Thursday, April 20, 2023

Missouri’s Anti-Trans Actions and Our Continued Resistance

  It’s not as if marginalized communities ever get a break, including gender and sexual minorities. But this year continues to be an excruciating one, especially for the transgender/nonbinary/gender-expansive community. While collective indulgence in outrage, like videos of people smashing or shooting their cases of Bud Light beer, are obviously ridiculous, they also send a clear message to us. It’s not like Bud Light is suddenly a champion of trans people just because they work with a transgender influencer like Dylan Mulvaney. This is a marketing strategy, and so is the outrage. But all this outrage also tells me that, not only do these Bud Light-bashing folks hate me and oppose my wellbeing, they hate and oppose anyone that is friendly to me. They are so committed to erasing the existence of trans people that they can’t even drink a beer that is guilty by association. 

This kind of outrage, and the vigilance it requires on the part of every trans person trying to navigate the world with some measure of safety, would be more than enough to deal with. But of course there is more. This last week, trans folks in Missouri have been living in the thick of the intentional, ongoing attacks against transgender lives. On Thursday, April 13, 2023, Missouri’s Attorney General, Andrew Bailey, issued expanded emergency regulations that effectively restrict and, in many cases, make impossible life-saving, life-giving care that many transgender and gender expansive people depend on. The official justification calls it “an effort to protect children,” 
“clarifying that, because gender transition interventions are experimental and have significant side effects, state law already prohibits performing those procedures in the absence of substantial guardrails that ensure informed consent and adequate access to mental health care."
Keep this reasoning in mind, because it plays a key role in this particular strategy. It follows and uses the accusations that Jamie Reed made in February 2023 that “a pediatric gender clinic in St. Louis is ‘permanently harming’ children by rushing to prescribe puberty blockers and cross-sex hormones.” Whistleblowing is important, and transgender people deserve the best care possible. However, and importantly, Reed’s testimony appears to be part of the problem, and not the solution. Jess Jones, who worked with Reed at the center, has shared, for example, that clients “had raised ‘red flags’ about Reed.” Jones said - 
"So I really wish the center had listened to trans people …  We said: ‘This is a person who isn't safe for us.’”
But Attorney General Bailey has doubled down, insisting in his proclamation that:   
“The regulation is necessary due to the skyrocketing number of gender transition interventions, despite rising concerns in the medical community that these interventions lack clinical evidence of safety or success.”
It’s cleverly done. If you read the entire announcement, for example, you’d never know that professional medical organizations have overwhelmingly published both policy statements supporting and standards outlining gender-affirming care, including: the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry, the Endocrine Society, the American Medical Association, the American Psychological Association and the American Psychiatric Association. As I pointed out last month and as Heather Boerner wrote in Scientific American, “All of those medical societies find such care to be evidence-based and medically necessary.”

As such, the Attorney General took another step this week in opening up a website for people to report medical providers providing gender-affirming care. This has caused a lot of understandable fear and anger, leading to speculation that the state is creating a registry of transgender people. However, the website’s purpose is most likely an attempt to locate people who can support the Attorney General’s biases against transgender people. In particular, they will be looking for people who follow the de-transition narrative, like Chloe Cole and Luka Hein. We’ve already observed how anti-trans lawmakers have used Chloe and Luka’s stories to “silence all other trans voices and deny us both basic care and human rights.” The Attorney General could employ a similar tactic in the upcoming legal defense of the emergency declaration. This is the most likely goal for the website portal: they are fishing for people with stories that they can weaponize against transgender people.
        So, at least for now, the Attorney General is focusing on and asking for people to report on medical providers. This does directly impact any trans or gender expansive person seeking medical care related to their gender identity/transition, but it does not mean (at this time) that the Attorney General is targeting trans people directly. At present, we are not at risk for being reported and/or arrested for being trans, but we are at risk at losing our medical care and care providers. 
        This is key: the Attorney General is seeking to destabilize the trans community through robbing us of our medical care providers. 
        This is especially cruel for two reasons. These providers are often a backbone in our communities. We crowdsource trustworthy providers. Those whom we trust with our care become a vital part of our networks and communities. We love and recommend many of them; they are family. So, in one stroke, the Attorney General is attempting to rob us of our medical, life-giving, and life-saving care AND cause division in our family. It puts medical providers in the difficult, almost impossible, position of having to decide if they risk the wellbeing of the transgender people under their care (by conforming to the emergency declaration) or risk their own career and medical license (by resisting the emergency declaration and continuing to provide gender-affirming care). 
        These purposeful actions are cruel to both our transgender community and our medical providers. 
But we have also been preparing for this attack for some time. From the very beginning of his time in office, Bailey has acted in ways that seem aimed at harnessing outrage related to transgender people. Please keep in mind that this is a long-term strategy that does not rely on the success of the emergency declaration, but on mobilizing outrage (at the expense of everyone who isn’t cisgender), the bigotry he is enabling, and the ways he is able to use this harm to empower political ambition. 
        This, of course, is part of a coordinated attack on trans lives, both in Missouri and around the nation. Powerful people are watching what is happening in states like Missouri to inform their own strategies against the transgender community. Please understand that these policies, emergency declarations, and legislation are being copied and pasted, and also adapted based on results, by governments in multiple states. 
        This means that this moment is a very tender time for many transgender people, especially in places like Missouri. I have spent a lot of time during this last week providing pastoral care. There is so much desperation, with lots of understandable and practical fear and grief. People are dealing with the shock, and it's really important that as a community we feel care and support right now to make it through this desperate moment. Suicidal ideation is high, along with fear of losing medical care, confusion over what needs to be done, frantic contact with care providers, and scrambling to relocate in another, safe state. It is especially crucial that we survive these next weeks, because the uncertainty is so high. I am reminded of Laverne Cox’s words from last January, when she reflected on a proposed bill in Oklahoma that sought to outlaw gender-affirming care, in words that also applies to Missouri’s situation now:  
“I'm exhausted and trans people are exhausted. … For years, we've been hearing from anti trans pundits and politicians that this is about protecting the children … . But I think what this Oklahoma law reveals is that it's never been about the children. It's always been about scapegoating trans people, stigmatizing us and criminalizing our existence, making us not exist.” 
         So, please remember all of us transgender and gender-expansive folks living in places like Missouri in your in your heart, your words, and your actions. Being trans (being anything other than a white, straight, cisgender, temporarily able-bodied, financial stable, Christian person) in Missouri is tough. We have weathered worse than this attack, but we are tired and this is still going to be a tough journey to protect trans lives and transform hearts and minds.
We have spent a week helping each other manage grief, rage, confusion, and suicidal ideation. We have spent a week managing pop-up clinics to expedite care for people getting that care established before the new restrictions go into effect on April 27. We have spent a week helping each other pursue options for accessing care through mail-order prescription services and out-of-state clinics. We have spent a week helping each other explore options for moving to other states. We have spent a week communicating with our medical care providers and watching as they make decisions that weigh their careers with our care. We have spent a week. 
        We are supporting each other and doing an amazing job of it. We are not giving up or backing down. 

        But we can use and need all the community support we can get right now. Please do not stand idly. Donate to organizations like ACLU-MO and Lambda Legal, who are spearheading the legal activities to oppose the Attorney General’s emergency declaration. Donate to support organizations that provide much needed medical care, mental healthcare, direct assistance, and social support. Volunteer at your local lgbtqia+ center or clinic. Listen to trans voices and reach out to your transgender and gender expansive friends. Be there with them if they need to talk, or if they need company and be quiet, and do your best to help them in whatever ways they request. Go to protests and lobby days. Contact your political representatives. Confront family, friends, and co-workers who spread lies and disinformation about transgender folks. Do whatever you are able to do. We need each other, both for our wellbeing now and for our future wellbeing. These are crucial moments when we decide what kind of community, nation, and world we are willing to live in. Please help us make it a world where everyone can be and feel safe, happy, and free.