Trans Legislators, LGBT Orgs Urge Biden To Reconsider Anti-Trans Statement: "A Betrayal"
On Tuesday, the Biden administration released a statement targeting surgery and other care for trans youth. Now, transgender and nonbinary state legislators are pushing back.
Last week, the Biden Administration seemed to falter on transgender healthcare issues, releasing and revising multiple statements opposing gender-affirming surgery for transgender youth and prioritizing "mental healthcare" over other forms of care. The statements were a reaction to a misleading story from The New York Times regarding Admiral Rachel Levine's comments on WPATH guidelines for transgender youth. Now, a group of twelve transgender and nonbinary legislators have released an open letter to the Biden Administration, calling the statement "a betrayal" and urging for clarification that the administration would continue to oppose bans on gender-affirming care.
“These are personal decisions, made on a case-by-case basis, by the young individuals, their families, and their medical providers. Yet anti-equality state legislators have passed bans on this healthcare in half the country,” the legislators state in the letter. Many of them work in states that have targeted transgender healthcare, such as Representatives Mauree Turner (Oklahoma), James Roesener (New Hampshire), Gerri Cannon (New Hampshire), Alissandra Murray (New Hampshire), Zooey Zephyr (Montana), and SJ Howell (Montana).
“The statement his administration shared with news outlet The 19th this week stands as a shocking repudiation of that promise. By stating that some forms of healthcare for transgender people should be limited solely to adults, the administration is surrendering the health care of young transgender people as something to be negotiated in the political domain, rather than something that needs to be carefully considered and decided by the medical community, by the parents of transgender youth, and by the youth themselves.”
The reaction of the transgender state legislators follows news that broke on June 27 when the administration informed Fox News that "the administration does not support surgery for minors," and reiterated that statement to The New York Times. These statements responded to a New York Times article asserting that Admiral Levine was pressuring the World Professional Association for Transgender Health to remove age limits for transgender surgeries, seemingly implying that Levine favored surgeries for very young youth. In reality, Levine opposed lowering age limits, favoring a more conservative approach that maintained the age at 18+ but allowed exceptions for individualized circumstances for transgender youth with severe dysphoria. These final, more conservative guidelines, which were passed and published, permit trans youth under 18 in some cases to obtain chest masculinization or feminization surgery—procedures that are also often sought and obtained by cisgender teens.
On Tuesday of last week, the White House issued a follow-up statement that many LGBTQ+ activists decried as worse than the original: “These are deeply personal decisions and we believe these surgeries should be limited to adults. We continue to support gender-affirming care for minors like mental health care and respect the role of parents, families, and doctors in these decisions.”
Notably, the statement not only opposed gender-affirming surgery for transgender youth but also failed to mention puberty blockers and hormone therapy, instead only mentioning mental healthcare. Mental healthcare alone is often used to support conversion therapy efforts targeted at transgender youth in states that bar hormone therapy and puberty blockers. After immediate outcry, the statement was revised, removing the reference to mental health care and replacing it with “a continuum of care.”
The legislators were not the only ones to condemn the statements. The nation’s largest LGBTQ+ groups also joined in. The Human Rights Campaign said in a statement, “The Biden administration is flat wrong on this. It’s wrong on the science and substance. These decisions belong between a patient, their family, and their health care provider. This administration has committed to fighting for trans youth and must continue without hesitation.”
Advocates for Trans Equality, the largest transgender rights organization, responded: “The Biden Administration is sending mixed messages that are misguided and dangerous for trans youth. We need the President to keep the promise he made to have the backs of trans youth and clarify his opposition to the dangerously sweeping bans that target trans youth and their families.”
Other organizations releasing statements included the Center for American Progress, the Transgender Law Center, Campaign for Southern Equality, and GLMA.
The letter concludes with a path forward for the Biden Administration, asking for a clarification that accomplishes three goals… an opposition to bans on all forms of care, a statement against discriminatory policies, and a commitment to following WPATH guidelines.
“We need an unequivocal signal that President Biden and his administration will oppose any attempt to ban puberty blockers, hormone replacement therapy, and surgery for transgender youth, that it will reject any policy that discriminates against transgender Americans, and that it will follow medical best practices as set out in WPATH when it comes to allowing care for transgender people,” say the legislators in the letter.
There has been no formal response since the letter was released on July 5th.
Disclosure: The author of this article is engaged to be married to Representative Zooey Zephyr of Montana.
Given the enormous issues and risks that trans people are facing - especially with the strong likelihood of a new Trump administration in six months - I find it very unfortunate that the Biden administration and trans advocates needed to engage in this squabble in the first place. The bottom line is: 1) gender confirmation surgeries - especially “bottom” surgeries - are rarely if ever performed on under-18s; 2) medical decisions wrt trans care should always rest with patients, families and doctors, and not politicians. These tenets are noncontroversial and we can all agree on them, correct? Including Democratic politicians? So why is there a need to expend much needed political resources on this? Maybe I’m missing something. But in six months, trans people will be facing dire threats to their IDs, civil rights, and medical care, and surgery for under-18s will seem a trivial issue by comparison.
OK, so they don't want gender affirming surgeries (usually top surgeries, breast reduction or enhancement) for trans youth. Are they also willing to ban these for cisgender youth?
Top surgeries are far more common for cisgender youth than for transgender folks. Breast reduction surgeries are done for cisgender male youth with excessive tissue (gynecomastia), cisgender girls with excessive breast tissue, and breast enhancements are not unheard of. (The "Alabama Sweet 16" birthday present...). And yes, these are gender affirming surgeries.
"Breast Surgery in Adolescents: Cisgender Breast Reduction Versus Transgender and Nonbinary Chest Masculinization"
https://pubmed.ncbi.nlm.nih.gov/38896845/
"Prevalence of Gender-Affirming Surgical Procedures Among Minors and Adults in the US"
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820437
Transgender youth and their families already have to jump through far more hoops than cisgender youth to gain access to gender affirming care. Is the Biden administration really intent on banning this care for one specific class or category of people?