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Evan Urquhart 🏳️‍⚧️Jul 14, 2023

I find myself wanting to contextualize the impact of gender-affirming care bans in a thread. I'm not writing a proper post on a Friday afternoon, Bluesky has reached a crisis point over moderation, Twitter feels death-throes-y to me, so I'm just going to post it here.

For reference, a judge in Kentucky just reluctantly reversed himself, allowing Kentucky's ban on gender affirming care to go into effect after the 6th circuit recently allowed a Tennessee law to.

https://substack.com/@chrisgeidner/note/c-19713769

Chris Geidner on Substack

BREAKING: Kentucky ban on gender-affirming care for minors can be enforced during appeal, judge rules. In fallout from last weekend’s ruling from the U.S. Court of Appeals from the Sixth Circuit, the district court judge who earlier granted an injunction against Kentucky’s bans on gender-affirming care to minors on Friday issued a stay of his ruling pending appeal. Friday’s order means that Kentucky’s ban on gender-affirming medical care for minors is enforceable now. The 2-1 decision from the Sixth Circuit on July 8 granting Tennessee’s request for a stay pending appeal in the challenge to that state’s ban is precedent for all district court judges within the circuit — which includes Kentucky, Ohio, and Michigan, in addition to Tennessee. U.S. District Judge David Hale concluded that Tennessee and Kentucky’s bans are too similar for him to deny Kentucky Attorney General Daniel Cameron’s request to stay the injunction pending appeal, given the 2-1 decision from the Sixth Circuit granting Tennessee’s similar request for a stay pending appeal. The challengers to Kentucky’s ban argued that the Kentucky law and circumstances were different enough that Hale didn’t need to follow the Sixth Circuit’s Tennessee-law decision. Hale — while still maintaining that his injunction ruling is correct — ultimately decided that he had no basis to deny the stay request given the similarities between the laws and what the Sixth Circuit panel concluded about the key legal question for a stay: “Likelihood of success on the merits.”

Substack Notes

BoloSassyandMe Jul 14, 2023

Evan Urquhart 🏳️‍⚧️

The three pieces of context I want to bring together are:

1. This impacts a tiny percentage of young people in the US.

2. Despite that, the damange being done to these kids is very high, and could be life threatening for some.

3. The full threat is much larger. There's a potential for precedents that could fundamentally change the relationship Americans have with medical care and place governments run by Christian zealots in the middle of deciding what medical treatments are allowed.

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

So, first, on the tiny number of children impacted.

Reporting on gender affirming care for youth often stresses that it has increased dramatically in recent years.

This is true, but only relative to a time in recent memory when it was almost unheard of.

Trans people are rare. I don't like to give firm numbers where research gives a range, but <0.5 percent to 1.5 percent is the range we see in the research, and people who medically transition are a smaller number of those.

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

For Slate, I calculated the number of American teenagers who medically transition, and it was well shy of 0.5 percent.

In other words, the number of young people transitioning medically is far fewer than the percentage of people we expect to transition eventually in life.

https://slate.com/technology/2023/03/trans-youth-health-care-debate-affirmative-new-york-times-jamie-reed.html

Do You Think “Too Many Kids Are Transitioning”? Here’s the Reality.

There’s an empirical argument for affirmative health care.

Slate

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

This is because parents and doctors are, understandably, reluctant to recommend medical transition for minors, and only do it in cases where it is believed to be medically necessary. When the young person's distress is high and interfering with their life and bth the parents and doctors agree it's probably owing to gender dysphoria.

(sorry, my sister wants to get a friday afternoon beer, so I'm going to put a pin in this and come back)

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

I'm back! (Relaxation is great, but so is writing about trans stuff)

So, we know there aren't that many young people acessing medical transition. And our best guess is that the young people who are accessing transition are the ones whose parents and doctors feel most certain would benefit from it.

So, this brings us to the second point. Although laws against gender affirming care don't impact that many young people, the children they do impact are harmed very badly indeed.

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

Cisgender people sometimes have a tough time understanding gender dysphoria.

My favorite analogies are to a physical condition. Imagine you had a headache and were mocked and asked prove your head was hurting before you could have an ibuprofin. Imagine someone claimed that because they didn't need ibuprofin you shouldn't have it. Imagine people with debhilitating migraines were treated exactly the same way, with skepticism and dismissal, and no allowance for how disabled by the pain they were.

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

The young people who are being medically treaed for gender dysphoria are, most often, more like the migraine sufferers.

Contrary to the hype, there's a strong reluctance to letting minors transition, which means the minors transitioning are usually the ones who are the most debhilitated by gender dysphoria.

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

This is the moment when I could tell you about suicide risk and suicide statistics. Those are, of course, real. However, most trans youth won't kill themselves and I prefer to talk about other forms of harm lack of treatment can bring.

A severely dysphoric trans youth might not kill themselves, but they might be hospitalized for suicidal thoughts multiple times. They might miss months of school, lose out on making friendships, have their ability to go to college impacted by the disruption.

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

I know the mom of a trans boy in Texas who sought medical treatment for her son, and she described a kid who wouldn't shower, wouldn't leave his room.

She got him gender affirming treatment and now he goes to school, has friends, a normal life.

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

Adolescence is a very formative time. These sorts of severe disruptions, even if they're not lifethreatening (and sometimes of course they are), are life altering.

You can't get that time back.

If there's a treatment that can help, denying these small number of families whose children need it the opportunity to access it is unutterably cruel.

But let's move to point three. There are also larger implications of these laws, way beyond these few families.

Evan Urquhart 🏳️‍⚧️Jul 14, 2023

There are a lot of things that those of us who aren't conservative Christians do in our lives that conservatives Christians might not agree with.

By asserting their right to ban gender-affirming care, an evidence based treatment, conservative Christians are testing the waters, seeing how far the judiciary has been transformed.

(sorry, again, it's dinner time. I'd better join my family, back for the last part soon)

Evan Urquhart 🏳️‍⚧️Jul 15, 2023

OK, I'm back once more, let's wrap up this thought,

Conservative Christians disagree with birth control. In right wing media, which I monitor in my work for Assigned, they're already suggesting the side effects make it unsafe.

Legally, it is not a far distance a all from banning gender affirming care for youth to banning hormonal birth control for adult women.

Evan Urquhart 🏳️‍⚧️Jul 15, 2023

In order to ban gender affirming care for youth, you see, the courts will need to ignore the evidence that gender affirming care is a mainstream, evidence based treatment.

Because there's, like, actually pretty strong precedents for this shit. There's established case law that says parents have the right to direct medical treatment for their children. There's also, of course, an established ability of the government to ban harmful treatments, quackery, medical fraud.

Evan Urquhart 🏳️‍⚧️Jul 15, 2023

In order to ban gender affirming care for youth the courts have to, functionally, say that states and/or the federal government can just arbitrarily declare a treatment unsafe or experimental even if the evidence for it is comparable to other medical care.

Because, in spite of what you might have heard, gender affirming care is a very normal treatment with a normal amount of evidence behind it and very normal side effects and risks.

Evan Urquhart 🏳️‍⚧️Jul 15, 2023

So, if we're in a world where states led by conservative Christians can just throw out that evidence and declare a treatment risky bc they oppose it on religious grounds there isn't an obvious place where all that ends.

Bans for gender affirming care for adults aren't a far step, and there's no reason bans on adult birth control wouldn't be at risk.

Evan Urquhart 🏳️‍⚧️Jul 15, 2023

In a worst case scenario, imagine if anal sex or adultery was just unilaterally declared a public health risk and re-introducing criminal bans on it was, therefore, once again something the federal government could do.

What's at stake, in other words, is at one and the same time the wellbeing of an absolutely tiny number of gender dysphoric youth... and also, perhaps, the ability of every single American to choose to live differently than conservative Christians would want them to. /thread

Evan Urquhart 🏳️‍⚧️Jul 15, 2023

Hey, I didn't put any tags on this thread, so I'm going to do that now, belatedly, so if people are interested in a thread on the impacts and broader implications of gender affirming care bans they can find it.

If you find this thread informative, you'd probably like https://www.assignedmedia.org/ I write about trans issues daily, with a focus on countering anti-trans propaganda in the right and mainstream.

#trans #transgender #lgbtq #lgbt #lgbtqia #TransMen #TransWomen #journalism #courts #uspol

Assigned

Founded by Evan Urquhart, Assigned Media is a news site dedicated to daily coverage of anti-trans propaganda and its effects.

Assigned

rhizome Jul 15, 2023

@e_urq
If the political is the personal, then every opinion and reason for meddling in others' lives is 1A protected.

Dan Gillmor Jul 15, 2023

@e_urq With respect, they are not conservative by any traditional definition of the word. They are extremists who have taken over a major political party.

✨buff dog himbo✨Jul 15, 2023

@dangillmor @e_urq this is just plain revisionism. The "conservative" section of American politics has always been in direct opposition to human rights of anyone else except conservative white Christians. The American right has always been responsible for scare-mongering, anti-scientific, anti-woman, anti-queer, anti-black, etc policy. Keeping them from legislating their morals has always been an intense struggle and pretending it hasn't is not helpful to understanding how we got here.

Jonathan Hendry Jul 15, 2023

IVF will be gone.

Inky The Changeling Jul 30, 2023

@e_urq There is a very clear case where that ends. Remember this is the same group that's flooded with anti-vaxxers.

It ends when we can no longer treat even bacterial infections. When doctors are entirely replaced by psychics and faith healers.

BoredomFestival Jul 15, 2023

@e_urq > states and/or the federal government can just arbitrarily declare a treatment unsafe or experimental

to be fair, they've already done this for abortion too

mybarkingdogs Jul 14, 2023

@e_urq Also, I'll jump in to say that it's incredibly important to realize that things like bans on minors transitioning or the sports controversy are "foot in the door" tactics.

Except in those cases, the foot in the door is a fascist jackboot.

Kevin Jul 14, 2023

@e_urq also add in questioning yourself about whether your head REALLY hurts or you're making it up like they say you are

Johanna's Garden Jul 20, 2023

@KevinLikesMaps @e_urq Actually, that happens, at least in intensity of the pain/distress, with both migraines and trans youth, though I'm not trying to compare the two in unwillingness to get treatment, but it can be a long fight to be taken seriously.

Evelyn Jul 15, 2023

@e_urq @Toastie

I don’t have to *imagine* any of the above. I’ve had endometriosis.

Evan Urquhart 🏳️‍⚧️Jul 15, 2023

@gorfram @Toastie I'm so sorry- I know that struggle all too well. My ex-wife went to multiple doctors complaining about abdominal pain, all of whom brushed it off. By the time it was finally figured out the endo had progressed to where she needed first her uterus and then her ovaries out. Went through menopause in her mid 30s. Very possibly preventable. Lost any chance of having bio kids, which she'd dearly wanted, as well.

Evelyn Jul 15, 2023

@e_urq @Toastie Thanks.

I had my uterus removed at 36. I was never really sure if I wanted kids; but, after several years of rating my pain level based on how much I regretted that the pain was unlikely to kill me, I made up my mind.

Excellent analogy, BTW, & a great thread (which I hope I haven’t swerved).

@e_urq Seems like you could get the point across with "imagine you got a really bad haircut, but even though you hated it, the government insisted that you couldn't change your hairstyle and have to keep getting the same bad haircut over and over again."

I think bad haircuts are the one dysphoria that is pretty universal. Everyone at some point looked in the mirror at the barbers and said "this is totally not me that I'm looking at."

Gnome Kat Jul 15, 2023

There were tings that made the sad bad feelings. I changed them to make the good happy feelings. Pretty simple I tink.. what so hard about that..

Faith, Purple haired feminist 🧋

@e_urq I've been thinking about trans kids healthcare this week from a bit of a different angle. Sorry if this isn't very well-formed yet but I need to get it out of my brain somewhere...

Denying trans kids healthcare doesn't just make life hard for a few years while they wait it out. It doesn't just increase suicide risk temporarily. It creates depressed and suicidal adults.

When I look around the community lately I see so many trans folks struggling. So many trans girls, in particular, feeling like no amount of makeup in the world will ever wash off that man look. So many people of all genders suffering from decades of trauma related to being stuck in the wrong gender. So much pain and suffering all around.

Almost all of that (let's say 90%) could be alleviated if they had just been allowed to transition as kids. Some were denied healthcare, others were denied even the knowledge required to understand ourselves and come out. Sometimes by legislation or oppressive systems and sometimes by cultural pressure and bigotry. Whatever the reason, the result is the same. Millions of depressed adults who are struggling with just living life. You can think of it like any other treatable childhood disease that leaves people permanently disabled like polio. If we just let them transition, they would be happier adults who are able to better contribute and enrich our society, whatever your definition of that is.

Even if you look at it from a iron-cold economic point of view, it would be better to just give 'em the pills at 12 years old.

Preventing kids from transitioning is nothing but cruel. The whole point seems to be to prevent them from transitioning until the wrong hormones have done so much damage to their bodies that they give up on their dream. They may say "grow out of it" but we know that's not actually what happens. If your goal is a totally cis society, I guess that's one way to do it. 🙄 If, on the other hand, we want a happy and flourishing society, letting people live their best lives starting as kids is the only way to get there.

Faith, Purple haired feminist 🧋

@e_urq And just to clarify, I'm not saying that adults are more important than kids or that the fact that they're hurting children doesn't matter. They're not and it does. I'm saying that these kids they're hurting today won't ever get over it. Conservatives love to think that a little pain today will save a lifetime of regret but that's not at all what's going to happen. They're just going to hurt them for life. 🤬

Dwight Williams (💉 x9)+😷🇨🇦Jul 15, 2023

@faithisleaping @e_urq My fear is that the infliction of that pain itself is the goal.

karizma🏳️‍⚧️Jul 15, 2023

@DEWLine @faithisleaping @e_urq
Real truth hours

Debbie Goldsmith 🏳️‍⚧️♾️🇺🇦Jul 15, 2023

@faithisleaping @e_urq Speaking as someone who wanted to transition in 1965 at age 8, but didn't get to until I was nearly 40, this is exactly right. Going through the wrong puberty causes pain for life.

✨buff dog himbo✨Jul 15, 2023

@faithisleaping @e_urq i don't think anyone should be laboring under the impression that the right wing are in any way interested in a happy, healthy society. That has never been one of their goals and they're pretty explicit about it.

KikoKate Jul 15, 2023

@faithisleaping @e_urq Well thought and cogent. Spot on.
Note: The cruelty is the point. It’s what Nazis do.
Also: Conservative thinking is, “There will be no more trans people if we don’t allow them to be made.”

🏳️‍⚧️Claire🏳️‍⚧️Jul 15, 2023

@faithisleaping
I love this Faith! This is spot on. The analogy to other childhood diseases is a perfect observation.
@e_urq

Miriam's on Medical Leave Jul 15, 2023

Concur, but I’d like to suggest the harder take: the method they’re employing to get to that cis world is to increase trans suicide rates.

Not just depressed eggs. Dead eggs.

@faithisleaping @e_urq

Faith, Purple haired feminist 🧋

@miriamrobern IDK that they want dead eggs. They just don't want thriving trans people. Honestly, I think they like depressed eggs because those are people they have power over and they like power. They love conformity and people suffering trying to conform to a standard they find natural gives them that power kick. 😫

@elfieclaire @e_urq

🏳️‍⚧️Claire🏳️‍⚧️Jul 15, 2023

@faithisleaping
On Reddit once I saw someone post the theory that what they want is clockable trans women. The cis white males in charge are terrified that they might sleep with a trans woman and not realize she is trans. They force trans women to go through male puberty first so they have better odds of clocking us
@miriamrobern @e_urq

@e_urq I presume you saw this (if not from me, from others):

https://mastodon.murkworks.net/@moira/110713930126200694

And to be extra clear about it: these initiatives _income sources_ for them.

Oregon Citizens Alliance and its spinoffs (Citizens Alliance of Washington, Idaho Citizens Alliance, Montana Citizens Alliance) were real moneymakers for the Mabon family in the 90s. Decline to Sign efforts are a big part of keeping it from being as profitable, but they'll be doing more of this.

Solarbird{y|z} :flag_cascadia: (@[email protected])

The Moms4Liberty cult are bringing anti-LGBT initiatives back to Washington State, starting with R-101, a bill to overturn protections for LGBT youth. They are naturally - and like every previous iteration of this kind of hate group - lying viciously and continuously about everything, lying in particular that the laws allow the state to kidnap children out of your homes. This kind of lie is what they do, and what they have always done. There is a Decline to Sign campaign underway. The best way to defeat these initiatives - and stop months of anti-LGBT hate campaign in advance - is to keep them from getting enough signatures to put it on the ballot at all. Get involved: https://solarbird.net/blog/2023/07/14/the-moms-4-liberty-cult-are-bringing-anti-lgbt-initiatives-back-to-washington-state/ #fascism #uspol #politics #wapol

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