A court reins in Javier Milei, benefiting trans people in Argentina

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Two years ago:

In progressive Argentina, the LGBTQ+ community says President Milei has turned back the clock, Débora Rey, AP, May 12, 2024

Three new U.S. federal rules toward ending trans healthcare for youth

In the Trump regime's quest to ban trans healthcare for people under 19, says Erin Reed today, it's been "threatening and subpoenaing providers for trans youths’ medical records, attempting to pull federal grants from hospitals and universities that offer gender-affirming care, and issuing vague guidance that’s driven even longtime allies into overcompliance. Now the administration is escalating with a blitz of three new rules that could effectively end most transgender youth care nationwide if enacted..."

Today, they finalized a federal rule (PSLF rule (full text)) to "bar nonprofits from qualifying for Public Service Loan Forgiveness" if any minor gets trans healthcare there. It will take effect July 1, 2026. "The change would punish entire institutions: doctors, nurses, and staff at any hospital, university, or nonprofit that provides gender-affirming care to minors would lose access to loan forgiveness, effectively coercing organizations to abandon care or risk their employees’ financial security."

Two more (see the first and second) are expected very soon. "One would prohibit federal Medicaid reimbursement for gender-affirming care provided to anyone under 19. The other would go even further, barring hospitals that treat transgender minors from receiving any Medicaid funds at all — a measure that would effectively eliminate access to such care nationwide, except at the few private clinics able to forgo Medicaid entirely, a rarity in transgender youth medicine."

Update on that: Trump Admin Cuts Medicaid Funding For Gender-Affirming Care For Youth, Li Zhou, HuffPost, August 11, 2026

"MassEquality strongly condemns the Trump administration’s latest attack on transgender people: a finalized federal rule that will prevent states from using federal Medicaid and CHIP dollars to pay for certain gender-affirming medical care for transgender youth. The rule’s reach also extends beyond minors as commonly understood: it applies to CHIP recipients under age 19, meaning that some young adults who have reached the age of majority could also lose federal coverage for gender-affirming care. That should concern all of us.. We must reject this dangerous slippery slope before politicians can turn a targeted attack on one population into a broader effort to deny transgender people the healthcare they need." MassEquality, August 12, 2026

In an email sent Aug 13, Massachusetts Trans Political Coalition described it as a "finalized Centers for Medicare & Medicaid Service rule that will prohibit Medicaid and CHIP from funding access to healthcare for transgender young people if it is allowed to go into effect on October 13, 2026."

It's about the federal shutdown too, Reed says:

"The new rules echo the negotiations over the FY26 appropriations bills tied to the ongoing shutdown fight, where House Republicans are similarly pushing to ban federal funding for gender-affirming care nationwide. As the shutdown drags on, transgender advocates and trans Americans are watching closely to see whether any of those provisions slip into law. Though the shutdown has primarily centered around a clean continuing resolution without those provisions, there has been some shift towards negotiation of the full appropriations bills, which could be a mechanism for anti-trans and anti-LGBTQ+ provisions to enter into federal law. If Trump gains access to even a fraction of the restrictions embedded in those House bills, it would further streamline his administration’s efforts to dismantle trans health care across the country."

It's not just for kids. Trans adults' healthcare is also threatened. Katelyn Burns said several days ago:

"...a federal judge in Mississippi overturned an Obama era rule mandating that health care providers and insurers can not deny trans people gender affirming care if that same care would be available to cisgender people for reasons other than transitioning their sex.

The court's ruling is incoherent, and essentially establishes trans people as a disfavored class of American citizen, with fewer rights than everyone else. If you're cis, you can walk into a doctor's office tomorrow and ask for a breast augmentation or reduction and they will do it, no questions asked. But if you are trans, no such luck.

If you are cis, and you want testosterone so you can feel horny again, that's fine as long as you're cis. Go pound rocks if you're trans. If you want estrogen for your perimenopause, go ahead. Fuck you if you're trans."

Please also read:

Informed Consent Doesn't Go Far Enough: The Case for Hormones Over-the-Counter. Jane Migliara Brigham, Assigned Media, Oct 23, 2025

TWIBS: University of Virginia Rolls Over, Shows Soft Underbelly to Trump, Aly Gibbs, Assigned Media, Oct 24, 2025

"DOJ tried to subpoena an online trans health care provider. A judge quashed it."
Seattle-based U.S. District Judge Jamal Whitehead says DOJ’s demand serves an “improper purpose” of executing Trump’s orders targeting gender-affirming care. Josh Gerstein, Politico, October 29, 2025

What To Know About Marjorie Taylor Greene's Felony National Trans Youth Care Ban, Which Will Receive A House Vote. Though the bill stands little chance of becoming law, it will be a major messaging vote for congresspeople on both sides of the aisle. Erin Reed, Dec 11, 2025

She's choosing to be remembered this way. The Advocate

"'Leader Steve Scalise has promised me that my bill Protect Children’s Innocence Act, H.R. 3492, will be brought to the floor for a vote next Wednesday, Dec 17th,' she wrote on X last week. 'This would make it a class c felony to trans a child under 18. Every Republican campaigned to protect kids from the trans agenda.'"
House poised to vote on MTG bill criminalizing trans health care: Civil rights groups warn the bill would be among the most extreme anti-trans efforts. Blaise Malley, Salon, Dec 16, 2025

Image: Toilette - Frau vor Spiegel (Woman in front of a mirror). Art by Ernst Ludwig Kirchner (1880-1938) © public domain. Wikimedia Commons.

New York attorney general Letitia James said: "“Whether you live in Brooklyn, Binghamton, Buffalo, or anywhere else in New York, and even if you don’t live in New York, I will not let this administration come for you, your doctors, or your lifesaving healthcare.”"
— “I will not let this administration come for you”: NY AG Letitia James Vows to Protect Trans Kids: “Your healthcare is still legal and protected, and your doctors cannot cut off your access to gender affirming care based on the administration's reckless proposal.” s. baum, Erin in the Morning, Dec 18, 2025

Trans Youth Emergency Project Offers Families Guidance To Help Keep Getting Care After New Trump Anti-Trans Rule: The organization tells EITM that they are prepared to scale up for further shutdown of care, and can offer most families places to continue getting care. Erin Reed, Dec 20, 2025

ACLU Pledges To Challenge Trump Admin In Court Over National Trans Youth Care Ban Rule The rule must undergo a 60 day comment period, whereupon the government must generally respond before it may be put into effect. Erin Reed, Dec 22, 2025

On the comment period:

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Federal Employees Sue Trump Administration Over Ban On Gender-Affirming Care The complaint argues that denying coverage of gender-affirming care is sex-based discrimination. AP, HuffPost, Jan 1, 2026

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BREAKING and HUGE news for transgender people: The bipartisan final negotiated text for these spending bills REMOVED language to restrict gender-affirming care as part of the Federal Employees Health Benefit Program. docs.house.gov/billsthiswee...

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— Eric Michael Garcia (@ericmgarcia.bsky.social) January 11, 2026 at 7:26 PM

Democrats Successfully Strip All Anti-Trans Riders From Final Appropriations Bills: The HHS and Education bills once contained the most sweeping anti-trans provisions in congressional history. Now they contain none. Erin Reed, Erin in the Morning, Jan 20, 2026

Hospitals Nationwide Caved to Trump on Trans Youth Care. Children's Minnesota Is One of the First to Bring It Back. “Offering science- and research-based health care to trans and gender diverse youth is part of Children’s Minnesota’s vision of being every family's essential partner in raising healthier children." s. baum, Erin in the Morning, Apr 08, 2026

Federal Judge Vacates Kennedy Declaration, Permanently Blocks Trump's Trans Youth Care Hospital Threats The judgment overturns the Kennedy Declaration which has been used to force 40 hospitals to drop trans youth care. Erin Reed, April 20, 2026

A federal judge has issued a blistering 49-page written opinion vacating the Kennedy Declaration, that threatened to revoke all federal funding, including Medicare and Medicaid, from any hospital that offered gender-affirming care for transgender youth, a virtual death sentence for any hospital.

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— Truthout (@truthout.org) April 21, 2026 at 1:40 PM

"A multi-state lawsuit challenging the Trump administration’s effort to restrict gender-affirming care for trans youth can move forward after a federal judge shot down a legal challenge from the Justice Department on Wednesday.
Last August, 16 states and the District of Columbia sued the Justice Department over an order to investigate providers of gender-affirming care for youth and halt federal support to them. Earlier this year, the Justice Department fought back in court, arguing that the states did not have the legal authority to sue over internal department policies."
Federal judge rules that states can challenge Trump’s campaign against transgender kids: The ruling allows 16 states and D.C., to continue fighting federal efforts to investigate providers and restrict access to gender-affirming care. Jack Walker, The Advocate, Jun 05, 2026

Hey, how are trans kids feeling these days?

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In August 2026, people are suing.

Trump Issues “Finalized” Anti-Trans Medicaid Rule, But Human Rights Groups Say There’s Still Time: “Despite this being called a ‘final rule,’ we have time to fight back. Nothing will change overnight.” s. baum, Erin in the Reed, Aug 13, 2026

Fenway Healthcare in Boston will only provide trans healthcare to age 19+

"We didn’t think this would happen here. For years, Massachusetts has been the place families point to when they say, “at least we’re safe here.” But on October 13th, Fenway Health, one of the most trusted names in LGBTQ+ care, announced it could no longer provide medical gender-affirming care for anyone under nineteen." — Rebecca Minor, We Thought We Were Safe Here: What Fenway’s Decision Reveals About Bureaucratic Fear, Oct 14

Fenway Health Restricts Treatment for Patients Under 19 In Capitulation To Trump: “This is a fundamental betrayal to the core mission of Fenway and the patients they serve.” s. baum, Erin in the Morning, Oct 14, 2025

MassEquality responds (PDF). Oct 15, 2025.

Contact the Trans Youth Emergency Project if you need help. You can also try GLAD Law. If you're a parent in a court case or going to mediation with the other parent, please write a parenting plan and try to anticipate situations like this that may affect your child.

What the heck was this email I received, then, post-Skrmetti?

"By cutting off the very trans youth who helped build its reputation today, Fenway is abandoning their mission. If the line isn’t drawn here, when it’s our lives on the chopping block, who will be left to draw it when it’s theirs?" — A Line Must Be Drawn: The Cowardice Of Historic LGBTQ+ Provider Fenway Health: Fenway Health must return to its roots and care for those the government casts aside. Erin Reed, Oct 22, 2025

Protect Trans Futures and ACT UP Disrupt Charity Gala at Fenway Health: The LGBTQ+ community health center recently announced they would no longer offer gender-affirming care to trans young people under the age of 19. Evan Urquhart, Assigned Media, Nov 14, 2025

Massachusetts AG struggles to explain why she won’t sue hospitals abandoning trans kids in heated exchange: A contentious live radio taping put Andrea Campbell face-to-face with a young transgender activist demanding accountability for disappearing care. Jacob Ogles, The Advocate, Aug 13, 2026

One year after Nex Benedict's death

Nex Benedict died February 8, 2024.

"Sarah Adams and Kendra Wilson Clements, the Choctaw, Two Spirit cofounders of Cousins, which provides support to queer and trans Indigenous youth in Oklahoma, watched the cratering of attention as winter turned to spring, then summer. “Over this past year, there [was] this big reaction, and then it fizzled,” Adams tells Teen Vogue. “I was talking to my [Two Spirit, nonbinary] kid yesterday about what has happened over the past year, and what that feels like, what it looks like, and they said something like, 'It's weird that the world kept turning. It's weird that things just kept going after that.' People just tend to forget.”

* * *

As reported by Marisa Kabas of the Handbasket, the National Center for Missing & Exploited Children was instructed by the Trump Department of Justice that they would lose their funding if they did not remove LGBTQIA+-affirming language from their materials, and also required them to deadname trans youth in their reporting.

The State Department has removed everything but “LGB” from its LGBTQIA+ acronyms on its resource pages. In late January, as the Trump White House rebuilt the site wholesale, mentions of Benedict were scrubbed from the White House website, as well as mentions of Matthew Shepard, who was murdered in 1998 at age 21 in a homophobic attack."

— Lex McMenamin, Nex Benedict Has Been Gone a Year. What Have We Learned?: Nex Benedict’s death was confirmation that anti-trans policies and rhetoric have a body count. Is anyone listening? Teen Vogue, February 11, 2025

More

Read: Oklahoma Trans Child Beaten to Death at School for Being Trans, James Finn, Prism & Pen, February 22, 2024

Read: Who Was Nex Benedict, the Trans Teen Taken Too Soon?: The reader, gamer, and cat parent to Zeus. Eleni Stephanides, Prism & Pen, February 28, 2024

Anti-gender-affirming-care article in The Federalist (Dec 2024)

Here's a treat from The Federalist a couple days ago.

If you'd like to find it, after https://thefederalist.com/ ...

...type: /2024/12/13/landmark-transgender-scotus-case-could-redefine-medicine/

(I'm trying not to give them SEO value on this one.)

It's written by Dr. Aida Cerundolo, who has practiced clinical emergency medicine for two decades. (Not a specialist in gender-affirming care, it seems.) She's arguing that doctors harm trans kids by affirming their gender.

She says: "Aspirin can be dangerous when taken inappropriately or by those with an allergy, but the risks and benefits have been studied since the 1800s." Since gender-affirming care has not been studied since the 1800s, I guess it fails to meet that standard, if "studied since the 1800s" is the standard. But hormones were synthesized in the early 20th century, so there is a century-long history of humans taking hormones. And there are plenty of medications and surgeries that are more recent than gender-affirming care.

"Conversely, so-called “gender-affirming” treatments have no long-term studies that establish a clear risk-benefit ratio." She doesn't cite a source for that. But then, a study can't be done until the "risk" and "benefit" are defined.

She then gives an example. As the risk of trans people attempting suicide is "a claim used to promote these treatments" (i.e., to allow trans people to live in their gender), she uses that as an example, and says simply: "the evidence so far from multiple systematic reviews does not demonstrate a reduction in suicide." For that, she links to the Washington Examiner (a right-wing news outlet) and the Cass Review (a politicized document in the UK).

Anyway, she says, whereas medications like aspirin are meant to make you healthier, "gender-affirming treatments seek to disrupt a healthy physiology." So it seems she doesn't think there can be any benefit.

Next: "Since it is impossible to diagnose which children will persist with a transgender identity into adulthood," there is an "unmitigable risk of misdiagnosis. Hippocratic oath medicine doesn’t allow this harm to be whitewashed under the premise that it is, as the ACLU attorney indicated, a 'very low' 'one percent.'"

Just consider, she says, "wrong-site surgeries (when a wrong limb or organ is removed)." An organization is investigating it because "that’s a harm rate of 0.00000788 percent — too high for doctors seeking to 'first, do no harm.'"

Of course this is illogical.

1. There is a commission investigating why some surgeries go wrong, not stopping all surgeries because the risk of error is too high.
2. In the case of wrong-site surgeries, the error belongs entirely to the nurse or surgeon (not the person getting surgery), so the commission can investigate what happened (e.g., the nurse wrote wrong information on the notepad, or the surgeon was drunk). Asking why some people change their minds about what they want their body to look like is another question.
3. Not everyone who detransitions has been "harmed" by taking hormones or getting surgery. Some are happy to have had that experience and simply decide they don't wish to continue with hormones or they adjust how they present themselves in the world, not minding that they've had hormones or surgery.
4. There isn't an acceptable risk percentage that applies equally to every kind of healthcare. Knee surgery has a high regret rate, yet surgeons continue to do it, because for whatever reason, that risk is considered acceptable.
5. If indeed 1% of kids regret transition but 99% are living full lives because of it, and if that's an unacceptable risk-benefit ratio, what she's saying is that one cis person matters more than 100 trans people.
6. As she acknowledges, "the stated 'one percent' risk of regret is unverifiable. The rate of detransition is unknown because there is no system in place to measure it." So if there's no evidence that many people are unhappy that their doctors allowed them to access hormones and surgery, whence the concern?

See the whole thread about the supposed 'controversy' over trans healthcare

It's actually profoundly similar to the way that eugenicist anti vaccine organisations worked to disrupt messaging around COVID (and previously MMR)

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— Mallory Moore (@sexabolition.blog) March 9, 2026 at 4:35 AM

Strangio: 'You are never just a lawyer. You are the trans lawyer'

Imara Jones, host of the TransLash podcast, summarizes that the Supreme Court in U.S. v. Skrmetti could "decide the overall constitutionality of gender-affirming care for all trans people in the United States," not just youth.

In that interview, Chase Strangio says that while there are "incredible advocates who are regularly appearing" as experts before the Supreme Court, there are fewer people who've been "in the trenches fighting for their communities" and who thus "know, in their bones, the consequences" of what the court is preparing to decide.

Jones: "I mean, you know, that's been a problem with, sort of, American life since the 1970s is the growing you know, one might argue over-professionalization of everything, which means that everything gets separated more and more from the people, which is why things seem to be esoteric and disconnected."

(This feels important to me because it's related to arguments about elitism and meritocracy. When Trump voters say that Democratic voters are elitist, maybe what they're experiencing is that many aspects of society (not specifically conservative or liberal, or otherwise partisan) are elitist. A thought I shall table for now.)

Jones asks Strangio: "After you stand up after the Solicitor General [at the forthcoming hearing on December 4, 2024], look those nine justices in the eyes, and let the words, 'May it please the Court' leave your mouth, what do you think is going to be the personal feeling that you have of both having to stand there at the highest level of your professionalism and at the same time be debating the essence of your humanity, facing off on the other side against people who refuse to to see that?"

 

Chase Strangio points out that he frequently testifies in state legislatures and committee hearings where he hears "the most vile misrepresentations and cruel things about about trans people," so he's not new to this.

"I cross-examine and depose experts who fundamentally don't believe trans people should exist, the same experts who are being used by the state of Tennessee in this case, and I have argued before courts that I know will have ruled against me, will rule against me in this fight that is so central to everything about me as a human being. So that is something that I am used to. I think obviously in this context where, when you enter the Supreme Court, it, in and of itself, just has that feeling of you were, many people were never meant to be in that space. It is a space that has been occupied by the very sort of, you know, most limited constructions of the elite, and over time, that has a lot more and more people have been able to enter the doors, but only in a very limited way. And so whenever you are in that space, and whenever you are representing a community of people that was never meant to be there, I think it is both powerful and destabilizing. A little bit it's sort of holding that those sets of truths and trying to be as best of an advocate for your community as you can be knowing that so much is being projected onto you, so much misinformation, misunderstanding and dehumanization in that moment, you never have the sort of privilege of just being a lawyer. And that is something that I think many lawyers from you know, sort of historically excluded and currently discriminated against communities feel. It's like: You are never just a lawyer. You are the trans lawyer, or you are the Black trans lawyer, or you are the disabled lawyer. People's experience of that obviously affects the theater of the courtroom very significantly, and I think to suggest otherwise would be to do a just huge disservice to the nature of law and how law is made through its very performative elements, so I'm thinking about those things. And then, you know, obviously, like, it's, it's not lost on me that we're having a conversation about health care, that the health care is the very reason I will be standing there in that, in that moment, like there is no version of me that gets to the Supreme Court that has the life that I have if I didn't have access to this health care that now the governments are seeking to take away."

This is from the November 14, 2024 episode of TransLash.

Please also see "Trans aura farming" and "Recording trans history", both by Rachel Saunders. For context, see CNN's definition of the term aura farming.

"Nazi art abounds in a Benjaminian aesthetic category called aura: the apparition of a distance, a certain cultic presence, religiosity. Fascist aesthetics is, at its core, all about mystification." Fascism as the Aestheticization of Politics: On Walter Benjamin and the Dionysian seduction of the masses, Eric Huang, deterritorialization, April 8, 2026

Anna Ádám writes: Certain words have served as "tools. Ways to survive. Ways to organize. Ways to name what dominant culture refused to see. Ways to imagine relations outside violent norms." There are "conditions that made the words necessary." There are power dynamics. There are stakes. Unfortunately, a centrist institution may begin using someone else's vocabulary "once it becomes culturally valuable. It takes the aura of experimentation without living experimentation." It turns a word like "radical" into a mere aesthetic. In the case of the word "radical," the institution "adopts the rhetoric of resistance without risking its own structure." Know: "if you borrow the language of the underground while maintaining the logic of the center, you are not progressive. You are simply fashionable." So, be responsible: "Credit the origins of the words you appropriate. Support the communities that produced them. And if you use the word radical, be ready to change something at the root."

Relatedly, see my info: Will SCOTUS Let Parents and Doctors Support Trans Kids? (5 min read) on Medium

See the documentary Heightened Scrutiny that followed Strangio as he prepared to argue Skrmetti.

U.S. v. Skrmetti is so important to trans kids

ACLU lawyer Chase Strangio, interviewed by Imara Jones, tells us that Tennessee

"very much wants to cast this case [U.S. v. Skrmetti] as a case about the federal government displacing the state government. But what this case really is about is…the government of Tennessee that has come in and said that: 'You parents who have loved your children since birth, who have cared for them, who have recognized in them deeply painful experiences of distress for years and found medication that your child and you and your doctors all agree is necessary - We know better. We are taking this option off the table.'"

A trans boy in the case

"started asserting himself and recognizing himself as a boy when he was two years old. He is only known as a boy in all aspects of his life, and he has been relying on this medication for years, and after, you know, six years of mental health treatment, after multiple specialists, after parents who themselves struggled and researched, and then you have the government of Tennessee acting like these are rash choices being made by individual eight-year-olds."

And

"they're standing in for thousands of families and young people across the country who are being displaced by these types of laws, who are being forced to flee their homes because of these types of laws, who...have had to split up with one parent taking a child out of state and another parent staying behind with other children...this is not just three people in Tennessee...I believe in my heart that every single one of the justices on some level can relate to the idea of just wanting to take care of someone that you love. And often those decisions are painful and personal and complex, and the idea that the government is going to impose insurmountable barriers to being able to make and execute those decisions is, I think, upsetting to many people, and hopefully the stories of these families, in addition to the legal arguments, will resonate with at least five members of the court."

This is from the November 14, 2024 episode of TransLash.

I summarized other parts of the episode on Medium.

But look, in January 2025, we're already here

Just because of Trump's executive order. Not waiting for Skrmetti.

NYU-Langone is cancelling appointments for gender-affirming care for young trans people, parents say. The cancellations come after Trump's order directing institutions that receive federal funding to end gender-affirming care for patients under 19. hellgatenyc.com/nyu-langone-...

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— Hell Gate *subscribe today!* (@hellgatenyc.com) January 31, 2025 at 10:52 PM

Contrary to Trump’s grotesque, self-congratulatory press releases, he has not ended gender-affirming care for young people; rather, as the health care workers I spoke to this week made clear, hospital management, boards, and their legal advisers have ended it for him. My new story:

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— Melissa Gira Grant (@melissagiragrant.com) August 8, 2025 at 6:54 AM

NYU Langone cuts off trans youth from treatment in the latest of a series of decisions by hospitals to abandon patients in need under pressure from Trump and the anti-trans right. Only on Assigned: Lana Leonard spoke with families whose childrens' treatments were cut off.

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— Assigned Media (@assignedmedia.org) February 18, 2026 at 1:59 PM

Seen on Bluesky: 'the trans protagonist *literally* defeats the villain with her transness'

here's another clip from the trans cartoon episode Disney pulled a few days ago, where the trans protagonist *literally* defeats the villain with her transness (with Unlock It by Charli in the background!!) this would have changed my life when i was a kid (content warning: some flashing lights)

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— sara (@sara.lgbtq.social) November 17, 2024 at 8:57 AM

its so gutting to see representation this good finally being made, only to be axed by bigots the whole damn episode is beautiful. her transness being "against the rules" of the system leads them to realize that the only way to win is by <breaking the system> its awesome. you should download it:

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— sara (@sara.lgbtq.social) November 17, 2024 at 9:00 AM

U.S. Supreme Court to hear the TN gender-affirming healthcare case

Just published

The U.S. Supreme Court Will Decide About Trans Kids’ Bodies
This fall, it’ll hear arguments over the Tennessee ban on gender-affirming care

Oct 2024: Still happening

HuffPost says:

"The highest-profile case on the agenda so far is a fight over transgender rights that is focused on state bans on gender-affirming care. It probably will be argued in December.

Republican-led states have enacted a variety of restrictions on health care for transgender people, school sports participation, bathroom usage and drag shows. The administration and Democratic-led states have extended protections for transgender people. The Supreme Court has separately prohibited the administration from enforcing a new federal regulation that seeks to protect transgender students.

The case before the high court involves a law in Tennessee that restrict puberty blockers and hormone therapy for transgender minors. About half the states have enacted similar restrictions."

— Mark Sherman, Supreme Court Opens Its New Term With Election Disputes In The Air — But Not Yet On The Docket Transgender rights, the regulation of “ghost guns” and the death penalty highlight the Supreme Court’s election-season term that begins Monday. AP, Oct 5, 2024

See also

Supreme Court to weigh state restrictions on gender-affirming care for youths The court is expected to hear oral arguments and make a ruling in its upcoming term, which starts in October and will end in June 2025. Lawrence Hurley, NBC News, June 24, 2024

I'm the parent of a trans daughter. There's nothing conservative about blocking her care. Politicians should stop trying to impose personal beliefs as statewide mandates that harm children and interfere with the private, individualized medical decisions of families. Sean P. Madden, USA Today, June 24, 2024

US Supreme Court to hear challenge to ban on transgender care for minors, Andrew Chung, Reuters, June 24, 2024

The Supreme Court Is Taking Aim at Transgender Rights: The justices have picked a case that can cause maximum harm with minimum blowback. Matt Ford, The New Republic, June 25, 2024

Legal scholars worry Supreme Court may prioritize “politics” over “real stakes” in trans rights case: SCOTUS announced it was taking up a case on transgender rights on the second anniversary of the Dobbs decision. Tatyana Tandanpolie. Salon. June 25, 2024

"Tennessee Gov. Bill Lee (R) signed a bill into law Thursday that vastly expands the state’s power to gather information about transgender patients and their healthcare providers.

Clinics that receive state funding will now be required to provide aggregated data about transgender patients and their doctors to the state, and the information will be made publicly available.

Health care providers will be tasked with detailing the age and sex of patients receiving any type of gender-affirming care, as well as the type of procedure, names of drugs, dosages, frequencies, methods by which drugs are administered, and any diagnoses of mental health or neurological conditions. Clinics will also have to disclose the name, contact information and medical speciality of any health care provider who offers gender-affirming care.

Any state-funded clinic that offers gender-affirming care will also have to provide similar information about patients who detransition, meaning they once sought gender transition and now want to stop or reverse some aspects of it."

— Levi Kalish, Doctors In Tennessee Now Have To Give The Government Detailed Information About Their Trans Patients: LGBTQ+ advocates say the law threatens the privacy of doctors and trans patients seeking gender-affirming care. HuffPost, May 7, 2026

If not for transphobia, 'what kind of conversations could we be having'?

Three years ago, Charlie Jane Anders wrote this:

"Republican state legislatures seem to be locked in a competition to see which can be the cruelest to trans youths."

(Of course, it's gotten worse since then.)

When a kid comes out as trans, they've already done a lot of self-examination.

"Often, it may appear that trans kids and adults emerge fully formed, like Athena from the brow of Zeus, when in reality we’ve spent endless hours trying to make sense of our selves. The moment we reveal the end result of our self-discovery to the world, we face microaggressions, outright hostility and discrimination."

Of course, there's always more to do. Kids "need time to explore their identities and personalities," so why such "extraordinary scrutiny and intervention from the government"? "It’s beyond heartless to expect young trans and gender-nonconforming people to navigate this challenge while also being the objects of a national outbreak of paranoia."

"Take the North Carolina bill, which would require teachers and other authority figures to spy on young people and report any signs of “gender nonconformity” to their parents or guardians. Even if no teacher ever contacted anyone’s parents, everyone would still be aware that their clothes, hair and habits could be singled out at any time.

“Everybody is under surveillance when we have these restrictive ideas about gender,” says Raquel Willis, a trans activist and writer who founded Black Trans Circles. Even cisgender children and adults would be “boxed out of a human experience, because they are told they have to act a certain way.”

Anders says she wonders: "What kind of conversations could we be having about growing up trans and gender-nonconforming if we didn’t have to argue constantly against a manufactured panic and a wave of authoritarianism?"

"Opinion: We should celebrate trans kids, not crack down on them, Charlie Jane Anders, Washington Post, April 12, 2021.

Cass Review: April 10, 2024

After four years, Hilary Cass produced a review of gender-affirming care for kids in the UK.

Notice things like this:

The Cass Report presents a certain timeline. Really it seems they just don't want to talk to any trans adults, which is why they focus on kids over the past decade.

The Times (UK) Archive.org

Start with these:

The Cass Review: Nothing But Anti-Trans Propaganda: When you thought it couldn't get worse, it did. Z. P.Hopkins, Gender Identity Today, 17 Apr 2024

The UK’s Cass Review Is Already Harming Transgender Young People: Despite finding no evidence of harm, the Cass Review has already led to restrictions on gender-affirming care, while further fuelling transphobic moral panic, Kaylin Hamilton, Prism & Pen, 22 Apr 2024

Erin Reed (Cass Met With DeSantis Pick Over Trans Ban: Her Review Now Targets England Trans Care, April 10, 2024) summarizes:

"Dr. Hilary Cass released a final report commissioned by the NHS, widely expected to target gender-affirming care. The report met these expectations, calling for restrictions on gender-affirming care and social transition, and even advocated for blocking transgender adults under the age of 25 from entering adult care. To justify these recommendations, the review dismissed over 100 studies on the efficacy of transgender care as not suitably high quality, applying standards that are unattainable and not required of most other pediatric medicine. Conducted in a manner similar to the anti-trans review by the DeSantis-handpicked Board of Medicine in Florida, which Cass reportedly collaborated on, the report and its reviews are likely to underpin further crackdowns on trans care globally.

The 388-page report featured 32 recommendations on how transgender care should be conducted within NHS England. It incorrectly claims that there is “no good evidence” supporting transgender care and calls for restrictions on trans care for individuals under the age of 18, although it does not advocate for an outright ban. ...it seemingly endorses restrictions on transgender people under the age of 25, stating that they should not be allowed to progress into adult care clinics."

The Cass Review, as Reed explains, used the subjective Newcastle-Ottawa Scale to declare that 101 out of 103 studies on gender-affirming care were low-quality, despite "connections between reviewers, Cass, and anti-trans organizations." In this, it resembles the Florida Review.

The Cass Review Buried Trans Youth Perspectives, Evan Urquhart, Assigned Media, May 15, 2024

Like sorry they found 10 detransitioners among the 3000 patients they looked at? Even if the records are spotty it's insane to try and claim the 30-80%(!) rates of desistance that people like to throw around.

— Turbo Duo Lipa (@cambrianera.radical.town) May 15, 2024 at 11:58 AM

Jesse Singal says that "objective" data is needed on whether trans people are OK, mentally and physically.

Also this

Fascinating and necessary analysis of the Cass Report from @gidmk.bsky.social, an epidemiologist who specializes in debunking shoddy science claims. This man is doing the lord's work. open.substack.com/pub/gidmk/p/...

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— Lydia Polgreen (@polgreen.bsky.social) May 10, 2024 at 5:27 PM

Here's the link that's inside the Bluesky post:
The Cass Review Into Gender Identity Services for Children - Part 4. Regret, persistence, detransition, and further mistakes in the Cass review. Gideon M-K: Health Nerd (Substack), May 10, 2024.

Trying to imagine if this were the standard for any other medical care.

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— Matt Goldberg (@mattgoldberg.bsky.social) May 8, 2024 at 4:18 PM

Here's the link that's inside the Bluesky post:
WBUR

Polgreen adds:

The first big boom of transgender medicine of the 1950s-70s ended when a researcher "discovered" that transition might make trans people happier but wasn't making trans people more likely to be "objectively" better members of society: straight, married, employed, etc.

— Lydia Polgreen (@polgreen.bsky.social) May 8, 2024 at 3:33 PM

Cass' version of this might seem kinder and gentler, but remember! People who are not trans are allowed to be unemployed, unhappy, have bad sex, etc, without being pathologized. That's just... life. A trans person should be entitled to the same ordinary unhappiness as anyone else.

— Lydia Polgreen (@polgreen.bsky.social) May 8, 2024 at 3:37 PM

Ask yourself: should a woman only be entitled to an abortion if it makes her more likely to have a job? Or get married? Or have children later? No, of course not. A woman is entitled to have an abortion because her body is her own and she can do what she wants with it.

— Lydia Polgreen (@polgreen.bsky.social) May 8, 2024 at 3:40 PM

"Although “sex-change” surgery was “subjectively satisfying” for the small sample surveyed, the operations they underwent conferred “no objective advantage in terms of social rehabilitation.”" A pretty good summary of this horrifying history: wapo.st/3UAZ5rj

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— Lydia Polgreen (@polgreen.bsky.social) May 8, 2024 at 4:06 PM

Here's the link that's inside the Bluesky post:
Washington Post (subscriber gift link)

"In an interview with NPR, Dr. Cass claimed that transgender individuals' care should be judged by their "employment," rather than their satisfaction with the care received. Later, during an interview with The New York Times, Cass misleadingly stated that she had not been contacted by any lawmakers or U.S. health bodies, despite having met with political appointees of Gov. Ron DeSantis to discuss banning trans care before her report was published."
"Endocrine Society And American Academy Of Pediatrics Respond To Cass, Reject Bans: In recent weeks, the Cass Review out of the United Kingdom has been used to argue for bans on care. The Endocrine Society and American Academy of Pediatrics respond, rejecting such arguments. Erin Reed, May 13, 2024

The Endocrine Society released a statement and pointed out that "they cite over 260 research studies to support their recommendations on transgender care," as Reed summarized.

Reed also pointed out:

"Interestingly, Cass herself advocated against care bans in her most recent New York Times interview released today, where she stated, “There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access,” although she added a caveat that those young people should be forced to consent to research in order to access care, leaving many to question the ethics of such an approach."

How this rhetoric works

"Its like there’s this system of coordinated transphobia where extremists like DeSantis give cover to Britain, who in turn give a formal basis to the ‘critiques’ of the NY Times. And the NY Times, in turn, give Britain the press attention they wanted."
— England’s Trying to Ban ADULT Trans Care After the Cass Report: It was never gonna stop at trans kids, ElizaBeth, Apr 14, 2024

Update: June 2024

Since the Cass Review came out, Cass has (according to Erin Reed) "blamed being trans on pornography and labeled the American Academy of Pediatrics as a "left-leaning organization" due to its support for the medical care of transgender youth."

"Last month, a handful of members of the RANZCP, some of which are notable figures in anti-trans activism in the country, wrote a letter to the organization stating that they had “serious concerns” about gender affirming care for transgender youth. They pointed to the Cass Review as justification for their concerns. The top signature on the letter is that of Jillian Spencer, who stated in an interview that she was fired for “being a danger to trans and gender-diverse children.” Now, the college has responded.

In a response posted to the RANZCP website, the college announced that the Cass Review is one of "a number of reviews,” and that it rejects the call for a “government inquiry” into trans care in the countries it represents. It further states that transgender care should be “patient centered” and individualized to a patient’s needs. Lastly, it expresses a full support for transgender youth and rejects claims that being transgender is a “mental health condition”..."

Another International Medical Org Rejects Cass Recommendations On Trans Youth Many of the largest medical and psychological organizations have rejected the Cass Review's recommendations on trans youth. The Royal Australian and New Zealand College of Psychiatrists is the latest. Erin Reed, June 14, 2024

Reed continues: "Conservative Women and Equalities Minister, Kemi Badenoch, admitted that 'gender critical' individuals were placed in health roles to facilitate the Cass Review — a mechanism remarkably similar to how Florida’s review led to the banning of care in the state, borrowing from DeSantis’ strategy."

Update: July 2024

Hilary Cass Repeats Transphobic Talking Points, Again, Alyssa Steinsiek, Assigned Media, July 3, 2024

Yet people are still saying no one is listening to J.K. Rowling?

The UK just banned puberty blockers, what would more engagement with her ‘concerns’ even look like

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— Michael Hobbes (@michaelhobbes.bsky.social) Jun 24, 2024 at 5:56 AM

Did the New York Times Call the Cass Report Fake? Its surprisingly good, ElizaBeth, Medium, August 20, 2024

Revealed: Over 200 Transgender patients have been refused hormone care by GPs, QueerAF, Medium, October 19, 2024

Previously, in 2023

Last year: The Myth Of "Low Quality Evidence" Around Transgender Care, Erin Reed, August 8, 2023

Here, Reed pointed out that "Gender-affirming care isn't unique in this regard. Some studies suggest that over 90% of medical care lacks "high-quality evidence" as classified by the GRADE system." That medical care might involve "individualized approaches," be justified by "observational evidence," or be ethical given that "withholding treatment would be considered unethical." Again, lots of medicine is like this — not just care for trans people. "No one labels gallbladder surgery as 'experimental," Reed says, even though there's no high-quality evidence for it if you ask GRADE.

Reed continued:

"Mischaracterizing the evidence around gender affirming care as 'low-quality' is a deceptive practice that relies on a layman understanding of the term. There is no level of evidence that will ever be acceptable to those seeking to ban gender affirming care, as controlled trials where trans youth are put through conversion therapy or denied medication are not ever going to ethically happen - especially given suicide risks among this patient population."

Kaylin Hamilton wrote that "literature reviews commissioned by the ongoing Cass Review into gender-affirming care for transgender youth, and similar reviews which were used as justification for the ban on gender-affirming care in Florida, all attempt to discredit the evidence base for gender-affirming care (at least partly) on the basis of these two issues," namely, "a lack of consideration for social factors and a comorbid approach to the relationship between gender dysphoria and mental illness."
— Gender Affirming Care isn’t a Panacea: We need to change the way we talk about — and research — the relationship between gender dysphoria and mental illness, Kaylin Hamilton, Substack, May 8, 2023

"If you’re in the UK, trans and your GP has refused you adequate care around your hormones get in touch with Dr Tlaleng at the UN who is collecting evidence for show down with the government in December.
Under Special procedures
spsubmission.ohchr.org"
Mrs Schwarzski, Bluesky, October 11, 2024

Not even an inch of let up on transphobia from Labour. Add meeting and sympathising with a group of wildly transphobic nurses, insisting on implementing Cass in full, and progressing with a review on adult healthcare apparently predicated on Cass’s expressed concerns.

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— Ethel Weapon (@lousadzak.bsky.social) November 20, 2024 at 7:17 PM

Anti-trans lobbyists pressing false dichotomy between “rights” and “evidence” following Cass Review, by Mallory Moore, Trans Safety Network, 14 Nov 2024

New French guidelines show doctors overwhelmingly support gender-affirming care: The medical guidelines contradict numerous conclusions from the UK's infamous Cass Review. Mira Lazine. LGBTQ Nation. December 27, 2024

Last week I updated my mega-post "What's wrong with the Cass Review?" with new links to analysis and evidence. I have no illusions about the current political landscape. It will likely take years to undo Cass' act of sabotage. But I am in this fight for the long haul and hope you are too.

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— Ruth Pearce (@notrightruth.bsky.social) January 29, 2025 at 3:25 AM

Hey, look at this: Not even 10% of the kids in the gender dysphoria dataset had been prescribed puberty blockers or hormones.

"Another key pillar of the Cass review was that the gender services in the UK had gone crazy with medications, and were giving them in a problematic fashion. The review describes the gender service’s actions as a “departure from normal clinical practice”.

However, the York data flatly contradicts this argument. Of the 3,782 children with a diagnosis of gender dysphoria in this dataset, 176 were ever prescribed puberty blockers and 302 ever got hormones. Given the rules about prescribing hormones at the time, that means that <10% of kids in this massive dataset with gender dysphoria ever had a recorded prescription. The authors acknowledge that this could be an underestimate, because the dataset is based on primary care and may not always capture specialist prescriptions, but it’s still a remarkably low number.

It also tracks with the other data that the Cass review identified. We know from the review that 27% of children attending the gender clinics were ever referred for endocrine services. But not all children diagnosed with dysphoria made it to the gender clinics, and not all kids referred to endocrine got medications. So it seems reasonable to say that <10% of kids with gender dysphoria in the UK were likely prescribed puberty blockers or hormones from 2011-2021."

— Health Nerd, "Gender Dysphoria, Children, And Moral Panics: What new data from the UK shows about trans children," Gideon M-K: Health Nerd, Jan 30, 2025

The Cass Review claimed it didn’t support conversion therapy — oops, now it does. Not Ashley, Medium, February 5, 2025.

"It is still unclear whether the Cass Review or NHS England destroyed public records, whether the Cass Review continued to exist until April or December 2024, or if the records will be transferred to NHS England if they haven’t already been.

In 60 days, it will have been a full year since the final report (April version) was published. None of the requests for the Cass Review’s internal materials have been fulfilled.

We will soon find out whether the Cass Review is above the law."

— Did the Cass Review shred the truth? How public records are kept out of reach. Not Ashley, Medium, February 16, 2025

Our methodological critique of The Cass Review has been peer-reviewed published & is therefore way more authoritative than Cass which is un-peer-reviewed. Streeting/Starmer can no longer claim Cass is “gold standard” or “landmark”. Cass is just junk science. link.springer.com/article/10.1...

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— Natacha (@natacha.bsky.social) May 10, 2025 at 11:43 AM

Results:

NHS threatens GP practice over trans care: A GP practice in Brighton and Hove is currently under investigation for legally providing gender affirming care to trans teens, Sophie Molly, Northwest Bylines, 3 Nov 2025

So, research funding for “research” about trans people BY CIS PEOPLE is likely between £13-£15 million. Trans researchers were excluded from ALL of these. Research funding for trans academics is WAY below this, if available at all. This is an equal opportunities issue as well as an ethical one.

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— Natacha (@natacha.bsky.social) March 15, 2026 at 4:45 AM

Oh, look what's happening in the NHS now

In a disturbing development in the British War On Trans, the databases used by the NHS (the British socialised medicine system) mean that GPs now cannot diagnose patients with gender dysphoria or similar codes because the codes have been removed and replaced with an euphemism #BWOT
by u/pkunfcj in transgender

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