Biden DOJ promises to 'vigorously' defend religious schools' 'right' to discriminate against LGBTQ people

40 LGBTQ students are suing the U.S. Dept. of Education for allowing the faith-based colleges they attend to discriminate against them while receiving taxpayer funds and federal support. The Dept. of Justice, which generally defends the federal government and the laws of the United States, has promised it will "vigorously" defend the several dozen schools against the lawsuit.

If this were the Trump Justice Dept., many Americans would not be surprised. And while there is a wall between the White House and the DOJ, President Joe Biden has said passing the LGBTQ Equality Act is among his top priorities. (Majority Leader Schumer has indicated he will bring it to the floor for a vote this month.)

Add to all this that the U.S. Supreme Court in the coming days is expected to hand down its decision in a case filed by a Christian adoption agency that lost its contract with the City of Philadelphia for refusing to work with LGBTQ and same-sex couples.

The Washington Post reports the DOJ's promise "it can 'vigorously' defend a religious exemption from federal civil rights law that allows federally funded religious schools to discriminate against LGBTQ students," is "a move that surprised some LGBTQ advocates who said the wording went further than just an obligation to defend an existing law."

During the Obama years the Dept. of Justice under Attorney General Eric Holder refused to defend in court a portion of the Defense of Marriage Act, declaring he and President Obama had decided it was unconstitutional. (The U.S. Supreme Court ultimately agreed.)

"In the filing," the Post adds, "the Biden administration said it 'shares the same ultimate objective' as the conservative Christian schools named in the case."

LGBTQ activists are displeased.

"What this means is that the government is now aligning itself with anti-LGBTQ hate in order to vigorously defend an exemption that everyone knows causes severe harm to LGBTQ students using taxpayer money," said Paul Carlos Southwick, director of the Religious Exemption Accountability Project, which filed the case in March on behalf of dozens of current and past students at conservative religious colleges and universities. "It will make our case harder if the federal government plans to vigorously defend it like they have indicated."

The lawsuit says the schools are "fueled by government funding," and yet the Dept. of Education's "inaction leaves students unprotected from the harms of conversion therapy, expulsion, denial of housing and healthcare, sexual and physical abuse and harassment, as well as the less visible, but no less damaging, consequences of institutionalized shame, fear, anxiety and loneliness."

The Religious Exemption Accountability Project says its lawsuit "asserts the constitutional and basic human rights of LGBTQ+ students, seeking to end the sexual, physical and psychological abuses perpetrated under the religious exemption to Title IX at thousands of federally-funded schools, colleges and universities across America."

The Constitution guarantees equal rights for all Americans, holding space for religious belief and practice, while ensuring that religion does not serve as a government-funded vehicle to harm racial, ethnic, gender, sexual, religious or other minorities. Government action that ignores this central principal, including the religious exemption to Title IX, is unconstitutional and must be remedied immediately.

Several right-wing groups are asking the courts to be included in the lawsuit to defend the religious exemption and their "right" to discriminate.

Among them, the Council of Christian Colleges and Universities, and the Alliance Defending Freedom, a legal firm that has won at the U.S. Supreme Court and appears on the Southern Poverty Law Center's list of anti-LGBTQ hate groups.

On its website ADF describes the lawsuit as a demand the schools "renounce core religious beliefs," which apparently includes discriminating against LGBTQ students.

Stephen Miller says he fights 'transgender ideology' that teaches 'people are whatever they want to be’

Stephen Miller, advisor to the former president, attacked on Wednesday what he calls "transgender ideology," claiming it is so concerning to a democratic society it impacts "what it means to have and maintain a country," and will force all Americans to "adopt a transgender viewpoint."

He did not explain what that means.

Miller says he's fighting to protect America's "Judeo Christian heritage" and "Western Civilization," although he never specifies from what, just transgender people in general.

A white supremacist who served as Senior Advisor to then-President Donald Trump and continues in that role, Miller told Christian Broadcasting Network's David Brody, on his Real America's Voice web show, that he is fighting an Equal Employment Opportunity Commission case, claiming that the EEOC failed "to include a constitutionally required religious exemption."

Miller started his own far right wing law firm, America First Legal, from which he says he is battling the EEOC "so that people can speak their truth." That apparently excludes transgender people.

"So they will be forcing religious Americans, religious believers, people of faith, to violate their deeply held beliefs, their own private conscience rights and to adopt a transgender viewpoint," Miller claims. "This is really an issue about science, it is about religion, but also about science because the undisputed biological definition of sex, really, is being turned upside down because of a radical agenda that really now is beginning in our elementary schools teaching young people, that there are no boys and girls, men and women, but in fact, people are whatever they want to be, which has profound implications for medicine for culture, for religion, and for truth itself," Miller said.

(For decades if not longer Americans have told their children they can be "whatever they want to be.")

"We are a country whose ethical, religious and moral heritage is Judeo Christian," Miller said. "What it means is that Judeo Christian values, form the bedrock of our declaration. Our constitution, our civil rights, our moral character, who we are as a people who we are as a country, we inherit from our founders that deep religious faith that deep cultural attachment to these principles, and when they are under assault, our whole nation is under assault, we ought to be teaching and inculcating into our children these fundamental values and principles that made us who we are, that makes Western civilization what it is that is critical to having not just a great present, but an amazing future for this country."

"My personal view is that this is a failed ideology that is destined to topple in on itself. For this agenda to succeed for the transgender ideology to succeed, they need people to be scared and quiet and not to speak the plain truth. Because once people say I'm not going to bow down to something I know is untrue. I'm not going to be afraid I am going to speak my mind respectfully tastefully, honestly, it's not going to hold it will crumble the edifice will collapse."


DeSantis kicks off Pride Month by signing 'appalling' and 'shameful' attack on trans kids

As part of an ongoing series of GOP attacks on the rights of transgender youth, Republican Gov. Ron DeSantis of Florida marked the first day of LGBTQ+ Pride Month on Tuesday by signing a bill to bar trans girls and women from participating in public secondary school and college sports in line with their gender identity.

The Human Rights Campaign (HRC) told CNN that Florida is the eighth GOP-led state to enact such a ban this year—which has also featured attacks on gender-affirming healthcare. The group vowed to challenge Florida's Senate Bill 1028 in court.

"DeSantis and Florida lawmakers are legislating based on a false, discriminatory premise that puts the safety and well-being of transgender children on the line," said HRC president Alphonso David. "Transgender kids are kids; transgender girls are girls. Like all children, they deserve the opportunity to play sports with their friends and be a part of a team. Transgender youth must not be deprived of the opportunity to learn important skills of sportsmanship, healthy competition, and teamwork."

"The harmful provisions added to S.B. 1028 will not just impact transgender people in Florida," David added. "All Floridians will have to face the consequences of this anti-transgender legislation—including economic harm, expensive taxpayer-funded legal battles, and a tarnished reputation. In Florida, we are ensuring that there are legal consequences to pay for being on the wrong side of history."

Under Florida's so-called "Fairness in Women's Sports Act," student athletes who were identified as male on their birth certificates at the time of birth will not be allowed to participate in any club, intercollegiate, interscholastic, or intramural athletic teams or sports for females that are sponsored by a public secondary school, high school, college, or university.

"As a father of two daughters, I want my girls, and every girl in Florida, to compete on an even playing field for the opportunities available to young women in sports," DeSantis said in a statement.

"In Florida... girls are gonna play girls sports and boys are gonna play boys sports," he added, speaking at Trinity Christian Academy in Jacksonville flanked by student athletes. "That's what we're doing, and we're gonna make sure that that's a reality."

While Florida Lt. Gov. Jeanette Nuñez (R), Senate President Wilton Simpson (R-10), and Speaker of the Florida House of Representatives Chris Sprowls (R-65) all framed S.B. 1028 as a measure that will "protect" the opportunities" for Florida athletes assigned female at birth, critics of the law accused state GOP policymakers of endangering trans girls and young women.

The Orlando Sentinel reports that Gina Duncan, Equality Florida's director of transgender equality, called the law "hateful and overtly discriminatory."

"They made it clear that they're not concerned about athletics," she said. "They simply don't believe that transgender people exist... It's not an accident that when transphobia is spewed from the highest levels of leadership, trans kids take the brunt of that bigotry. This bill is shameful. This bill is violent, and it just made the world less safe for our most vulnerable young people."

In a series of tweets on Tuesday, state Rep. Carlos Guillermo Smith (D-49) called DeSantis' move "appalling," highlighted Trinity's treatment of LBGTQ+ students, and charged that "if GOP lawmakers would have spent half as much time helping Floridians struggling with economic issues as they spent pushing trans kids out of school sports, our state would be much better off."

"Unfortunately, S.B. 1028 contributes to the dangerous stigma that drives the epidemic of violence against and bullying of transgender youth," said Smith, Florida's first openly LGBTQ+ Latino lawmaker. "We adults have a responsibility to protect trans youth, not use them as political pawns in a cynical attempt to score partisan points."

"Right now, the only message that matters is our message for transgender youth," he added. "We see you. You exist and are beautiful and loved. We stand alongside you in the fight for fairness and equality!"

'Rampant homophobia': Democrats blast Pennsylvania GOP for voting to keep anti-gay law

Republicans in the Pennsylvania House of Representatives on Monday voted to keep the word "homosexuality" included in the state's public indecency and obscenity laws, angering top-ranking Democrats including those who introduced legislation to remove the classification from the books.

Currently, for example, Pennsylvania law on prostitution characterizes "homosexual" sex among "deviate sexual relations."

Pennsylvania's obscenity law even includes this archaic definition in relation to "Obscene and other sexual materials and performances."

"Sexual conduct means acts of masturbation, homosexuality, sexual intercourse, sexual bestiality or physical contact with a person's clothed or unclothed genitals, pubic area, buttocks or, if such person be a female, breast."

SB 609 would have removed the word "homosexual" or "homosexuality" from obscenity laws.

But on a party-line vote every Republican, led by Speaker Brian Cutler (photo), elected to abuse, attack, demean, mock, and marginalize the state's LGBTQ community by voting against the bill.

Democratic Rep. Brian Sims, the state's first openly gay elected lawmaker who is running for Lieutenant Governor in the 2022 election, blasted his GOP colleagues:

"Compounding the rampant homophobia of the Republican caucus with this type of aggressive cowardice is so painfully on brand. May you never have to see your colleagues vote to keep the ways you love a 'crime,'" Sims also tweeted.

The Democratic House and Senate sponsors of the bill also blasted Republicans:

School board president compares LGBTQ flags to support for white supremacy

An Indiana school board of trustees president is under fire after defending the board's order to have LGBTQ pride flags removed from three high school classrooms at Pendleton Heights High School. Last week the school district ordered the flags removed from French, Spanish, and art classrooms, claiming they violated a policy forbidding "political paraphernalia," The Herald Bulletin reports.

After an uproar, South Madison Board of Trustees President Bill Hutton sent a district-wide email to students, families, and school staff, comparing the LGBTQ pride flag with flags promoting "other groups," including those "supporting white supremacy."

"The issue with displaying the flag in a school is a double-edged sword. If an LGBTQ+ flag is allowed to be displayed, then any other group would have the same ability," Hutton claimed. "That could include such flags as supporting white supremacy, which is in direct conflict with LGBTQ+. I hope we can model equality and support through our actions."

But as many noted, comparing being LGBTQ to holding white supremacist beliefs is not supporting equality.

The board's order and Hutton's defense appears to expose what at least one student says is a lack of support for LGBTQ equality.

"LGBT students, including Tai Wills, disagree that the flags are political," The Herald Bulletin reports.

"Why would you compare a racist flag?" Wills, a 16-year old sophomore at Pendleton Heights High School, said. "Those two have nothing to do with each other."

"One is about inclusiveness and the other is about hate and exclusion, and I don't think that's the same thing at all," she observed. "It's already hard dealing with bullying and judgmental kids, and now you can't even have a flag saying, 'We support you in the classroom.'"

The Herald Bulletin adds that "Wills said she worries about the mental health and educational success of her classmates. South Madison's schools during the 2018-19 school year had a rash of suicides and suicide attempts at all grade levels, some of which did involve LGBT students."

In reality, Wills said, Pendleton Heights has not been supportive of its LGBT students. For instance, last year she started the Gay-Straight Alliance but was told they could not post fliers and raise money like the other clubs.

"Their only excuse was, 'It's a sensitive topic,'" Wills adds. "It didn't really feel like we were a club because we weren't allowed to do much."

Pendleton Heights High School junior Bryce Axel-Adams, "started an online petition to allow the flags to be displayed again. He had hoped for several dozen supporters — he had received nearly 3,000 signatures as of Thursday morning," The Indy Star reports.

That number is now over 4300.

"As a freshman, I remember walking by (a teacher's) classroom," Bryce said. "She had it right on the wall so when you were passing by and looking into her room you could see it."

"I remember walking by her classroom, glancing at it and just being happy. I knew we had an ally here at the school."

The flags, which had been up for over a year, remain removed.

State Department ends anti-LGBTQ policy that targeted same-sex parents

The U.S. State Dept. under Secretary of State Antony Blinken on Tuesday ended a Trump-era policy targeted directly against LGBTQ families. The policy, supported by then-Secretary of State Mike Pompeo, mandated that children born outside the United States to parents who are U.S. citizens must be biologically related to both parents, or they would not be allowed to be granted U.S. citizenship.

The discriminatory policy ensnared only same-sex couples, and hewed to Pompeo and Trump's anti-LGBTQ and anti-immigrant beliefs.

In a statement U.S. Department of State Spokesperson Ned Price said the "updated interpretation and application of the INA [Immigration and Nationality Act] takes into account the realities of modern families and advances in ART [assisted reproductive technology] from when the Act was enacted in 1952."

In one case NCRM reported on in 2019, the Pompeo State Dept. actually allowed one of two biological twins to be granted U.S. citizenship but prohibited the other from the exact same rights.

The non-profit group Immigration Equality in a statement Tuesday said the Trump-era policy had affected "many married same-sex couples," and noted that "the Immigration and Nationality Act has never required a biological relationship for married parents. As such, every federal court that heard the issue found that the State Department's policy was inconsistent with the statute."

Conservatives' dangerous play to rally their base by targeting trans kids has real costs

by Alison Gash, University of Oregon

On April 6, 2021, despite Republican Gov. Asa Hutchinson's veto, Arkansas became the first state to prohibit physicians from providing gender-affirming medical care like hormone treatments designed to delay puberty in transgender youth. So-called “puberty blockers" are used to delay the physical changes associated with puberty and provide time for transgender young people to consider their options.

Arkansas physicians now face criminal penalties if they prescribe puberty blockers or other forms of cross-gender health care to transgender youth. Twenty other states are considering similar bills. Some would classify puberty blockers and other gender-affirming medical treatments as child abuse or would revoke the medical licenses of physicians prescribing these therapies.

These anti-transgender health care bills are part of a record number of anti-transgender policy reforms that conservative legislators have introduced this year in state legislatures across the country.

These include bills that will bar transgender athletes from participating in student sports and mandate parental notification for a school curriculum that is inclusive of LGBTQIA – lesbian, gay, bisexual, transgender, questioning and/or queer, intersex and asexual – issues. One additional variety – just signed into law by Republican Montana Gov. Greg Gianforte – requires gender reassignment surgery before any individual can change the sex marker on their birth certificate.

So far, anti-transgender athlete bills have gained the most traction. Despite consistent public opposition, 30 states have now considered barring transgender athletes from playing on teams that match their gender identity. Alabama, Arkansas, Mississippi, South Dakota and Tennessee have already passed legislation, and other states are likely to follow.

As a civil rights scholar, I have found that campaigns that mischaracterize LGBTQIA-supportive policies as harmful to young people are a staple strategy conservatives use to galvanize their base.

'Save our Children'

Anti-gay activist and Florida orange juice queen Anita Bryant first perfected the strategy in the 1970s to oppose ordinances prohibiting sexuality-based discrimination. Bryant's “Save our Children" campaign demonized gays and lesbians as “recruiting children." Bryant successfully encouraged voters to oppose legislative attempts to protect gays and lesbians from discrimination and prompted Florida legislators to bar same-sex couples from adopting children, a law that was later overturned in 2010.

In the late 1990s and early 2000s, conservatives prompted over 40 states to bar same-sex marriage on the basis that all children could be at risk – those raised by same-sex couples and those introduced to marriage equality at school.

In 2015, when the Supreme Court overturned these bans in the landmark case Obergefell v. Hodges, conservatives began targeting transgender rights.

Conservatives again trained their focus on nondiscrimination measures – this time those prohibiting gender identity discrimination. They misleadingly argued that any measure protecting transgender individuals would place cisgender girls and women (individuals whose gender identity and birth-assigned sex are both female) at risk by allowing men dressed as women to use women's locker rooms and restrooms.

There is no evidence supporting this claim. Yet there is significant evidence of health and safety risks to transgender students if they are prohibited from using bathrooms that reflect their gender identity.

Significant costs

Anti-transgender athlete and health care bills follow a similar approach. Advocates for bills targeting transfemale athletes claim that transmale teammates will “ruin women's sports forever."

Supporters of anti-trans health care bills claim that children are being pressured to employ these therapies, by physicians and parents, and describe the effects as permanent and scarring.

There is little empirical evidence to back up these assertions. Puberty blockers are an increasingly common treatment precisely because they provide a reversible and less invasive option for transgender adolescents and are provided only with the patient's fully informed consent. Cross-gender hormone treatments (which are typically provided in later adolescence) are also relatively low-risk.

And there is little evidence to suggest that transgender female athletes are unfairly outcompeting their cisgender competitors – particularly if they have been on puberty blockers. In fact, conservative legislators have pointed to only one instance in their campaigns, when two Black transfemale athletes in Connecticut took first and second place in a 2017 statewide track tournament. Several cisgender female athletes who lost are suing state officials for permitting the transgender athletes to compete.

A far more common story is the relative obscurity of transgender athletes in women's sports and their similarities with their cisgender teammates. Many of the states considering the legislation have no known transfemale athletes or have transfemale athletes who are performing on par with cisfemale teammates.

And even the cisgender Connecticut athletes currently suing state officials prevailed in several championship races against their transgender competitors shortly after filing their lawsuit.

But none of this has prevented bill supporters from stoking fears.

We do know, however, that the bills will harm transgender young people.

Prohibiting gender-affirming care like puberty blockers or barring transgender-inclusive athletic teams imposes real and devastating risks on transgender youths. Transgender people who do not have access to the kinds of hormone therapies that are being outlawed are four times more likely than cisgender people to struggle with depression.

They are also nine times more likely than cisgender individuals to attempt suicide.

Put simply, gender-affirming policies and supportive health care therapies are lifesaving.

Furthermore, if upheld in court, the athlete bills could require any female athlete to “prove" their gender to participate, potentially through invasive physical examinations.

Political landscape

Conservatives may be using these bills – which some describe as “erasing transgender youth" – to catalyze Republican voters to participate in upcoming midterm elections. And the strategy could work.

Attempts to bar transgender athletes appeal to at least some self-described feminists. And some high-profile women's athletes have joined the fray. The Women's Sports Policy Working Group convened in order to “protect" cisgender female athletes.

Conservatives are also using anti-trans-athlete talking points to oppose the Equality Act, a bill now circulating in the Senate that would add prohibitions against sexual orientation and gender identity discrimination to existing federal civil rights bills. The House passed a similar measure last year, but it failed to pass the Senate.

Transgender advocates have some recourse to fight the bills. Corporate backlash is one option. Litigation is another. Advocates for transgender rights have secured legal victories in state and federal court challenges involving bathrooms and locker rooms. More recently a federal judge in Idaho blocked that state's anti-transgender athletes bill passed in 2020.

And the Supreme Court's recent ruling in Bostock v. Clayton County, which protects LGBTQ individuals from certain forms of discrimination, seems at first blush to support transgender student equality. But the Bostock case is new, its application to sports and health care untested and political fervor is mounting. With a solid conservative majority on the Supreme Court – and in federal courts across the country – legal battles are unreliable.

In the meantime, transgender young people across the country are contemplating a more uncertain and dangerous future. Some are working with their parents to find out-of-state sources for puberty blockers. Others are contemplating moves to less hostile states. All of this because conservatives have channeled trumped-up claims into harmful legislation that outlaws transgender youths to further divide American voters.

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Alison Gash, Associate Professor of Political Science, University of Oregon

This article is republished from The Conversation under a Creative Commons license. Read the original article.

West Virginia governor comes up short on TV when he tries to defend his anti-trans law

MSNBC's Stephanie Ruhle delivered blow after blow when she shredded West Virginia Gov. Jim Justice's (R) futile argument in defense of the state's newly-passed anti-trans bill that restricts transgender girls and women from competing on athletic teams.

On Friday, April 30, when Justice appeared on the show with Ruhle, she asked if he could identify one isolated incident where a transgender child attempted to gain an unfair athletic advantage. The Republican governor failed to provide a solid answer.

"I can't really tell you one, but I can tell you this, Stephanie, I'm a coach and I coach a girl's basketball team and I can tell you, we all know — we all know what absolute advantage boys would have playing against girls," he reasoned, misgendering transgender girls. "We don't need that."

Ruhle fired back at Justice by asking him why he chose to sign a bill into law when he had no actual evidence to support a prioritized need for it. She went on to offer Justice details about more pressing issues in his state with a brief overview of poor statistics about his governing state as she criticized him for prioritizing the wrong initiatives.

"Let's talk about other things I can give you examples of in your state," she said. "According to U.S. News & World Report, West Virginia ranked 47th in health care, 48th in the economy, and 50th in infrastructure. If you cannot name one single example for me of a child doing this, why would you make this a priority? I named four things that would seem to me like a much bigger priority."

West Virginia Governor Unable To Provide Evidence Of Transgender Athletes Gaining Athletic Advantage

Justice insisted that he did not view the bill as a priority, but Ruhle appeared unimpressed with his response.

"It just came to me and I actually signed it because I believe from the standpoint of a coach, I believe that girls worked so hard to obtain Title Nine, and I do not have any idea now why we are trying to disadvantage them in participating in a sport that they put so much into," he replied. " I don't know why we're doing that. This is not like it's a big priority to me."

After doubling down on the fact that the bill was not a priority, he admitted that there are probably no more than a dozen transgender children across the entire state of West Virginia. However, he still felt the need to incorporate a statewide measure.

"I mean for crying out loud, Stephanie, I sign hundreds of bills, hundreds of bills," Justice added. "This is not a priority to me. But with all of that, I would say, I think that it would impose an unfair disadvantage on the girls. So, from that standpoint, I support it."

Before concluding the interview, Ruhle added, "I can show you evidence of how ranking that low in education is disadvantaging young women and men in West Virginia."

Andrew Yang tried to win an LGBTQ group's support in the mayoral race — it did not end well

Former Democratic presidential candidate Andrew Yang, who was a surprising breakout success but suffered criticisms about "tone," and continues to, is running to become New York City's next mayor. He's currently the frontrunner in the very early race but once again, as The New York Times reports, his inability to build support among minority groups is hurting him.

Yang spoke to the Stonewall Democratic Club of New York City, a top LGBTQ organization, on Wednesday.

"It did not go particularly well," the Times reports.

Yang's approach and the way he treated LGBTQ people was seen as "outdated," according to Stonewall's president, Rose Christ.

"Yang cited gay members of his staff as apparent evidence of his openness to the club's concerns, and expressed enthusiasm about the prospect of visiting Cubbyhole, a storied New York lesbian bar, participants said," the Times reveals.

"He proactively talked about resurrecting the city's Pride March, but failed to pay sufficient heed to more substantive issues they were actually concerned about, including homelessness and affordable housing, they said."

"When I see a candidate come in just with Michael Scott levels of cringe and insensitivity, it either tells me Andrew Yang is in over his head or is not listening to his staff," said Alejandra Caraballo, a member of the organization, referring to the character played by Steve Carell on "The Office." "Those are both radioactive flashing signs that say he is not prepared to be mayor of New York."

Yang also repeatedly referred to LGBTQ people as a "community," telling members of the Stonewall Democratic Club how much he cares about "your community."

"I genuinely do love you and your community," Yang told members. "You're so human and beautiful. You make New York City special. I have no idea how we ever lose to the Republicans given that you all are frankly in, like, leadership roles all over the Democratic Party."

Filmmaker and Stonewall member Harris Doran said Yang "kept calling us 'Your community,' like we were aliens."

"We have, like, this incredible secret weapon," Yang also said. "It's not even secret. It's like, we should win everything because we have you all."

"Gay, gay, gay. Wow," one person wrote in the chat accompanying the forum, which was later shared with The New York Times. "More to us than just that."

I’m a pediatrician who cares for transgender kids — here's the truth about their treatment

by Mandy Coles, Boston University

When Charlie, a 10-year-old boy, came in for his first visit, he didn't look at me or my colleague. Angry and crying, he insisted to us that he was cisgender – that he was a boy and had been born male.

A few months before Charlie came into our office, he handed a note to his mother with four simple words, “I am a boy." Up until that point Charlie had been living in the world as female – the sex he was assigned at birth – though that was not how he felt inside. Charlie was suffering from severe gender dysphoria – a sense of distress someone feels when their gender identity doesn't match up with their assigned gender.

I am a pediatrician and adolescent medicine specialist who has been caring for transgender youth for over a decade using what is called a gender-affirmative approach. In this type of care, medical and mental health providers work side by side to provide education to the patient and family, guide people to social support, address mental health issues and discuss medical interventions.

Getting on the same page

The first thing our team does is make sure our patients and families understand what gender care is. We always begin initial visits in the same way. “Our goal is to support you and your family on this journey, whatever that may look like for you. My name is Mandy and I am one of the doctors at CATCH – the Child and Adolescent Trans/Gender Center for Health program. I use she/her pronouns." Sharing pronouns helps transgender people feel seen and validated.

We then ask patients and families to share their gender journey so we can better understand where they are coming from and where they hope to go. Charlie's story is one we often hear. A kid may not think much about gender until puberty but begins to experience worsening gender dysphoria when their body starts changing in what feels like the wrong way.

Social transitions with family help

Transgender and gender-diverse youth (those whose gender identity doesn't conform to the norms expected of their assigned sex) may face transphobia and discrimination, and experience alarmingly higher rates of depression, anxiety, self-harm and suicide than their cisgender peers. One option can be to socially transition to their identified gender, both at home and in the outside world.

An important first step is to help parents become allies and advocates. Connecting parents with one-to-one as well as group support can help facilitate education and acceptance, while helping families process their own experience. Charlie's parents had been attending a local parent group that helped them better understand gender dysphoria.

In addition to being accepted at home, young people often want to live in the world in their identified gender. This could include changing their name and pronouns and coming out to friends and family. It can also include using public spaces like schools and bathrooms, participating on single-gender sports teams and dressing or doing other things like binding breasts or tucking back male genitalia to present more in line with their gender identity. Though more research needs to be done, studies show that youth who socially transition have rates of depression similar to cisgender peers.

Many young people find that making a social transition can be an important step in affirming identity. For those that still struggle with depression, anxiety and managing societal transphobia, seeing a therapist who has knowledge of and experience with gender-diverse identities and gender dysphoria can also be helpful.

However, most young people also need to make physical changes to their bodies as well to feel truly comfortable.

Gender-affirming medical interventions

When I first met Charlie, he had already socially transitioned but was still experiencing dysphoria. Charlie, like many people, wanted his physical body to match his gender identity, and this can be achieved only through medical interventions – namely, puberty blockers, hormonal medications or surgery.

For patients like Charlie who have started experiencing early female or male puberty, hormone blockers are typically the first option. These medications work like a pause button on the physical changes caused by puberty. They are well studied, safe and completely reversible. If a person stops taking hormone blockers, their body will resume going through puberty as it would have. Blockers give people time to further explore gender and to develop social supports. Studies demonstrate that hormone blockers reduce depression, anxiety and risk of suicide among transgender youth.

Once a person has started or completed puberty, taking prescribed hormones can help people match their bodies with their gender identities. One of my patients, Zoe, is an 18-year-old transgender woman who has already completed male puberty. She is taking estrogen and a medication to block the effects of testosterone. Together, these will help Zoe's body develop breasts, reduce hair growth and have an overall more female shape.

Leo, another one of my patients, is a 16-year-old transgender man who is using testosterone. Testosterone will deepen Leo's voice, help him grow facial hair and lead to a more male body shape. In addition to testosterone, transgender men can use an additional short-term medication to stop menstruation. For nonbinary people like my 15-year-old patient Ty, who is not exclusively masculine or feminine, my colleagues and I personalize their treatments to meet their specific need.

The health risks from taking hormones are incredibly small – not significantly different, in fact, than the risks a cisgender person faces from the hormones in their body. Some prescribed hormone effects are partially reversible, but others are more permanent, like voice deepening and growth of facial hair or breasts. Hormones can also impact fertility, so I always make sure that my patients and their families understand the process thoroughly.

The most permanent medical options available are gender-affirming surgeries. These operations can include changes to genitals, chest or breasts and facial structure. Surgeries are not easily reversible, so my colleagues and I always make sure that patients fully understand this decision. Some people think gender-affirming surgeries go too far and that minors are too young to make such a big decision. But based on available research and my own experience, patients who get these surgeries experience improvements in their quality of life through a reduction in dysphoria. I have been told by patients that gender-affirming surgery “literally saved my life. I was free [from dysphoria]."

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Ongoing gender care

In March 2021, nearly five years after our first visit, Charlie walked into my exam room. When we first met, he was struggling with his gender, anxiety and depression. This time, he immediately started talking about playing hockey, hanging out with friends and making the honor roll. He has been on hormone blockers for five years and testosterone for almost a year. With the help of a supportive family and a gender-competent therapist, Charlie is now thriving.

Being transgender is not something that goes away. It is something my patients live with for their entire lives. Our multidisciplinary care team continues to see patients like Charlie on a regular basis, often following them into young adulthood.

While more research is always needed, a gender-affirmative approach and evidence-based medicine allows young transgender people to live in the world as their authentic selves. This improves quality of life and saves lives, as one of our transgender patients said about his experience receiving gender-affirming care. “I honestly don't think I would be here had I not been allowed to transition at that point. I'm not always 100%. But I have hope. I am happy to see tomorrow and I know I will achieve my dreams."The Conversation

Mandy Coles, Clinical Associate Professor of Pediatrics, Boston University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

​Florida pushes ban on trans girls in sports — including a disturbing 'reproductive anatomy' exam provision​

Florida House Republicans have passed legislation that bans transgender girls from participating in girl's sports, and allows anyone to dispute a student's gender, which would legally result in an examination of "student's reproductive anatomy."

HB 1475, the "Fairness in Women's Sports Act," passed along party lines in a 70-44 vote, Law & Crime reports.

"Athletic teams or sports designated for females, women, or girls may not be open to students of the male sex," the legislation reads. The intent is to ban transgender girls or women on the "basis of students' biological sex."

The bill also says that if there is any "dispute" about a student athletes' "biological sex," it "shall be resolved by the student's school or institution by requesting that the student provide a health examination and consent form or other statement signed by the student's personal health care provider which must verify the student's biological sex."

"The health care provider may verify the student's biological sex as part of a routine sports physical examination by relying only on one or more of the following: The student's reproductive anatomy; The student's genetic makeup; or The student's normal endogenously produced testosterone levels."

The legislation does not define "dispute," who gets to file a dispute, or by what method a dispute should be filed or with what entity, or who has to pay for the exam. It leaves all that up to the State Board of Education.

In theory, a student who didn't make the team and were to blame anyone who did could file a dispute and force that student athlete to have a genital examination.

House Republicans killed 18 proposed amendments, including one that would have removed the section providing for examination of a student's reproductive anatomy.

The legislation, sponsored by Republican Rep. Kaylee Tuck must now go to the Senate, which also has a 24-16 GOP majority. If it passes, 2024 Republican presidential hopeful, Governor Ron DeSantis, would have to sign it into law.

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