Fighting Attacks on Trans Healthcare

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Attacks on the rights of transgender people have taken several forms over the past decade. In 2015-2017, legislatures considered dozens of “bathroom bills,” that would ban trans people from using the bathroom corresponding to their gender identity. This brought broad backlash and no state successfully passed a “bathroom bill.” 

Over the past year, the right wing has whipped up hysteria around trans people participating in gender-divided competitive sports. Already, this has been a more successful endeavor for the right wing; Arizona, Florida, and Iowa have passed trans sports bans this year.

Now, these attacks have taken on a particularly brutal and life threatening form – banning transgender minors from receiving gender-affirming health care, including puberty blockers, hormone treatments, and transition surgery. So far, 15 states have legislation being actively discussed that would ban trans health care for minors. This could become the most significant anti-LGBTQ offensive in decades, and we urgently need to organize a fight back.

The Significance of Healthcare

These health care bans are a new phenomenon – according to the Movement Advancement Project, which tracks the progress of these bills, no state considered a ban on trans healthcare for minors prior to 2020. And yet, this new right-wing offensive is incredibly fast-moving: a third of trans youth live in states where a ban is being considered.

In Texas, Gov. Greg Abbott avoided legal challenges by issuing an order (instead of binding legislation) that families of transgender teenagers be investigated for felony child abuse for letting them transition. Tragically, healthcare providers are entirely compliant, pulling gender-affirming procedures for minors.

Most of the bills in question take specific aim at puberty blockers, a treatment that will, in prepubescent children who show clear gender dysphoria and identify with a different gender than their sex assigned at birth, delay the onset of puberty. 

While Republican lawmakers claim that this is an overused and dangerous form of treatment, the reality is that minors who take puberty blockers have to do so in consultation with therapists and health care providers in a process that takes months and often years. The effects of puberty blockers are completely reversible if a patient stops taking them, and most often they are used to delay irreversible unwanted effects of puberty while a patient considers hormone therapy. 

Additionally, because these procedures are deemed “cosmetic”, they’re most often not covered by insurance – putting trans people and their families on the hook for potentially thousands of dollars just for the ability to feel comfortable in their bodies. This treatment is far from “overused.”

Study after study shows that transitioning, and especially transitioning at a young age, corresponds to lower rates of depression and suicidality in transgender people. When your gender doesn’t match your sex assigned at birth, going through puberty and gaining sex characteristics that are contrary to your self-perception is damaging and traumatic. 

There is also a real significance to discouraging early transition for trans people. It is much more difficult socially to transition as an adult, and those who do so are at much higher risk for discrimination in the workplace and in housing. While many adults still transition, and even late in life, barring someone from transitioning as a young person amounts to discouraging them from transitioning at all.

The reality is that for transgender minors, especially those who are prepubescent, transition most often looks like getting a new haircut and wardrobe. However, even that is a step too far for the Republican Party, which seemingly aims to legislate transgender people out of existence. Bills introduced in Alabama and Iowa list the practice of encouraging trans children to dress as the gender they identify with as the beginning of an “unproven, poorly studied series of interventions.”

These attacks are a serious threat to the health and safety of trans and queer people, who already face severe marginalization in society – especially increased risk of housing insecurity, poverty, and gender-based violence. 

Democrats Fail to Build Opposition

The Republican Party is on the warpath against trans people, with plans to go further. While debating one such healthcare ban directed at minors in April, Missouri lawmakers suggested that access to hormone therapy and gender-affirming surgery be restricted for individuals until they turn 25. 

For the GOP, transgender people (especially youth who are especially vulnerable) make a convenient political scapegoat. Due to comparatively small amount of transgender people in the United States, we remain an easy demographic to fearmonger about. Most Americans don’t know any trans people personally, and education about us was limited even before Republicans began to ban it from schools – and the only knowledge people are given about trans identity and healthcare come from media attacks. During the primaries, Republicans spent $4.5 million on ads vilifying trans people. 

So, how much ad money has the Democratic Party – the supposed pro-LGBTQ party – spent this cycle on campaigning to defend the rights of transgender people? 


To say the Democrats’ approach has been limited to “nice words” would be generous; it would imply that Democratic Party politicians are even spending significant time talking publicly about the attacks. The most significant reference so far came from Biden’s speech on May 17 – International Day Against Homophobia, Biphobia, and Transphobia – in which he said, “hate is hate,” and people have “a responsibility to speak out.” Despite over 320 anti-LGBTQ bills being introduced in state legislatures this year, Biden said nothing about meaningful protections for queer people.

It’s clear that defending crucial trans rights doesn’t rank anywhere on the list of priorities for the Democratic Party. They, like the Republicans, see us as a campaign issue – and not an advantageous one.

This falls in a lineup with severe issues threatening marginalized and working people that Democrats patently refuse to play offense on: attacks on abortion rights, racist voter suppression, and climate change, just to name a few. 

Moreover, the Democrats have never been, and have no intention of becoming, advocates for truly universal healthcare – not just for trans people, but for all working people. In America, medical expenses account for the majority of all bankruptcies – and two years into a global health crisis, despite holding a majority in both houses of Congress and control over the White House, Democrats have not put single-payer healthcare back on the table in any way.

We need an independent movement to secure trans rights, and we need a mass working-class party to represent the interests of transgender people as part of a working-class program that will cut across the division of the GOP. We should be clear: the Republican Party cynically uses the existence of trans and queer people to whip up their base to a program of austerity and poverty that does not benefit working-class people of any gender or sexual orientation.

The most effective way to undermine right-wing bigotry and hysteria is with a program that addresses the needs of working-class people. Bernie Sanders showed this when his 2016 campaign won over a serious number of traditionally Republican voters, with a program that included widely-popular working-class demands like Medicare for All. We need a party that will link economic demands for all working people to rights for the marginalized, like Medicare for All including gender-affirming and reproductive care.

The Struggle Ahead

We especially need a united movement to defeat these attacks on trans rights alongside the effort to defend Roe v. Wade and abortion rights. Tens of thousands of people nationally came out into the streets when the Supreme Court leaked a draft decision overturning Roe, and students and workers have organized walkouts against the potential rollback. We need to mirror and expand this fighting approach to defending trans rights. We need a genuine mass movement demanding a Medicare for All healthcare system that includes high quality reproductive and gender affirming care.

These attacks show that we cannot rely on the slow “changing of attitudes” to clear the way for a safer existence for transgender people – and importantly, that the “changing of attitudes” has never happened in a vacuum, and can be wrenched backwards by powerful political forces. But in the same way, they can be wrenched forwards through the building of genuine solidarity between working people, on the basis that the interests of transgender people are also the interests of the working class. 

Autonomy over our bodies, safety in public spaces, free and accessible healthcare, high-quality and affordable housing, safe workplaces and living wages – this is the reality that transgender people are desperately seeking, but it is also the world that the working class has long been denied. In the face of a political system that is determined to keep that world from us, we owe it to ourselves to build the movement necessary to win it. 

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