IRA FLATOW: This is Science Friday, I’m Ira Flatow.

So far in 2021, state legislatures in more than 30 states have introduced more than 100 bills legislating the bodies and choices of transgender people. Many of these bills target youth, their ability to play sports in grade school or college. Many others target their access to medical care, whether that’s hormones that help them transition or puberty blockers, which pause puberty until a child is ready to decide what they want to do next.

Earlier this month, Arkansas was the first state to pass such a bill. The Republican state legislators behind this bill said it was necessary to protect children from what they called, quote, “experimental treatments.” But bills like Arkansas’ have been opposed by many experts in medical care, including the Pediatric Endocrine Society, the American Academy of Pediatrics, and the World Professional Association for Transgender Health. And in hearings prior to the bill’s passage, trans adults, parents of trans youth, and medical providers all argued that this restriction would harm kids. Here’s a small sample of what that bill’s opponents had to say in one state legislative committee hearing in Arkansas in March.

SPEAKER 1: I very strongly oppose this bill. It not only creates many problems including further marginalizing an already marginalized population, but it pretends to fix a problem that doesn’t even actually exist. If this bill passes, people will die.

SPEAKER 2: We, as pediatricians, are truly dedicating our lives to keeping children healthy and safe. And this is why I feel that, alongside parents, we are most qualified to determine the best course of care for our patients.

SPEAKER 3: I just can’t go on enough about them. They’re just amazing kids, OK? And they know who they are, and they know who they are from a very young age.

SPEAKER 4: Let me first speak directly to Arkansas’s transgender youth with the love of a real father. You are loved. No matter what happens here today, you are loved.

IRA FLATOW: With me to talk about this is Kate Sosin. Kate is the LGBTQ reporter for The 19th News and one of the few trans reporters covering these bills. Welcome, Kate.

KATE SOSIN: Thank you for having me, Ira.

IRA FLATOW: Nice to have you. First of all, can you walk us through this Arkansas bill? What exactly is it saying?

KATE SOSIN: Yeah. The Arkansas bill is like a lot of these bills that limit gender affirming care for trans youth in that it basically says that a trans kids are not allowed to access– or their physicians are not allowed to give them the kinds of care that most medical associations have agreed trans kids would need in order to navigate puberty.

So most commonly, if you’re a trans kid and you’re experiencing gender dysphoria, a lot of times, they’ll tell trans kids, OK, you want to go on puberty blockers. And puberty blockers are these entirely reversible medications where they can just press a pause on puberty and decide later when they’re older with their physicians or parents if they want to medically transition. So a kid who’s trans won’t have extreme mental duress of going through puberty in a gender that they don’t identify, and these have been shown to reduce suicidality in trans kids.

A lot of media have reported that this is actually preventing kids from medically transitioning with hormones. That’s actually a lot rarer than what we see. For the most part, it is puberty blockers, which just press pause so that kids don’t have to make that decision right away so that their parents don’t have to.

IRA FLATOW: And what is the legislators’ argument for doing this?

KATE SOSIN: It seems to be that there’s some confusion between what a puberty blocker does and what hormones do. A lot of people who don’t understand trans health care think that puberty blockers and hormones are the same thing, that this is an irreversible change that you’re transitioning children and making irreversible decisions about their sex and gender at a really young age. Puberty blockers are actually meant to do the opposite, to give kids some breathing room to figure things out, and also to just relieve some of the mental stress of experiencing bodily changes at a time when they’re really not ready.

IRA FLATOW: Is there any scientific research that the legislators point to to justify these restrictions?

KATE SOSIN: Yes, although for the most part, that scientific research is not backed up by major medical associations. They often bring out a doctor here or there, but those physicians have largely been debunked. The science pretty much has settled on this care for transgender youth, the American Medical Association, pretty much every major medical group and psychiatric group is in line with this kind of treatment for trans kids.

IRA FLATOW: As I mentioned, the Arkansas bill is one of more than 100 related to trans rights this year. It’s the first one to pass. Can you talk about a few more of the bills relating specifically to medical care?

KATE SOSIN: So Alabama has a similar bill and that would make it a felony for doctors to provide this kind of care. Texas also has a bill which would classify it as child abuse for parents to allow their kids to access this kind of care. Tennessee also has a similar bill that classifies this kind of care as child abuse unless three physicians sign off on it. Louisiana, South Carolina, and Missouri also are still considering bills like this. A number of other states also have these bills pending, but we haven’t seen a lot of movement on this.

These kinds of bills are not just limited to trans kids necessarily. We’ve seen all kinds of medical restrictions for transgender people more largely, right? Bills that would allow physicians to turn transgender people away on the basis of what are classified as “conscience protections,” so if a trans person went into an emergency room and a doctor didn’t want to treat them if they had an ethical or religious objection, they could turn people away.

IRA FLATOW: And what about the insurance companies? Are they able to fund these procedures, these medications if the kids want them?

KATE SOSIN: This is a really interesting question because we do have the Affordable Care Act and transgender people were supposed to be protected under the Affordable Care Act. The Trump administration, of course, really made significant moves to removing those protections for transgender people. And then we have the Biden administration coming in to enforce protections in the Affordable Care Act for trans people.

And now states are going after those protections in a piecemeal way, so we’re going to have a battle to see how that turns out. But yes, we do have these bills. We have a bill in Texas that tries to ban coverage for trans kids.

And so I think what we’re inevitably going to see is court battles over some of this care, and it’s going to boil down to what is legal in terms of what you limit. What are the rights of transgender minors and what human rights do transgender kids have, and what are insurance companies required to cover on the basis of that?

Because the Affordable Care Act was a watershed for transgender people. It stated that insurance companies had to cover health care for trans people as medically necessary care. That was deeply important for trans people. It opened up access for trans people in ways that had never been possible before.

IRA FLATOW: You bring up different administrations. I can’t help think that there’s politics involved here.

KATE SOSIN: There have been a lot of questions about why this is happening and why it’s happening all at once. After the advent of marriage equality in 2015, there was a shift in focus from mainstream gay issues to transgender rights, both from progressives who wanted to see transgender issues taken up, and also from opponents of LGBTQ rights. And after that time, we saw a lot of focus on bathroom bills, and then it got to kids.

And the idea of protecting children is so close to our hearts. All of us want to protect kids. And it seems that at the heart of this is this idea that we want to protect kids, but we want to protect them from being transgender. That is because pop culture has made the idea of being trans so terrifying, if you look at the media that we’ve consumed for all of our lifetimes. But as a transgender person, I know that being trans is a wonderful life, and that the thing that makes it actually terrifying is people legislating away your ability to move throughout the world.

There’s been a lot of polling that suggests that actually, these bills are not particularly popular with Republican voters. A new poll came out from NewsHour that said actually that 50% of people knew transgender people, and that was about the number of conservatives who supported transgender people playing sports, which shows that if you know a trans person, it’s hard for you to oppose transgender rights.

And there’s also this issue of we have a 6-3 conservative Supreme Court. Whether or not these bills are going to pass muster in a lower court certainly is a question. But if one of these bills gets elevated to the Supreme Court, then there’s a real question of changing the law of the land here.

IRA FLATOW: I know we’ll be talking to clinicians who work with transgender kids in our next segment, but while I still have you, I’d like to ask what misconceptions do you see people have about care for trans kids that might be fueling these bills?

KATE SOSIN: These bills are founded on the idea that being trans is some kind of mental illness, or some kind of problem that needs correcting, or is a life of pain. And the reality is that this is not something that you need to try to avoid or fix for a kid. The only problem with being trans is the way that the world treats you. This medical care is medically necessary. We have legislators who are trying to legislate away science. This has been settled science for years now.

There’s one other thing that’s been hidden in all of this, which is there’s been a lot of talk about these bills and their impact on kids. Even when they don’t pass, we’re sending a message to kids, you’re not welcome in your states. But I did a story last week that reported that transgender homicides in the last year have doubled. At this time last year, we had six trans homicides reported.

And last year, by the way, was the highest number of trans homicides we’d ever seen by far, 44 trans homicides when the record had been 29 before. And this year, we have 14 in April, whereas at this point last year, we had 6.

And I asked advocates, I said, do these bills matter at all? Are they doing anything? And across the board, from advocates to black trans women who are targeted at the highest level, they said yes. They said, this stigma is sending a message that the government doesn’t like these people, so why should I care? The government says that we’re less than human, so it’s fine if we dispose of them.

That is a story that’s not being told. These bills, it’s not just about children, right? There’s an impact on trans adults. The stigma is fueling a crisis across the community that is not just about mental health access. But it’s also about the violence that the community faces.

IRA FLATOW: I want to thank you, Kate, for taking time to be with us and enlightening us about what’s going on here.

KATE SOSIN: Thank you so much for having me.

IRA FLATOW: You’re welcome. Kate Sosin, LGBTQ reporter for 19th News. Kate joined us from Los Angeles.

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