released a story about how there are massive wait lists in many of the states that protect care and that safeguard people whenever they’re traveling over state borders. We are already seeing hospital wait lists balloon for gender-affirming care in protective states.

There was a recent study by Data for Progress that shows that 8 percent of all transgender people have already moved from their home state, with an additional 40 percent of transgender people considering it. Eight percent may not seem like a large number, but in raw numbers, there are about 1.5 million to 3 million trans people in the United States according to various estimates, and so that amounts to 130 to 260,000 transgender people who have already fled from their home states.

Before I talk about the specifics of this particular moment, I want to stress that the United States has a history of persecuting the LGBTQ community every couple decades — from the drag bans of the 1950s and ’60s, which gave us Stonewall; to the AIDS crisis in the 1980s; to the ex-gay movement and the constitutional marriage amendments in the 2000s. And now twenty years later, they’re calling LGBTQ people groomers and banning transgender care.

We saw in 2015 the gay marriage ban go down with the Obergefell decision, and they needed a new target within the LGTQ community. Transgender people were ripe for the picking, and so they ended up passing a law in North Carolina 2016: the bathroom ban. This is what I look to as the seed of where we are today.

So the bathroom ban got passed in North Carolina. It barred transgender people from bathrooms, and it resulted in an enormous backlash. The NBA All-Star game pulled out, PayPal pulled out, Deutsche Bank pulled out — it set back the anti-trans movement by four years because no state wanted to pass these laws. But they licked their wounds and moved on, and in 2020 we got the new wave: the sports bans, the gender-affirming care bans, the birth certificate bans.

There are really good articles about this in the New York Times and CNN where they interview people like Terry Schilling at the American Principles Project, one of the organizations behind these anti-trans laws. They speak very frankly about how they had to focus on sports because that was an issue where they could get their foot in the door, and how they focused on making these laws hit several states at the same time, so they could avoid the fate of the North Carolina bathroom ban, which had the enormous backlash.

Absolutely. The Alliance Defending Freedom, the Heritage Foundation, and the American Principles Project are just three of the many names that have come up in these conversations. There’s a heavy religious motivation behind these laws done by groups like the Alliance Defending Freedom, which wants to usher in a new age of Christian law in America.

You can also tell that these laws are coordinated, because you see several laws drop in several states at the same time, and they have identical language. You can see how after certain court challenges happen, they add a new provision to the law designed to make it harder to challenge in court.

There are various ways to frame the question: Are you in favor of gender-affirming care for transgender youth? Are you in favor of criminalizing gender-affirming care? Do you support trans people in sports? Do you support laws protecting trans people from discrimination? And I’ll be frank, the polls are all over the place, depending on the wording.

What is constant is that whenever you ask people what the most important issues are, or do you think your legislators should spend time legislating on this stuff, transgender issues always end up at the bottom. On top of that, people do generally support nondiscrimination protections for transgender people, and they tend to oppose criminalizing gender-affirming care for transgender youth and adults.

But the biggest thing I want to highlight is that there’s a lot of uncertainty in the polling because people don’t know much about transgender care. A lot of people haven’t had to live the life of a parent with a trans kid or as a transgender person themselves. So I think most people understand their own limitations of understanding on this. And they understand that it’s important to let these decisions be undertaken by the doctors, the patients, and, in the cases of kids, the family.

We have decades of medical evidence around care. The very first trans kid we have evidence of was back in the 1890s (and of course, trans people go back much further). In the current era, we see, for instance, research showing that puberty blockers lower the suicide rate for transgender youth by up to 73 percent. These are real lives saved. It lowers the depression and anxiety rate by 60 to 70 percent. These are enormously helpful for the transgender youth who need them.

I want to make clear that I don’t disagree with being careful around care. Being careful is extremely important. I think that allowing this care to be individualized and personalized for every patient, rather than having a blunt hammer approach, where care is outright banned, is in the best interest of the kid and their medical care.

There’s a lot of research on this as well. There was a recently study that showed for gender-affirming top surgery — chest masculinization surgery — the regret rate was almost nothing. I know that gender-affirming care has seen regret rates of 1 to 3 percent, and there have been studies on detransitioning that show that detransition rates tend to be between 1 to 5 percent.

Here’s the important point: Whenever you see a detransitioner like Chloe Cole testify against gender-affirming care, it’s very similar to the ex-gays of the early 2000s, where they would say that being gay was a choice and that they made the wrong choice and you should ban gay marriage because of that. The reality is, of that 1 to 3 percent of people that detransition, only 5 percent of those people do so because they no longer identify as trans. Most of those people who detransition do so because their families don’t support them anymore, because they’re getting fired from their jobs, because they can’t afford their hormones, because they can’t afford their surgery, because they cannot obtain the care.

I know many people who have detransitioned, and they would never advocate against care. They want the care for themselves, but they can’t get it because society’s too harsh on them right now. You’re going to see a lot of people detransition in Florida in the coming months, and that’s not going to be because they no longer identify as trans. It’s because Florida bans medical treatment for adults in most circumstances right now.

Yeah, at this point Florida is absolutely the most extreme. It’s dangerous for LGBTQ people, especially trans people. About ninety-four thousand transgender people live in Florida, and about 80 percent of those people cannot obtain their hormones, and they have not been able to obtain their hormones for the last three months. That’s because of a law that essentially bars nurse practitioners from providing care. On top of that, it requires these informed consent, medical misinformation forms that are still being developed.

They’re also targeting trans people in bathrooms in Florida. For instance, if I went to Florida right now, and I were to use the bathroom that I’ve been using for the last five years that I feel the most comfortable in, I could be arrested and put in jail for a year.

You’ll often hear in congressional testimony that the only study on trans people that is high-quality is a Swedish study that says transitioning increases suicide rates. The truth of the matter is that the study, which came out in 2011, looked at trans people and what happened after transitioning from 1973 to 2003. So this was a historical retrospective. It found that trans people post-transition had a nineteen-times higher suicide rate than the general population.

However, and the author stresses this, and it’s very important to note, it was not comparing transgender people who can get care to ones who can’t get care. It’s comparing them to cisgender people, who don’t have all the violence, all the health care discrepancies that trans people have in that time period. The reality is that in that time, from 1973 to 2003, the vast majority of these trans people were suffering. They were getting HIV and AIDS in the 1980s, they were homeless, and prior to 2003, it was almost impossible to medically transition. You had to spend about $12 to $20,000 just in therapy visits before they would give you your first hormones.

And so in most of these cases, these people could not transition, and therefore the rates were rather high for this population. Modern studies, of which we have about fifty at this point, show that gender-affirming care reduces suicidality by about 73 percent.

It’s primarily an export out of the UK. It does not have a lot of roots in American history. In the United States, a lot of the opposition to feminism has been from a religious perspective, and so I think that in the United States the anti-abortion movement is so closely tied with the anti-trans movement — indeed, the very same people are pushing both — that I feminists in the United States clearly see those tie-ins. They see that the threat posed to one group poses a threat to the other group.

In the United Kingdom, that religious antiabortion movement did not develop in the way it did in the United States, though those tie-ins are starting to develop. We’re seeing in the UK more pushes to ban abortion, and we’re seeing those pushes come from anti-trans forces. And I think people are realizing that the trans-exclusionary movement in the UK is not congruent with the goals of feminism at large.

Absolutely. In many cases these laws being pushed are contrary to public opinion, especially among Gen Z and among millennials. These two cohorts poll extremely high on LGBTQ acceptance and transgender acceptance.

The majority of Gen Z and millennials know somebody personally — they’re either friends or family with somebody who is transgender. That’s not the case for some of the older cohorts, and I think that will change over time as more of us come out.

I think that this radical push, using laws to target us, is a reaction to that change. They are a reaction to the fact that trans people are coming out in large numbers right now and that we are starting to see increased acceptance.