Last year it was ‘bathroom’ bills. Now it’s the criminalization of medical care for trans kids.

A slew of anti-transgender state bills has recently appeared across the U.S. seeking to block trans children from receiving gender affirming care. These are just the latest attacks being made on a highly vulnerable minority in an attempt to divide working people. Such bills are based on bigotry and go against basic standards of medical care.

South Dakota lawmakers are due to vote soon on the controversial bill HB 1057, which would make it a felony for health care providers to give trans children puberty blockers, hormone supplements or other gender affirming care, punishable by up to 10 years in prison. However, the law makes specific allowances for surgeries on intersex children. In doing so, South Dakota lawmakers would be criminalizing the standards of care for trans and intersex youth recommended by the Endocrine Society.

The editorial board of the Argus Leader, South Dakota’s most widely-read newspaper, blasted the bill in no uncertain terms, writing on January 23 that “Bills like HB 1057 and its ignominious forebears exist only to scratch an ideological itch. This is culture-war red meat, a tiresome parade of hot-button social issue legislation of no practical benefit to our state but with plenty of potential downside.”

Hate group coordinates the legal assault

South Dakota Rep. Fred Deutsch, who sponsored HB 1057, is the same legislator who presented the 2016 “bathroom bill” that would have criminalized transgender people from using the public restroom that matches their gender identity. That bill, and others just like it across the country, was authored by the Alliance Defending Freedom, an anti-LGBTQ group categorized by the Southern Poverty Law Center as a hate group. Similar bills with nearly identical language to HB 1057 have been presented in state legislatures in Texas, Oklahoma, Colorado, Missouri, South Carolina, Georgia, and Florida.

Deutsch has also closely coordinated his efforts with satellite groups of the Family Research Council, a radically homophobic and misogynistic organization also identified by the SPLC as a hate group for the “false claims about the LGBT community based on discredited research and junk science” it peddles in an effort to roll back LGBTQ rights.

The Daily Beast also noted that in the months before the law was introduced that Deutsch attended the “Summit for Protecting Children from Sexualization,” hosted by right-wing think tank The Heritage Foundation, a summit that aimed “to establish legislation to criminalize doctors that provide sex change operations in children.”

Libby Skarin, the policy director for the American Civil Liberties Union of South Dakota, noted that Republican-dominated South Dakota often serves as a bellwether for conservative legislation proposed by groups like ADD and the Heritage Foundation. “Once you pass one of these bills somewhere, it gets a heck of a lot easier to pass them somewhere else,” she said.

A danger to trans youth

Denial of gender affirming care poses an extreme danger to transgender youth. According to a 2018 study published in the American Academy of Pediatrics, 50.8 percent of trans male teenagers, 29.9 percent of trans female teens, and 41.8 percent of nonbinary trans teens had attempted suicide. Another study published earlier this month in the same journal showed that suicidal ideation was far lower in trans teens who received gender affirming care, especially “pubertal suppression,” than those who did not.

Further, trans youth who face a lack of family acceptance often run away or are kicked out of their homes. A shocking 40 percent of unaccompanied homeless youth in the U.S. are LGBTQ – roughly 700,000 people. The National Coalition for the Homeless notes that “LGBT individuals experiencing homelessness are often at a heightened risk of violence, abuse, and exploitation compared with their heterosexual peers. Transgender people are particularly at physical risk due to a lack of acceptance and are often turned away from shelters; in some cases signs have been posted barring their entrance.”

These are the fates to which transphobic South Dakota legislators are willing to condemn children who dare to exist outside the boxes for them created by capitalist patriarchy. It makes a mockery of their claim to be protecting vulnerable children with bills like HB 1057. Moreover, conservative bigots have proven time and again that they do not care about children once they have been born.

“Youth with gender dysphoria often experience significant trauma at the onset of their endogenous pubertal process,” the Endocrine Society notes. “Not uncommonly, gender dysphoria first emerges with the onset of puberty. The development of secondary sexual characteristics can be the solidification of an undesired physical developmental process for those with a gender identity that is incongruent with their assigned sex at birth.”

“With the high frequency among transgender youth of mental health challenges including anxiety, depression, social isolation, self-harm, drug and alcohol misuse, many providers view early treatment as life-saving,” the group notes.

Proponents of the law claim they are protecting children from “dangerous drugs and treatments,” characterizing surgeries as destruction of healthy tissue – an echo of the rhetoric used by abortion opponents to control women’s bodily autonomy. Like abortion, the question of trans health care is also a fight for bodily autonomy.

Bigoted politician Deutsch makes the misleading claim that gender affirming care equals poisoning children with “mega-doses of the wrong hormones,” calls such treatment “chemical or surgical castration and sterilization” and asserts that children will be subjected to the removal of healthy breast and reproductive tissues.

This is highly misleading. As Texas-based psychologist Colt Keo-Meier put it, “There are absolutely no medical interventions or surgical interventions on any prepubertal child. That is not happening.” (PolitiFact) However, even surgeries on adolescents under the age of 18 are extremely rare. In all cases, the process of transition is driven by the children themselves, affirming their desire to change their appearance in line with their identity, which is different from that assigned to them at birth.

In fact, hormone blockers are fully reversible. “That is literally just hitting pause,” Keo-Meier told PolitiFact. A puberty blocker is simply a compound that can be injected or implanted, mimicking  the actions of a puberty-stimulating hormone in the brain called “gonadotropin-releasing hormone.” The compound makes the pituitary gland less sensitive to the hormone, basically placing puberty on “pause” as long as the blocker continues to be applied. Once the blocker is removed or stopped, puberty begins. If the person desires transition, then a different hormone is supplied to the body to induce a different puberty than that which their own body would produce.

Ironically, Deutsch has also characterized his proposed law as a “pause button.” But being forced to go through a puberty you don’t want to, watching your body change in oftentimes irreversible ways, is not a pause button, it’s just the opposite: it’s adults deciding for children what role they must play in society.

Regulating the boundaries of gender

Given that even the notorious bathroom bills mostly failed to pass, one might ask what is the purpose of even introducing these bills? Even without passing, the introduction of anti-trans legislation heightens the climate of transphobia and bigotry by giving a platform to unscientific nonsense based on uncritical allegiance to patriarchal gender norms.

The remaining provisions of HB 1057 only further prove this: while they block the ability of trans children to receive surgeries and hormonal care, the bill explicitly allows “corrective” surgeries on intersex children – those born without the supposedly correct sex organs – in order to bring them in line with the patriarchal definition of “normal” genitalia. This is the coercive assignment of gender by the state in action.

Medical experts, from former surgeons-general to the National Institutes of Health and the Intersex Society of North America, are in consensus that medically unnecessary “corrective” surgery on intersex children without their consent is destructive. Intersex children must be free to develop their own gender identity and not have one forced upon them. The United Nations’ special rapporteur on torture even criticized the practice as “violations of fundamental human rights.”

“Intersex children and adults should be the only ones who decide whether they wish to modify the appearance of their own bodies – in the case of children, when they are old or mature enough to make an informed decision for themselves,” the UN Office of the High Commissioner on Human Rights wrote in 2016. “They should have access to support as well as to medical services that respond to their specific health needs and that are based on non-discrimination, informed consent and respect for their fundamental rights.” We might add that the same is true of transgender children and adults.

Since Donald Trump was elected in November 2016, trans people have seen their hard-fought rights repeatedly rolled back. In many cases, the U.S. government has dropped the language of “gender” entirely, changing the word to “sex” and defining it in biological terms. The U.S. Departments of Justice, Education, and Health & Human Services have led this drive, effectively erasing the existence of trans people by insisting that only genitalia and chromosomes define a person.

Bills like HB 1057 only attempt to drive this wedge further into the working class by creating a false division between children and  trans people and our advocates. In this scenario, children are falsely cast as the victims of “trans ideology.” As socialists we must resist these attempts to divide our class and weaken our movement. Trans people are part of the working class and one of the many oppressed groups fighting back against capitalism and trans children are among the most vulnerable people in capitalist society.