States push anti-LGBTQ laws as Equality Act looms

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Photo by Kelly Burkhardt.

The Equality Act is closer than ever to becoming law under a Biden-Harris administration. President Biden promised the law would be passed in his first 100 days. But the nearer LGBTQ Americans come to full protection under the law, the more Republican-led legislatures and Republican governors are pushing anti-LGBTQ laws to circumvent that Equality Act passage.

Anti-LGBTQ legislation has become a focal point of the Republican Party since January, suggesting that the new culture wars will pivot off LGBTQ discrimination.

More than 60 anti-LGBTQ bills are being considered across the country, according to the American Civil Liberties Union (ACLU), which lists anti-LGBTQ rights laws in proposal. These bills fall under a range of categories — all discriminatory and dangerous to LGBTQ lives. They are wide-ranging, including overall restriction of health care and social services to LGBTQ people, so-called “bathroom bills,” single-sex facility restrictions, bills excluding trans-identified youth from athletics, restrictions on identification documents, religious exemption bills, religious exemptions in heath care implicating LGBTQ people, religious exemptions in adoptions and foster care, religious exemptions in schools and student organizations, and bills pre-empting local protections against discrimination.

While some of these bills are only in process, others are getting passed.

On March 29, Arkansas became the first state to pass a bill prohibiting doctors from providing gender-affirming medical care to transgender youth following a vote in the state Senate. HB1570, the Save Adolescents From Experimentation (SAFE) Act, prohibits trans youth from accessing health care and insurance coverage for gender-affirming health care. The bill passed 28-7 in the state Senate. The state House passed the bill earlier in March.

The bill is sweeping: Under the SAFE Act, doctors are banned from offering any and all hormone treatments or surgery to trans minors. Nor can physicians refer minors to other providers for treatment, say, outside the state. Even reversible puberty blockers and hormones are banned under the law.

Unless GOP Gov. Asa Hutchinson vetoes the bill, it will become law.

Advocates for trans, gender nonconforming and non-binary youth have long contended that early intervention for transgender and gender non-conforming non-binary (TGNCNB) youth would allow cessation of development of secondary sex characteristics, which in turn allows TGNCNB youth to feel more comfortable in their bodies. Early puberty blockers make transitioning for transfeminine and transmasculine people easier, and make some surgeries unnecessary later, which in turn lowers health risks to the TGNCNB individual.

Opponents of these and other medical interventions argue that they are, as the name on the egregious Arkansas bill declares, “medical experimentation.”

Except it isn’t. While treating gender incongruence with puberty blockers is a relatively recent application, these drugs have been used on children since the 1980s for slowing down puberty if it happens too early or too quickly, particularly in girls who present with accelerated development, including menstruation, as young as five. In those cases, puberty blockers in girls who are not trans-identified allow for a more normative maturation process.

According to the renowned Mayo Clinic, the use of the puberty blocker medication gonadotropin-releasing hormone (GnRH) analogues has been in use for decades, primarily on young girls, but now on TGNCNB youth.

The clinic states “Puberty’s physical changes can cause intense distress for many gender-nonconforming adolescents. When taken regularly, GnRH analogues suppress the body’s release of sex hormones, including testosterone and estrogen, during puberty.”

The Mayo Clinic says these hormones affect the sexual organs present at birth, including the penis, scrotum and testicles and the uterus, ovaries and vagina. But most importantly for TGNCNB youth, the hormones affect the secondary sex characteristics. These are the physical changes in the body that typically appear during puberty, such as breast development and growth of facial hair. In those identified as male at birth, GnRH analogues decrease the growth of facial and body hair, prevent voice deepening and limit the growth of genitalia. In those identified as female at birth, treatment limits or stops breast development and delays or stops menstruation.

Puberty blockers are fully reversible, relegating arguments against them to the purely political and religious, rather than medical.

Medical rationale for the use of early intervention with puberty blockers in TGNCNB youth is clear. The Mayo Clinic notes such treatment can “improve mental well-being; reduce depression and anxiety; improve social interactions and integration with other kids; eliminate the need for future surgeries; and reduce thoughts or actions related to self-harm.”

Yet despite the clear science — and benefits — to TGNCNB youth, Republican efforts to pass laws like HB 1570 are ramping up in many states.

Trans youth represent a tiny percentage of the U.S. population. Recent estimates assert trans feminine and trans masculine minors are only 0.7% to 2% of youth. Yet Republican legislators have introduced dozens of bills directly related to TGNCNB youth since January — the highest number of anti-trans legislative proposals filed in a single year.

The American Civil Liberties Union (ACLU) responded immediately to the Arkansas law, tweeting, “BREAKING: Arkansas has become the first state to ban health care for trans youth. HB 1570 was just passed through both chambers in the Arkansas legislature, banning trans youth from accessing health care and health insurance coverage that we deserve and need. Our rights and lives are under attack. Governor Hutchinson must veto this bill.”

Noted trans activist and advocate Chase Strangio, deputy director for transgender justice at the ACLU LGBT & HIV Project, called the bill “the single most extreme anti-trans law to ever pass through a state legislature.” Stangio, a trans man, has argued major cases like that of Aimee Stephens and Gavin Grimm.

Alabama and Tennessee are also pushing bills similar to the Arkansas law. Alabama’s Senate approved a bill that would make it a felony to provide puberty blockers or hormones to trans minors. The Tennessee House Committee also has a bill banning puberty blockers to TGNCNB youth that includes misdemeanor criminal penalties for physicians.

Pediatric endocrinologist Dr. Michele Hutchison (no relation to the governor) testified before the Arkansas Senate about the dangers of the bill. She said, “I’ve had multiple kids in our emergency room because of an attempted suicide just in the last week.” The ACLU put video of her full testimony on their website.

Lesbian soccer star and Olympian Megan Rapinoe addressed another major focus of Republican bills: banning trans feminine youth from girls sports. (There is no corresponding effort to ban trans masculine youth from boys sports.) In a March 28 op-ed in the Washington Post, Rapinoe said, “Being able to play sports as a child shaped my life’s path.” She continued, writing “It taught me so much more than is seen on the field and brought me so much joy. Every child deserves to have that experience.”

Jeanette Jennings, mother of trans youth activist and reality TV star Jazz Jennings, told the Guardian that her daughter being banned from the girls soccer team and being forced to play on the male team was devastating. “She’d go out to the field and just stand there, paralyzed and frozen or crying.”

Jennings said, “You have these politicians out there that have this fear of trans kids, with bathrooms and now with sports. I don’t understand it. We fought so hard to win our battles. To see it all unraveling now is breaking my heart. I’m torn up. It’s discrimination at its ugliest.”

Rapinoe said these sports ban bills “cause incredible harm to trans youth” and said as a lesbian, she knows the feeling of being “singled out and treated differently.”

On Equal Pay Day, March 24, Rapinoe, who was part of a class action suit by the National Women’s Soccer League for pay equity, spoke on the issue at the White House. She said the problem in women’s sports is not trans athletes.

In her op-ed, Rapinoe wrote, “As a woman who has played sports my whole life, I know that the threats to women’s and girls’ sports are lack of funding; resources and media coverage; sexual harassment; and unequal pay.”

Strangio told CNN that the anti-trans youth bills are dangerous. He said, “There have been many existential threats to trans existence, but there’s something uniquely dangerous about what’s going on right at this moment with the combination of the sports bills and the health care bills.”

Strangio said, “I think the impulse underlying both is to try to establish governmental policy that it’s harmful to be trans.”