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Attacks on Transgender Americans Are Attacks on Health Care
This is not difficult: Gender-affirming care is health care, period, and decisions about that care belong to patients and their health care providers (and families in the case of minors), not politicians on an ideological crusade.
Mar 21, 2026
For some time now, right-wing forces have been attacking gender-affirming health care for transgender individuals, and especially for trans youth. Those attacks ratcheted up seriously in December, when the Trump administration proposed rules designed to ban gender-affirming care for young people, with HHS Secretary Robert F. Kennedy Jr. flatly calling such care “malpractice.”
The medical community promptly and unequivocally disagreed, with American Academy of Pediatrics President Dr. Susan J. Kressly telling NPR, "These policies and proposals misconstrue the current medical consensus and fail to reflect the realities of pediatric care and the needs of children and families." AAP’s view represents the overwhelming consensus among medical, nursing and psychiatric organizations, but that has had no impact on the crusade by the administration as well as right-wing state officials to erase trans people and eliminate and even criminalize their health care.
The Trump administration’s push to erase trans people began early last year with a presidential executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.” The order declared, “Efforts to eradicate the biological reality of sex fundamentally attack women by depriving them of their dignity, safety, and well-being.” Trump’s order oddly failed to acknowledge the existence of transgender men but effectively declared all transgender humans to be nonpersons according to the U.S. government. “It is the policy of the United States,” it read, “to recognize two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality.”
That’s not a scientific statement but an ideological one. In fact, as Nathan Lents, a molecular evolutionary biologist at the John Jay College of Criminal Justice in New York City explained to a reporter after the executive order was issued, “Biology doesn’t operate in binaries very often … Reducing sex to a binary really doesn’t make a lot of sense for how we actually live.”
Many cultures around the world, particularly indigenous cultures, have long recognized gender diversity. In Hawaii, where I live, native Hawaiian culture understood and respected māhū, the Hawaiian word for a person of dual male and female spirit. What administration officials and other right-wingers dismiss as “radical gender ideology” is in fact a factual, science-based understanding of a facet of human diversity that has been recognized by different cultures around the globe for millennia, starting long before either modern science or modern politics entered the picture.
Nevertheless, the president’s order and subsequent messages from the Department of Health and Human Services put intense pressure on hospitals and health care providers, many of whom responded by curtailing gender-affirming care, especially for minors. Those pausing or such care included major hospital systems such as Kaiser Permanente with its 40 hospitals. By late August, news outlets had counted at least 17 major hospital systems in at least nine states and the District of Columbia that had paused, discontinued, canceled or ended gender-affirming care for pediatric patients.
States—generally Republican-leaning states—have also piled on restrictions. Late last year, KFF reported that 27 states had passed laws limiting access to gender-affirming care for minors. Roughly half of the nation’s trans or nonbinary youth are estimated to live in these states. Half a dozen states, including Florida, Alabama and Idaho, have made it a felony to provide gender-affirming care for young people under 18. Though the Supreme Court upheld such bans last year, some of these state laws face legal challenges in state courts based on individual state constitutions.
On the other hand, a number of states—generally “blue states,” including New York and California—have passed laws protecting gender-affirming care, while a few others have such policies via executive orders. Recently, New York Attorney General Letitia James informed a major Manhattan hospital that its actions to curb gender-affirming care under federal pressure violated New York State law. Hospitals and other providers may find themselves more and more caught between conflicting state and federal requirements.
It’s important to remember that for those under 18, gender-affirming care almost never involves surgery, but typically focuses on social and psychological support. Medical interventions such as puberty blockers are sometimes used after puberty begins. Puberty blockers, which are entirely reversible (and which a White House executive order has dishonestly branded as “chemical mutilation”) pause puberty in order to buy the young person time to mature and consider their options before major and complex-to-reverse physical changes set in.
Opponents of gender-affirming care sometimes focus on a handful of patients who later changed their minds and regretted having this care. Nearly any medical procedure results in a few patients wishing they hadn’t done it, but research consistently shows that regret rates for gender-affirming care are quite low. For example, a 2024 review of 55 articles that looked at regret rates after various types of plastic surgery found that gender-affirming surgery had far lower regret rates than other surgeries, including breast augmentation or reconstruction, not to mention other major life decisions such as having children or getting a tattoo.
A later study of 150 youthful individuals (median age 18.6 years) who had had gender-affirming hormone therapy and/or surgery found that the most common emotions associated with these treatments “were satisfaction (88.0%) and confidence (86.7%).” Only one of the 150 wished they hadn’t had the treatments, leading the authors to conclude, “Individuals who accessed [gender-affirming care] as adolescents are largely satisfied with this care. Care-related satisfaction and regret are more nuanced than sometimes portrayed and should not be used to limit access.”
State attacks on transgender residents don’t stop with medical care. Kansas, for example, just summarily invalidated all driver’s licenses in which the driver had legally changed their gender to match their lived identity. Such policies can impact the health of those affected, both by adding new layers of stress and by interfering with their ability to drive to obtain care or just make a living.
All of these policies are based on a myth: That transgender identity is the product of some new, “woke,” “radical gender ideology” and that trans people are simply confused and have been propagandized into believing that they can change their gender.
Trans people know better. Take “Perry” (a pseudonym), a young friend of mine whom I wrote about last October for Defend Public Health. Perry, 17 when I met him and now turning 21, knew something was amiss from early in his childhood. “I always felt uncomfortable,” he told me. “I rebelled against every single authority most of my childhood.” His feelings clarified when he was about twelve. As he explained it, “I always felt like I wasn’t myself, like I was playing a role” -- the role assigned to the female anatomy he was born with.
Despite some parental unease, he eventually began living as a boy and instantly felt more comfortable and like his authentic self. Trans people like Perry know who they are and don’t need politicians dictating what care they can and can’t obtain.
Happily for Perry, he lives in Hawaii, a state that has not restricted gender-affirming care and is unlikely to. But Hawaii doesn’t yet have a shield law to protect providers (such a bill is now up for consideration in the state legislature), and can certainly be impacted by misguided federal policies, so he’s not completely out of danger.
This is not difficult: Gender-affirming care is health care, period, and decisions about that care belong to patients and their health care providers (and families in the case of minors), not politicians on an ideological crusade. We must fight back against these attacks and push our politicians to defend the rights of all, including transgender people, to get the care they need.
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Transgender Kansas Residents Sue Over State's Invalidation of Driver's Licenses
"SB 244 is a transparent attempt to deny transgender people autonomy over their own identities and push them out of public life altogether.”
Feb 27, 2026
Accusing Kansas Republican lawmakers of violating the state's Constitution and waging "a direct attack on the dignity and humanity of transgender Kansans" by passing a law that invalidates their driver's licenses, the ACLU on Friday filed a lawsuit on behalf of two transgender residents and called on a state judge to block the statute.
The organization took legal action a day after SB 244 went into effect, rendering the birth certificates and driver's licenses of about 1,700 Kansans invalid because they have been changed to reflect the gender identity of the people they were issued to, rather than their sex assigned at birth.
Transgender Kansans across the state received letters this week from the Kansas Department of Revenue instructing them to "surrender [their] current credential" and exchange it for one that matches their sex assigned at birth.
“Your current credential will be invalid immediately,’’ warns the letter, adding that driving without a valid license could result in penalties.
SB 244 also prohibits transgender Kansans from updating the gender marker on state-issued birth certificates and driver's licenses in the future, prohibits transgender people from using public restrooms that match their identity on government property, and allows anyone who suspects a transgender person is in violation of the law to sue the individual for damages of up to $1,000.
The bathroom provisions were added to SB 244 without a hearing or any public comment.
The state's Democratic governor, Laura Kelly, vetoed the legislation, but Republican legislators overrode her veto.
"A confident republic does not need to erase people to prove a point. It can hold together across deep differences without turning paperwork into a weapon."
Harper Seldin, a senior staff attorney for the ACLU's LGBTQ and HIV Rights Project, called the law "a cruel and craven threat to public safety all in the name of fostering fear, division, and paranoia."
“The invalidation of state-issued IDs threatens to out transgender people against their will every time they apply for a job, rent an apartment, or interact with police," said Seldin. "Taken as a whole, SB 244 is a transparent attempt to deny transgender people autonomy over their own identities and push them out of public life altogether.”
States including Texas, Florida, and Tennessee have laws requiring the gender marker on a person's driver's license to match their sex assigned at birth, but Kansas is the first state to invalidate the licenses of people who have changed the gender markers.
The law was passed as President Donald Trump and Republican lawmakers denounce what they view as radical "gender ideology," including science-backed findings that a person's gender can be fluid and that gender-affirming healthcare can reduce depression and suicidal ideation.
In 2025, the ACLU tracked more than 600 anti-LGBTQ laws and proposals in states. At least 74 were passed into law.
In the lawsuit filed in the District Court of Douglas County, two anonymous plaintiffs identified as Daniel Doe and Matthew Moe argue that SB 244 violates the Kansas Constitution's guarantees of personal autonomy, privacy, equality under the law, due process, and freedom of speech.
They argue that the law is discriminatory and violates equal protection laws because other Kansans are free to change their name or choose whether or not to list other aspects of their identity, such disclosing veteran status or a disability, on their licenses.
One critic calledlled SB 244 "humiliation with a state seal."
"This does not make anyone safer on the road. It just forces people to carry documents that lie about who they are, and then punishes them when those lies put them at risk at traffic stops, pharmacies, airports," the social media user said. "A confident republic does not need to erase people to prove a point. It can hold together across deep differences without turning paperwork into a weapon."
Heather St. Clair, a lawyer with Ballard Spahr, a law firm helping to represent the plaintiffs, said the law amounts to "state-sanctioned attack on transgender people aimed at silencing, dehumanizing, and alienating Kansans whose gender identity does not conform to the state Legislature’s preferences."
Ballard Spahr, she said, "is dedicated to protecting the constitutional rights jeopardized by this new law.”
The plaintiffs are seeking a temporary restraining order and a temporary injunction to block the law from entering into force while the case is being decided.
The advocacy group Southern Equality applauded the legal challenge.
"We are grateful to the ACLU for filing a lawsuit against this heinous law in defense of trans Kansans," said Southern Equality. "We join in solidarity with trans people everywhere: You belong in public spaces, and we will not stand by while your rights are stripped away."
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Michiganders Vow to Fight Trump Attacks on LGBTQ+ Youth as DOJ Probes Public Schools
"We urge federal officials to focus on real threats to student well-being like gun violence, funding cuts, and staffing shortages rather than singling out districts that work to support all children," said one advocacy leader.
Feb 20, 2026
Denouncing the Trump administration's probes to determine whether three public school districts "have included sexual orientation and gender ideology" content in courses as "part of a broader attack on our rights as Michiganders," the head of one progressive group pledged Friday to keep fighting to ensure that "all of our kids can thrive at school free from bullying, harassment, and other unfair treatment."
The US Department of Justice announced Wednesday that its Civil Rights Division is investigating Detroit Public Schools Community District, Godfrey-Lee Public Schools, and the Lansing School District. The DOJ is examining content for pre-K through 12th grade courses, opt-out policies, and whether the districts "limit access to single-sex intimate spaces, such as bathrooms and locker rooms, based on biological sex."
In a Friday statement, Justin Mendoza, executive director of Progress Michigan, emphasized that his state's "civil rights laws explicitly protect LGBTQ+ students, and our state must enforce them to the fullest extent."
Mendoza condemned not only the Trump administration's efforts to harm "the most vulnerable and historically marginalized among us," but also Republicans at the state and federal level who "are trying to limit honest conversations about our nation's history, while fighting each and every attempt to create safe, inclusive schools for our children."
"Attorney General Pam Bondi is setting a terrible example for younger generations—considering the way she behaved at a recent congressional hearing where she name-called members of Congress—and now she's going a step further by throwing nondiscrimination policies into the dumpster," he said. "People of all genders, races, and backgrounds benefit from strong nondiscrimination policies."
"From Marquette to Monroe, teachers, students, and their families are committed to having an educational system that reflects the diversity of the world they live in," Mendoza continued. "Classrooms deserve to have age-appropriate conversations about health, identity, and respect, and if parents choose to opt their children out of participating in these conversations, they are already allowed to by Michigan law."
"The Trump Department of Justice is truly looking to invent problems instead of actually fighting crime and violence towards youth," he concluded, "and Michiganders won't take this intrusion into our education system."
"The Trump Department of Justice is truly looking to invent problems instead of actually fighting crime and violence towards youth, and Michiganders won't take this intrusion into our education system."
Other state and nationwide groups have also spoken out against the administration's probes and targeting of LGBTQ+ youth this week. Brian Dittmeier, director of LGBTQI+ equality at the National Women's Law Center, blasted the investigations as a "blatant attempt to discourage inclusive education."
Jay Kaplan, a staff attorney for the ACLU of Michigan, told Chalkbeat that "this is an attempt to harass and bully districts into discriminating against trans kids and into erasing the existence of LGBTQ people."
Equality Michigan executive director Erin Knott said that "LGBTQ+ youth are among the most vulnerable young people in our state. They face higher rates of bullying, harassment, and mental health challenges. Inclusive education policies are not 'ideology,' they are evidence-based efforts to ensure that every student feels safe, respected, and seen in their own school community."
"All kids deserve an education that reflects the diversity of the world they live in," she stressed. "Age-appropriate discussions about health, identity, and respect help create safer classrooms for all students. We urge federal officials to focus on real threats to student well-being like gun violence, funding cuts, and staffing shortages rather than singling out districts that work to support all children."
State Superintendent Glenn Maleyko was similarly critical of the federal administration in his response, saying Thursday that "the Michigan Department of Education strongly supports all students and supports the school districts that have been targeted by the US Department of Justice."
Maleyko continued:
If we want to put Students First and make sure children can learn, we need all students to be healthy and safe and feel included. The much-needed updates to health education guidelines—which the Department of Justice falsely said are state requirements—help local districts make decisions on how they can support student health.
As required by state law, MCL 380.1507, local school boards set health curriculum with input from local sex education advisory boards. Local control remains in place. Parents retain the right to decide whether their children should participate in sex education instruction.
The Michigan Department of Education strongly supports and will work closely with the three districts' efforts to select a curriculum that best supports the needs of their students, consistent with state standards and guidelines. We remain committed to protecting the rights of all students and to upholding Michigan’s constitutional guarantee of access to a free public education for every child.
"The breadth and scope of the federal requests, premised on a mischaracterization of the Michigan Health Education Standards Guidelines adopted by the State Board of Education, place a significant administrative burden on local districts and risk diverting time and resources away from the core mission of educating students," Maleyko added.
As for the targeted districts, a spokesperson for the Detroit schools declined to comment, while Guillermo Lopez, the Lansing school board president, told the Detroit Free Press that parents in his district are informed that "they can opt out of certain classes."
Arnetta Thompson, superintendent of Godfrey-Lee schools, told Chalkbeat that her district will provide information requested by the DOJ and "is not facing any charges or findings of wrongdoing. We remain committed to complying with all applicable federal, state, and local laws and have consistently operated in accordance with those laws."
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