Trans Adults Are the Next Target in the GOP’s War on Gender-Affirming Health Care

“It’s so disheartening to know that, even if we came out almost 50 to one, these legislators are still going to vote on party lines,” he tells Them. “The goal here is trans erasure. When I say that statement, it sounds extreme, but I really don’t think it is. I think we’re being realistic. The folks who filed these bills do not want trans people living in their states, and if they’re going to be in their states, they don’t want them to be able to thrive. That’s the end goal.”

Some GOP leaders have admitted openly that their ultimate intention is to ban all forms of trans medical care for both adults and children. In a January 26 Twitter Spaces conversation with fellow legislators from both Michigan and Ohio, Michigan state Rep. Josh Schriver (R) argued that adults should not be allowed to consent to gender-affirming care, comparing consenting to gender-affirming treatments to consenting to “self-mutilation.” “If we are going to stop this for anyone under 18, why not apply it for anyone over 18?” he asked. “It’s harmful across the board, and that’s something we need to take into consideration in terms of the endgame.” Participants in the discussion included Ohio state Rep. Gary Click (R), who sponsored the trans youth care ban recently enacted over DeWine’s veto. “That’s a very smart thought there,” Click said in response. “I think what we know legislatively is we have to take small bites.”

But even as Republicans increasingly push to ban transitioning for everyone, trans adult health care still remains widely available. To date, just one state followed through on restricting gender-affirming treatments for adults: Florida, which enacted strict regulations on telehealth and nurse practitioner care in May 2022. In contrast, a March 2023 order that would have made Missouri the first state to ever limit trans adult medicine was eventually terminated following the threat of a lawsuit. The emergency rules issued by its attorney general, Andrew Bailey, mandated 26 criteria that Missourans would have to meet before receiving gender-affirming treatment; those steps included 18 months of therapy and a consistent diagnosis of gender dysphoria for three years. If left in place, opponents said at the time that the draconian policy would have ended virtually all transition care in the state.

And even in affected states, advocacy groups have continued to do what it takes to ensure all trans people are able to get the health care they need, including adults. TransOhio is partnering with Elevated Access, a volunteer-led helicopter service that will fly patients to another state to access treatment, to ensure that anyone affected by the new regulations remains in care. The organization also operates a hotline for emotional support and offers emergency funds for those who need to leave Ohio for their medical needs. Strive, a trans support group based in northwest Florida, has been helping its members to find doctors over the state lines in Alabama or Georgia.

Strive’s president, Devin Cole, says Florida’s telehealth regulations have resulted in long wait times at the clinics that have been able to keep seeing patients, but the community has remained resilient, turning to each other during a time of immense need. “When you take somebody who needs medical help and you don’t provide them that help, it damages their will to live,” Cole tells Them. “It’s leaving people in a place of feeling helpless and hopeless. I come home and sit in the darkness of my bedroom to take it all in because there is a side that is very grim, but the important thing is that we’re not going to give up. Transgender people have always existed and will always exist. This is another fight in the struggle for our liberation and freedom.”

Trans Legislation Tracker provided research and data support for this story.

Get the best of what’s queer. Sign up for Them’s weekly newsletter here.