Human Rights Watch Issues Scathing Report on Anti-Trans Healthcare Bans in the US

A first-of-its-kind Human Rights Watch report documented the impacts of trans youth care bans in-depth.

Photo by Markus Spiske on Unsplash

Human Rights Watch released a sweeping report on Tuesday detailing the harrowing experiences of trans youth, their families, and their healthcare providers in the United States—a first-of-its-kind analysis, the global non-profit says.

“It is the first comprehensive account by an international human rights organization to document how US state bans on gender-affirming care violate fundamental rights—including the right to health, the rights of the child, the right to non-discrimination, and the right to personal autonomy,” said Yasemin Smallens, an officer in the LGBT Rights Program at Human Rights Watch, who is the document’s principal author.

The report is titled “They’re Ruining People’s Lives”: Bans on Gender-Affirming Care for Transgender Youth. Smallens told Erin in the Morning that, while gender-affirming care bans are often framed solely as an “LGBT issue,” these findings situate trans health care within the broader framework of international human rights law. The bans may outlaw surgeries, hormone therapies, or affirming psychotherapy; they may criminalize providers of such care and punish parents who support their trans child.

The report was based on 51 interviews across 19 states with transgender youth, parents, healthcare providers, and advocates. The testimonies were pseudonymized to protect interviewees amidst growing political attacks. Even with guaranteed anonymity, however, Smallens said during a press conference that trans people and their loved ones were reluctant to speak out, especially upon the election of Donald Trump.

“With time, people were more and more afraid to speak to me,” Smallens said. The report also notes that it was largely limited to trans kids who had supportive parents, and that the harm runs even deeper for trans kids in unsupportive families.

However, these narratives are vital in informing public debate about trans health and policies, especially as junk science and studies are elevated by the Trump Administration and anti-human rights zealots. In May, Trump’s Department of Health and Human Services released a 400-page anti-trans screed full of pseudoscience and transphobia couched in graphs, charts, and the veneer of statistics and academic rigor.

“People are talking about the ontology of sex as opposed to the people that these policies are harming,” Smallens said. “But these histories and these stories will remain.”

Participants described navigating the current minefield of care barriers as devastating. “I want [lawmakers] to know they’re ruining people’s lives,” one trans teen, identified as Sophia, said.

Multiple families reported having to move or otherwise change their location of care on two different occasions; when they fled to one place, another ban was enacted. Parents said they pay tens of thousands of dollars out-of-pocket for out-of-state care. They discussed doctors who have abruptly stopped care without warning, and that even the appearance of offering a referral sparked fears of legal action under states’ “aiding and abetting” laws. One family reported that their gender clinic was targeted by an arson attack.

At the same time, the report supported and was supported by the overwhelming body of evidence that shows trans-affirming care is life-saving. Many of the trans young people profiled were happy, thriving members of their community until the healthcare bans, or the threat of such bans, drove children to attempt suicide.

“It felt like I wasn't allowed to have puberty and be happy and just be a regular child,” said Kai, a trans youth. “I had to feel horrible and depressed and suicidal because it isn't who I am—to be in a woman's body, to be going through a female puberty—because I'm not a girl.”

Meanwhile, Smallens struck a hopeful note about the potential for radical change at every level, issuing recommendations for the Oval Office and Congress cascading down to the most local levels of government—things lawmakers and officials can do to protect trans kids, their families, and their providers. State legislatures can enact “Shield Laws,” which protect doctors from out-of-state, anti-trans prosecution. Medical boards can reaffirm their support of holistic, evidence-based best practices when it comes to treating trans patients. County officials can resist orders to investigate families for providing gender-affirming care to their trans children.

When these kids are allowed the care and support they need, Smallens’ report highlights the potential for trans joy, growth, and resilience. One parent, Grace, said her son used to cry at his own reflection until he accessed gender-affirming care. “Shortly after [he started] testosterone, I walked by and he was in the bathroom grinning, grinning at himself [in the mirror] like an idiot,” she told Human Rights Watch “And I'm like, ‘What are you doing?’ And he said, ‘I finally feel like myself.’”