Healthcare for trans youth is becoming a central issue for Republican presidential candidates


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Trans girls playing women’s sports, Nikki Haley said for months on the campaign trail, is the women’s issue of our time. In Iowa, on the first day of his presidential campaign last week, Mike Pence said he would support a nationwide ban on radical gender ideology and gender-affirming health care for transgender children.


Florida Governor Ron DeSantis has vowed to take his Florida policies nationwide; those include a set of laws that limit how schools can talk about gender and sexuality, including pronouns. The current Republican presidential camp leader, former President Donald Trump, released a campaign video that suggested his campaign was a war on trans identity.

In the Republican presidential primaries, healthcare for transgender youth, as well as how schools accommodate them, became a central issue, garnering as much attention as inflation and public safety.

The issue is active among the party’s most ardent supporters, who see trans politics as part of a heated culture war over race and gender. Among most Americans, however, trans-child policies aren’t high on the list of priorities entering the voting booth; a recent survey found that a large majority may be fatigued by public discourse on the subject, and a low share personally know someone who is transgender.

For advocates for trans children and adults, the rhetoric and misinformation from the GOP camp add to the chorus of hostility from more than a dozen states that have enacted laws limiting the care parents and caregivers can get. offer trans children. The policies led the Human Rights Campaign, the nation’s largest LGBTQ+ civil rights organization, to declare a state of emergency for LGBTQ+ Americans.

Ari Drennen, LGBTQ+ program director for Media Matters, a progressive nonprofit that studies media, said Republican candidates were toying with a base of voters who have been radicalized on the issue by conservative news outlets like Fox News and the Daily. Wire. Beneath the surface is a years-long, well-funded campaign by Christian and socially conservative groups to target LGBTQ+ rights, specifically touching on parents and the concept of parental rights.

Nikki Haley leaves after giving a speech in Arlington, Virginia in April 2023.
(Bonnie Jo Mount/The Washington Post/Getty Images)

Many Americans say they don’t know someone who is transgender or non-binary, which Drennen says has created a vulnerability to disinformation, fear, and hostile messaging. According to the Pew Research Center, approximately 1.6 percent of U.S. adults identify as trans or non-binary. Estimates of how many Americans know someone who is trans or nonbinary vary: Pew found that among the general public, 44% say they personally know someone who is trans and 20% know someone who is nonbinary. A recent survey by the non-profit PRRI narrowed the figure, saying 36 percent of Americans know someone who identifies as trans or non-binary.

This lack of knowledge creates a lot of room for misinformation to take hold, Drennen said. Most of these people are registering pretty strong opinions about who trans people are and how we deserve to live our lives and have often never met any of us they know.


The share of Republicans who say social acceptance of trans people has gone too far has risen steadily since 2020, according to an analysis by The Washington Post. Across the board, top Republicans are tapping into those strong opinions with monotone speeches that mention health care and school policies related to trans children, or general rhetoric about gender roles and sexual identity. Advocates for trans children and adults say they are doing so with disinformation and potentially harmful hostile rhetoric.

The fervor with which these comments were received by Republican rallygoers appears to have surprised at least one candidate.

It’s amazing how strongly people feel about this, Trump said during a speech over the weekend at the North Carolina state Republican convention. I talk about cutting taxes, people do that, she said, mimicking lethargic applause. I talk about transgender, everyone goes crazy. Five years ago, you didn’t know what the hell he was.

Trump said in January, just weeks after the launch of his third presidential bid, that if re-elected he would punish doctors who provide gender-affirming health care to children under 18 and use the power of federal agencies and law enforcement agencies to discontinue such assistance. He said his administration will ban any federal agency from promoting the concept of sex and gender transition to any age, including adults, and will push public schools to teach students the traditional roles of mothers and fathers.

DeSantis, seen as Trump’s strongest challenger, has leaned into the policies he passed in Florida regarding trans children. In Florida, we banned teachers from forcing students to choose pronouns, DeSantis said at his first official rally in Clive, Iowa, to applause last month. DeSantis also highlighted the ban on gender-affirming treatments for trans children.

A federal judge has temporarily blocked parts of a new Florida law that bans transgender minors from receiving puberty blockers, arguing that gender identity is real and that the ban ignores the risk to the patient. The injunction applies only to the three children named in the lawsuit.

Republicans have found some success in enlivening their grassroots on this issue by tapping into universal anxiety among parents about their children in post-pandemic America, said David Stacy, director of government affairs at the Human Rights Campaign. . People feel much less certainty about their school, their community and the challenges children face, Stacy said. If you say children are under threat, parents want to protect their children.


During a recent town hall on CNN, Pence said he will support a federal ban on gender-affirming medical care for people under the age of 18, arguing they are too young to make firm decisions about their identity and care.

Mike Pence speaks to diners at a campaign event at a restaurant in Waukee, Iowa in June 2023.

Haley, the only prominent candidate who is a woman, refined the inclusion of trans girls in women’s sports, using the hashtag #FightForOurGirls. Stacy pointed to a 2022 Utah survey of trans participation in school sports teams that found that only four children in the entire state were participating in high school sports and only one played girls’ sports.

Here’s what it is. Four kids who are just trying to find some friends and feel a part of something. Rarely has so much fear and anger been directed at so few, Republican Utah Governor Spencer Cox said when he vetoed a ban on trans youth sports participation. The state legislature overrode his veto.

A few days earlier during her CNN town hall, Haley falsely linked alarming rates of suicidal ideation among teenage girls to the inclusion of trans girls in some school locker rooms. When asked about the equally alarming rates of suicidal ideation among trans youth and nonbinary in particular, those reporting the lack of social support from the Haley family said: We give them the help, the therapy, whatever they need. so they can feel better and not be suicidal, but don’t go make all these other kids feel so pressured. Haley had said in previous interviews that she does not support some gender-affirming treatments in children under 18.

Debi Jackson, a trans rights activist in Missouri and mother of a non-binary child, said the growing attention from Republicans at the federal level was alarming. Jackson said the candidates’ comments about caring for trans children do not reflect reality for most families and lack respect for parents’ ability to make informed decisions for their children.

Jackson said he first sought medical care when his son was 4, and for years the visits were supportive and monitoring. At the time, Jackson identified as a Christian and conservative. As puberty approached, the family weighed their options and finally decided to pursue puberty blockers, an expensive treatment that took them four years to pay off.

Jackson stressed that the care her son received, and which families typically receive, was carefully developed by the World Professional Association for Transgender Health (WPATH), an international body of more than 3,000 experts, mostly medical professionals. The American Academy of Pediatrics also supports gender-affirming care.


Jackson said decisions are best left to families and experts.

I want Mike Pence and every other politician to stay out of the doctor’s office and exam rooms, Jackson said, adding that his family is planning to leave Missouri due to a new ban on trans treatments, adding to financial stress and emotional.

None of us want to talk about the stress and trauma our children are going through right now. We’d rather tell stories of trans glee. We’d rather tell stories of how families, school systems, and entire communities have embraced our children, loved our children, and supported our children.

How the eventual Republican nominee will carry the matter into the 2024 general election is an open question.

The fact that trans people exist has entered the American consciousness in the past decade like never before, said Lisa Bunker, a former New Hampshire state legislator, who said she was at a loss for words for the unease she felt as she she grappled with her gender identity as a child and teenager in the 1960s and 1970s.

Bunker recently wrote a book with a trans teenager, Kai Shappley, focusing on the joy of being a kid and the challenges Shappley faced as he tried to make his school’s cheer squad. Bunker said she hopes stories like theirs will appeal to voters who don’t immediately embrace hate.

There’s certainly information in there that will help you understand the trans experience more fully, she said. And we don’t need everyone in the country to become enthusiastic supporters of trans people, we just need enough people to decide that it’s not a scary issue and that they can just not care and let it go.

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