State legislatures have significantly advanced a record number of attacks aimed at restricting LGBTQ+ rights this year. Our guest this week points out that “the number one priority, without any ambiguity” of Republicans has been attacking trans people. Nearly half of the country could see health care bans for trans adolescents by May. This tidal wave of anti-trans legislation, which restricts gender affirming and medically necessary care, continues to have wide-ranging and deleterious impacts, especially on adolescents. Chase Strangio, who is transgender, is deputy director for Transgender Justice with the ACLU’s LGBT and HIV Project and a nationally recognized expert on trans rights. Strangio joins WITHpod to discuss how politics has eclipsed healthcare in some cases, anti-transgender legislation being used as a gateway to broader government control and why conversations about trans people is often predicated on fear and confusion. He also talks about the ongoing political and legislative fights to protect bodily autonomy, gender expression and personal freedom.
Note: This is a rough transcript — please excuse any typos.
Chase Strangio: Trans people present this deeply troubling set of freedoms when people need and want order because, at the end of the day, we also represent this possibility that you can’t figure certain things out just by looking at someone’s body. And that is so troubling to people, and right now especially, as they feel the world changing around them.
I think it’s beautiful and amazing and incredibly liberatory to say, you know what, the world is telling me all these things, my parents are telling me all these things, my school is telling me all these things, but I know something deeper about who I am and how I want to manifest that in my body.
Chris Hayes: Hello. And welcome to “Why Is This Happening?” with me, your host, Chris Hayes.
So I’m speaking to you in April of 2023. And last week the Kentucky governor, Beshear, a Democrat, tried to veto this legislation that would ban gender-affirming care for young people in the state of Kentucky along with all kinds of other stuff about discussions of sexuality and gender in school; and requiring schools to notify parents about changes in pronouns that do not conform to the student’s biological sex; and require, like, a plan for de-transitioning for certain youth who are under gender-affirming care. A huge slew of, like, really, really draconian, aggressive and brutal restrictions on trans youth care and trans people’s lives.
And that piece of legislation which was vetoed by the governor was overridden, large majorities of the Republican Houses in Kentucky, it was signed and enacted into law.
And there’s this website you can go to. It’s run just by two volunteers who put together this great website called tracktranslegislation.com. And if I go there right now and I just pull up, and you can sort by state, by bill type, and whether it’s signed or enacted. If I just pull up signed and enacted, I get 16 different pieces of legislation, signed and enacted, going after trans people in one way or another in just March of 2023.
In March of 2023, in the last few weeks, Kentucky, Idaho, Georgia, Utah, Tennessee, Wyoming, have all passed, signed and enacted laws that outlaw drag performance, that restrict bathroom access, that restrict youth participation in athletics for trans folks, trans health care.
I mean, this has been the number one priority, I think it’s fair to say. Republican state legislators around the country, keep in mind these Republican legislators, you know, their sessions started let’s say in January. So the first thing they did more or less in a lot of these states, we’re three months in, is go after trans youth sports participation; the bathrooms that trans folks can and can’t use; drag performance; and, most crucially, trans health care.
This is a four-alarm fire. It is a complete crisis. And I think it’s an outrage, and it’s despicable. And it’s an insult to the full dignity that equal citizens in our great nation are entitled to. Whatever their lives are; whatever their gender status is; whatever their sexual preference, race, creed religion, right, it’s an offense against the basic pluralistic values that I hold dear, and I hope we all hold dear (ph).
And so, I wanted to talk to someone who’s in the trenches fighting against this ceaseless onslaught.
My guest today is Chase Strangio. Chase is a Deputy Director for Transgender Justice with ACLU’s LGBT and HIV Project. Chase is a lawyer, trans rights activist, has been on WITHpod before, actually. And when we spoke before, things were better than they are now. And it’s a really alarming realization, when you follow an issue, to watch it moving in reverse. But I can’t think of anyone I’d rather walk through all this with than Chase Strangio.
Welcome to the program.
Chase Strangio: Thanks so much for having me, Chris.
Chris Hayes: You sort of life and breathe this. Like, your work is litigating, right, on behalf of trans folks across states. Like, I guess I’d start with, like, level setting of where things are right now for trans rights, trans legal protections in America in 2023.
Chase Strangio: Yeah. So I mean, I live and breathe this in sort of every way. I litigate cases on behalf of trans litigants. I lobby in-state legislatures over the anti-trans bills that we’re seeing around the country. And then I live as a trans person with communities of trans people. So on every level, I feel like I’m sort of taking in the realities of what’s happening to trans communities at this moment.
I would say that in the legislative context, we are at a catastrophic point in terms what we’re seeing: the volume of bills attacking the community, the subject of the bills attacking the community, and the pace at which their moving through state legislatures and being enacted into law.
So on that side, in terms of happening at the states, absolute catastrophe, worst it’s been in the, you know, eight legislative sessions that this has been slowly escalating.
On the litigation front, in terms of how we are faring in court in the current legal landscape with respect to litigation, we’re sort of on the precipice of potential catastrophe but, so far, are holding on and sort of bracing for, I think, what I think we could imagine being a sort of Dobbs-like future for trans rights. Whereas now we’re still holding on in the lower courts.
Chris Hayes: I want to talk about both of those things. But I also want to just take a step back.
When you said eight years, or eight sessions, that’s interesting to me, because it seems to have gotten worse. I mean, I think it is worse. And by any empirical metric in terms of, like, anti-trans legislation or what states are trying to do, clearly there is a very ferocious, intense and pointed backlash, right, which was not necessarily there in the same way even five years ago.
If you were to, sort of, try to catch someone up on, like, what has happened over the last eight years, why are we in the arc we’re in, why are we here now, how would you explain that trajectory?
Chase Strangio: Yeah, so I say eight years because that would have been the 2016 legislative sessions. And the 26 (ph) legislative sessions in the states were the sessions that immediately followed the Supreme Court’s decision on Obergefell v. Hodges striking down bans on marriage equality. So that was when we saw this contemporary set of legislative attacks on trans people in the form of the anti-trans bathroom bills and the emergence of the rhetoric around trans people as a threat to cis people, to safety, to privacy.
And if, you know, we sort of brought ourselves back to 2016, we were sort of having a similar conversation then which was, why is this happening right now? What’s going on? What’s this fixation on trans people? And it very much was a response to the Obergefell decision from the Supreme Court. And then this fixation on trans people because the right, particularly the Christian right, needed somewhere to go after they lost marriage equality.
From 2016 to the present, there was sort of a spike and then a dip in terms of what was happening during, actually, the Trump administration because the states sort of took a back seat in attacks on trans people while they had allies at the federal government.
During his presidency from 2016 to 2020, President Trump, with the exception of, you know, Sessions doing some horrible things to trans people, the military ban, Trump wasn’t fixated on trans people. He is now, and we can get to that, but he —
Chris Hayes: Right.
Chase Strangio: — wasn’t then. And so, what we had was sort of a moment of calm.
Around 2019, this starts to pick up. It picks up in the anticipation of the 2020 elections, and then, of course, in the response to Biden taking office, and to the Supreme Court’s positive decision for LGBTQ people in the Bostock cases (ph) holding that LGBTQ people are protected under Title VII of the Civil Rights Act.
Now have a new series of backlashes that are sort of picking up on those marriage backlashes.
Chris Hayes: Hmm.
Chase Strangio: And this becomes a real fixation point for the right in state legislatures, increasingly from 2021 to 2023.
And now I actually think, and I am a deeply pessimistic person, that we are at a state that is so far worse than I could have anticipated, even two years ago when it was bad. And that’s a product of a lot of different factors, one of which is the inability of many people to take seriously the writing on the wall about the types of attacks that trans people were facing leading up to this moment.
Chris Hayes: You used the word, which I think is useful for this discussion, fixated, that Trump was not fixated on trans people. And I think that’s (ph) I would agree with that as someone who covered him quite closely.
He had other fixations.
Chase Strangio: Yes.
Chris Hayes: You know?
Chase Strangio: He did.
(LAUGHTER)
Chris Hayes: But that was not one of them. But fixated seems a really useful word here. There is an obsessive, a compulsive obsessive session with trans people, trans bodies, with trans health care, with trans youth and trans adults. And then drag performance as well, which sort of is another example of deconstruction of the gender binary, you know. Why? I mean, I know why, and we’ll talk about why.
But the why, now, to me, I mean, the theory I’m hearing from you or what you’re talking about is basically the following sort of post-marriage equality looking for a place to go, right, with that sort of, like, anger, with that defense of what they view as traditional, you know, gender roles, and traditional marriage, all that stuff.
So you go after trans people, because that’s going to be the next front, sort of ratcheting down when Trump was in power because you’re not in this oppositional stance, and then in, sort of, preparation of losing power and sort of going (ph), but there is something going on here that is, even for me as an observer, it’s just like, I remember a campaign dispatch in Michigan on the eve of the midterms, and it was like the whole state candidate slate, right. It was like all of the candidates who were running statewide. And the big guest speaker was a woman who was mad about trans swimmers in sports. OK?
And I just thought to myself, like, I hope I’m right about this. And I turned out to be right about this but, thank God, it was like, who cares? Like, I mean, whatever. Even if you don’t have particularly progressive values or whatever, like, this is the big thing facing Michigan voters? This is your closer to go talk to the people of Michigan?
And it’s like, it turned out that that was not a great closing message. But how do you understand the obsession?
Chase Strangio: Yeah, and it wasn’t a great closing message. And if you look at the election results, Michigan being a perfect example, you would think this is entirely not strategic. And yet starting in January of 2023, we go into every single —
Chris Hayes: Yeah.
Chase Strangio: — Republican-controlled state legislature, and the number one priority without any ambiguity is attacking trans people. It’s unbelievable. It’s the first bill filed in Tennessee. Oklahoma has 21 bills just on gender-affirming health care. Like, for a week they did nothing but this. And you know, every single state, this is what we’re seeing.
Half the country is going to ban health care for trans adolescents by May. And so —
Chris Hayes: Jesus Christ.
Chase Strangio: — even though it is not in any way politically strategic, and you can go back to 2016, when, you know, Governor McCrory lost in North Carolina —
Chris Hayes: Yes.
Chase Strangio: — this has actually always been true.
Chris Hayes: Yeah.
Chase Strangio: And yet they come back each time, and it is absolutely a fixation.
Chris Hayes: Well, part of my point is that, like, one way you could view this, right, is like, oh, well, this is cynically good politics, right?
But I don’t even think it is cynically good politics. I mean, it’s probably good politics in Oklahoma. But like, I don’t even actually think it is good politics. I think it’s genuine. Like, I think they genuinely hate trans people, don’t want trans people to exist and are trying to use the force of the state to bring that about.
Like, I don’t think it’s, like, artifice. I don’t think it’s cynicism. I think there’s a lot of people on the American right who view trans people as like a kind of existential threat to gender hierarchy and the gender system and don’t want trans people to be around.
Chase Strangio: I mean, there are sort of like three things that I would want to saying response, which I do think there’s a way in which they’re sort of modeling this after the early 2000s, putting same-sex marriage on the ballot.
Chris Hayes: Yes. Right, yeah.
Chase Strangio: But the difference there was same-sex marriage was quite literally on the ballot because they put constitutional amendments on the ballot so people could go in and lodge their objection to same-sex marriage, literally with their vote because they put it on the ballot to drive out voters. And I think they’re trying to do that here.
It’s a little bit different when you’re just sort of voting for candidates, and they sort of abstractly represent hatred of trans people. But, when you’re sitting there, they’re just a person. And I don’t know if it’s going to translate in 2024 to that same result in voter turnout that it did in the early 2000s with the same-sex marriage. I just don’t know.
I think, to your point about why the fixation, there’s sort of two things, I think. There’s the big structural government point about, it is true that, throughout history, attacking trans people has been a gateway to some of the most far-right and extreme fascist governments that we’ve seen, in part, because, if you erode this level of bodily autonomy to the point to where you can posit someone as so deviant and destructive that the state has the authority to prevent them from existing and you start with a group of people that is widely misunderstood, that becomes a gateway to other things. And I think there’s that.
I also happen to think that in a time of great just anxiety in the world that trans people represent a type of freedom that is deeply disconcerting to people. Like, the one thing people think they know about the world is, like, you’re born a boy or a girl —
Chris Hayes: Yes.
Chase Strangio: — and that is like comforting with that restriction. And we’re just like blowing it up, and people are troubled by that.
Chris Hayes: OK. Let’s stay on this because I think —
Chase Strangio: Yes.
Chris Hayes: — this is actually important, because I want to, like, take these, I want to brook no quarter to the assault on trans folks and their lives, but I also want to take seriously, like, the substrate of the politics that’s generating this.
And what I feel like is, like I read Judith Butler as an undergrad, right. And Judith Butler is a gender theorist. That was the first time that I encountered the notion that, like, you know, gender is performance, that gender is something distinct from biological sex, and these are two distinct things. And that was like a pretty radical idea. Like, I definitely didn’t encounter that earlier. It was, you know, these are all the same thing. You were a boy or a girl. You were a man or a woman.
And I understood, like, queerness. I understood gayness as something in terms of people’s sexual preference, but the notion of, like, unhooking those two things, right, there’s sort of biological sex, there’s gender, is pretty radical.
I think it’s great and liberatorialy (ph) radical. But like, it is actually radical, right, like, I think, in an amazing way, in an amazing, generative, beautiful way.
But like, the reaction to it is because, to your point, like, it is a level of freedom where it’s a vision of the world free of a fundamental set of, like, very strict categories people are taught from the second they come to the Earth.
Chase Strangio: I mean, and actually I think transness takes it a step further than that, because it’s not just about gender as we understand it in terms of these things that we think of as performative or expressive. The reality is, is transness, and so does, you know, the realities of intersex people, complicates our notion of the body altogether.
And so, I think, for example, biological sex as a construct, as a legal construct, it emerges in 2016, in the North Carolina bathroom bill. We don’t have biological sex as a concept in the law. It comes into being because people are so anxious about the idea that our bodies are more complicated than we thought they were.
And so, this emerges as a way to distinguish the trans body from the sort of truly biological male or biological female. But the reality is these are already contingent categories, and we assign meaning to them in various contexts. And we can see this shifting over time.
Trans people present this deeply troubling set of freedoms when people need and want order because, at the end of the day, we also represent this possibility that you can’t figure certain things out just by looking at someone’s body. And that is —
Chris Hayes: Right.
Chase Strangio: — so troubling to people —
Chris Hayes: Right.
Chase Strangio: — and at (ph) right now especially as they feel the world changing around them. I think it’s beautiful and amazing and incredibly liberatory to say, you know what, the world is telling me all these things, my parents are telling me all these things, my school is telling me all these things, but I know something deeper about who I am and how I want to manifest that in my body.
And so, it’s sort of like, you know, in the gender theory realities, it’s sort of Anne Fausto-Sterling’s, you know —
Chris Hayes: Right.
Chase Strangio: — way of sort of saying that the body itself is sexed through cultural and other legal social contexts. And this is really upsetting to people.
Chris Hayes: Yeah. Anne Fausto-Sterling wrote an incredible book called “Sexing the Body: Gender Politics and the Construction of Sexuality” that was published in the late 1990s. 2000 or so, I think, was when I read it. She was actually, I believe, at Brown University when I was there maybe.
And she talks about the idea that, like, there’s a neat biological division, and then there’s like the complexity of gender as performance. Like, her point is like actually the biological division is nowhere near as neat as we’ve been told, that there’s actually like sex surgery performed on newborns all the time because they don’t have sex organs that adhere to the neat binary, and that we just come in and intervene because the binary sort of orders the science, right. That the natural world is actually more complicated than the kind of, like, conception of it. It’s an amazing book people should check out.
But it’s also like, that sort of radical promise, the other thing I just want to add to that just for listeners is, like, I also want to make it clear like this is not new, right, that, like, there are trans people all over the world. Throughout history there are, you know, all sorts of cultures that have, like, institutionalized cultural roles for folks that are trans. There are Hijras in India. You know, like, the idea that, like, basically the liberals got too much power and they made everyone trans, which is basically the argument, I think, on the right, is just like not also historically true.
Chase Strangio: Yes. I mean, they’ve turned it into a verb, if you listen. Like if you listen to, you know, a lot of the rhetoric right now around affirming youth in schools, using pronouns that match who someone is in schools, what we’re hearing from the right and now from lawmakers is, you know, schools are transing children or transitioning children, as if this is an act that’s being done as part of some big project to create a mass of trans people that it is totally and completely unclear to me why or how this would be happening, but this is actually a huge, driving force behind a lot of the anti-trans legislation that we’re seeing, this produced anxiety through the repetition, from largely media personalities, that there are too many trans people, that people are becoming trans by virtue of some sort of social contagion, that this —
Chris Hayes: Yes.
Chase Strangio: — contagion is happening in schools or online in a variety of ways.
Of course, this in no way accounts for the difficulty of actually living in the world as a trans person, accessing any medical care as a trans person, going and finding any affirmation as a trans person.
It’s so incredibly counterfactual. And yet, because we hear it over and over and over again, people start to think, God, there’s really a problem. There’s just like all these trans people appearing out of nowhere. The schools must be making them trans. The Internet must be making them trans, rather than we have always been here. And like, how beautiful, if there’s a modicum of increased acceptance such that people feel slightly more comfortable coming out and being who they are.
And the response has just been this absolute assault in trying to say there’s too many of us.
Chris Hayes: Right. So, the too many of us really gets at something, because I think that anxiety is being manifested in mainstream coverage, not just, you know, there’s this sort of right-wing coverage, which is like, these people are destroying, you know, really vile, like almost sort of genocidal talk, right, about sort of getting rid of, or frankly genocidal talk about —
Chase Strangio: Yes.
Chris Hayes: — getting rid of transness, right? Then there’s a lot of mainstream coverage, which there are two issues I want to get to with that, because I do think it’s like part of the cycle that’s driving this, right.
So one is just, like, focus. Like, my feeling about this, and my job is to, like, publicly communicate for a living, so I think a lot about persuasion, publicly communicating. Like, there’s sort of different categories, right?
And so, there’s folks who are going to be allies. And then there’s some persuadable group of people that maybe aren’t going to be allies affirmatively, but I do think are reachable on a, like who cares, like —
Chase Strangio: Yeah.
Chris Hayes: — live your life. Let them live their lives. Like, you don’t have to obsess. Like, everyone, just do your thing. Like, it’s too —
Chase Strangio: It’s fine. It’s fine. It’s not —
Chris Hayes: It’s fine.
Chase Strangio: — affecting you. Like —
Chris Hayes: It’s fine, exactly.
Chase Strangio: Yeah.
Chris Hayes: It’s fine. And I actually think that’s actually, in the context of American politics and rhetoric, it’s not like the progressive view, right, which is like, this is beautiful, liberatory support, you know, but it is actually, I think, pretty effective.
And I think this obsession, what you’re talking about, there are too many trans people, is absolutely either the explicit or implicit premise of much of the coverage. What is going on?
Now, it does seem to me that, like, there probably is more in certain circles adjacent to people who live in like very liberal metropolitan communities among folks with like-minded credentials that there is more trans acceptance. There are probably more high schoolers coming home and asking for different pronouns. I think that’s almost certainly empirically true.
And I think, to me, the question, and I’d love to hear you talk about this is like, A, so what? But, B, like, do you think there’s anything to the social contagion idea? Like, not obviously in places like Alabama, Mississippi, whatever. In certain communities, like, and does it matter if there is something to it?
Chase Strangio: Well, I mean, so one of the things that troubles me about all of the social contagion discourse is, as someone who grew up in the ’90s when there was nowhere to find anything, I had —
Chris Hayes: Yeah, right.
Chase Strangio: — like no idea that there were trans people —
Chris Hayes: Right.
Chase Strangio: — or it was a thing. So, you know, I remember on dial-up Internet trying to find examples of queerness in anything. And there was like, you know, desperate to see, like is there anyone like me and is there a way to find them?
And so, this idea that we go to people like us to become someone we’re not instead of to find solidarity —
Chris Hayes: Right. Right.
Chase Strangio: — with who we already are. And especially for those of who are, you know, I’m 40, my age and older, we’re like, oh my God, like, yes. You know what my life looks like now? It’s a lot of trans people and queer people because I also spent much of my life not having that.
Chris Hayes: Right. Right.
Chase Strangio: And it was awful.
And I’ve said this before, but the literal only trans-masculine person I knew of for a long time was Brandon Teena, who was murdered.
Chris Hayes: Yes.
Chase Strangio: That was it for me, you know. And I think that what I want for kids is to be able to go to school or online and say, wow, like, there are more people and there’s more options for being. And yes, do we find out things about what’s possible by these set of available options?
Chris Hayes: Yes.
Chase Strangio: Yes.
Chris Hayes: Right. Yeah, right —
Chase Strangio: Like, of course we do. And the idea that the only social contagion is one towards, like, transness and queerness when we live immersed in a sea of compulsory and obsessive heteronormativity and cisness is ridiculous. Like, we all spend our lives, like, I am a trans advocate —
Chris Hayes: Right, right.
Chase Strangio: — like, and everywhere I go is, somehow, I’m like a big red flag of transness. Every time I talk about having a child, they’re like, boy or girl?
So, even in the conversation with me, it’s not changing how we —
Chris Hayes: Right. Right, of course.
Chase Strangio: — you know? It’s so —
Chris Hayes: It’s the foundational binary of —
Chase Strangio: Yes.
Chris Hayes: — all of society.
Chase Strangio: It’s like there is a strong compulsion and contagion towards heterosexuality and cisness. The idea that in some places there’s some circles of people who are finding their way towards something else is, should be, that is a normal reaction —
Chris Hayes: Right.
Chase Strangio: — to existing in the world.
Chris Hayes: Yes, and I think, again, that the unescapable thing, which I think is a little bit of what’s insidious about some of the mainstream coverage is people not copping to the nested implicit, the unarticulated implicit thing, which is like this is not natural, right.
Chase Strangio: Yes.
Chris Hayes: Like, that is the thing. That’s the thing that (inaudible) and people, I think, in certain, obviously, in the right, people come out and say, this is not natural, this is abomination.
Chase Strangio: Yes.
Chris Hayes: People who have discomfort, who are not on the right, just bury that even though that implicit assumption is the thing that is guiding the misgivings, right? Like —
Chase Strangio: Yes. And they give up their knowledge about everything else in the world. Like, it’s so shocking to me when people are like, well, you know, everyone’s getting this care so easily and this and that.
And I’m like, have you ever tried to make a doctor’s appointment in this country? Like, have you? What is it like for you? Are you getting care, like, I have to take my kid to a gastroenterologist. It’s not easy. They’re like, we’ll see you in nine months. And that’s, like, if it’s urgent.
And that’s the same here. It’s like we can’t suspend our knowledge of all other systems when we’re talking about this. People aren’t saying, oh my God, my kid is trans, I need hormones tomorrow and getting it.
And I think we have to understand that there’s so many administrative, and financial, and structural and geographic barriers to care. And yet, the only thing we’re talking about suggests that there are so many trans people that they’re taking over our schools and getting health care in some sort of anomalously easy fashion in this country where it is so difficult to get health care.
Chris Hayes: More of our conversation after this quick break.
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Chris Hayes: So, let’s talk about trans youth health care, because I think this is like the germ of the thing. And this is, again, I’m trying to talk to people. There are people in my inbox —
Chase Strangio: Yes.
Chris Hayes: — that are viewers of mine who, I think, are decent and good people who are like, they’re uneasy —
Chase Strangio: Yes.
Chris Hayes: — or they’re reading things or they’re sending me e-mails. They’re like, have you checked out this about what Scandinavian countries have done on youth gender care, right?
And one of the things I wanted to talk to you about is like making this distinction, which I think is actually important for everyone in this debate, of good faith. Back when COVID first happened, right, there was this really intense debate that grew up among pulmonologists about ventilator care, which was, like, what’s the best way to deal with people with COVID.
And it got, like, fraught and sometimes like, really nasty, actually. Like, pulmonologists accusing each other of like killing people. Like, you’re doing this wrong —
Chase Strangio: Yeah.
Chris Hayes: — right?
Chase Strangio: Right.
Chris Hayes: There was zero ideologically political stakes to it. It was a fight about health care under conditions of changing knowledge and uncertainty. Every scientific dispute is like that. I mean, anyone who’s ever been around science or medicine, fights get incredibly nasty on questions that have nothing to do with what we map onto as politics, right?
So, there are debates that people have about the provision of care, the right care protocols. I mean, you know, like get a credentialed psychologist to talk about psychoanalysis and vice versa. And they’re like, those people are cranks. Right?
Chase Strangio: Yes.
Chris Hayes: So, like —
Chase Strangio: Or like ADHD meds, I mean there’s many things where this plays out, yes.
Chris Hayes: Yes. So, I guess my point is that, like, there can be and probably are debates about the best way to provision care for trans youth. The correct protocols, the pacing, hormones. My feeling is I have zero expertise on this.
And if people are engaging in good-faith debates about the best way to provision care, like, I don’t feel like I have an ideological stake in one or the other, nor does everyone have to say, like, but that’s fully distinct conceptionally and politically, and should be for people with good faith, again, from whether you should have access to the care.
Chase Strangio: Completely, it’s so mind-boggling. And I want to say that part of what is so troubling about this entire conversation is people have decided that there is some massive conspiracy —
Chris Hayes: Yes.
Chase Strangio: — about the provision of this care that would involve so many people who are just trying to practice medicine, or provide mental health care to adolescents, or live their lives, or parents who are usually struggling tremendously.
And so, this has all been —
Chris Hayes: Yes.
Chase Strangio: — reduced to some sort of secret cabal of powerful trans people and doctors who are hiding scientific truths rather than, exactly to your point, what this is, which is a robust area of debate among professionals about how to best deliver care to a population who needs it.
But if you start from the premise that, A, the population is too great, too powerful and shouldn’t get the care, you start having a lot of these very politicized and very disturbing conversations that have been playing out in the public discourse over the last seven years.
Chris Hayes: Exactly. And that, to me, is what’s so broken about this, right. Because then you end up in this position where it’s like, A, there are bad-faith people who are going to swoop in and be like, we should, you know, stop this care, right. And then you get this sort of knee-jerk thing of like, I find myself being pulled into like defending which protocol over another.
And it’s like, I genuinely don’t know. Like, I don’t. I have no idea. I’m trying to read in, I’m trying to listen to trans folks and trans parents and practitioners and there are trans practitioners on different sides of different questions about protocol.
But like, the two have become conflated to the point where like, to get where we were, like, how many bills are there? How many states are about to essentially make it illegal for the provision of care to adolescent trans folks?
Chase Strangio: Period, full stop. And I do think this is important because we hear about Europe all the time. Not one of the places in Europe that are routinely brought into this conversation ban care in the way that we are now doing in almost half the country. And so, just to keep in mind, and we are not known for modeling our care systems after European —
Chris Hayes: Right.
Chase Strangio: — particularly Scandinavian countries.
Chris Hayes: Right.
Chase Strangio: So, already this is ridiculous. But all that to say, I have now read the care guidelines for Finland, Sweden, the United Kingdom, Norway, France, Australia and Canada on a regular basis, which I never wanted to do. And where we are. But the reality is, they aren’t banning care, anywhere.
And what we’re doing is banning care now in almost 21 states. And I want to sort of take a step back and say, like, what does this mean for people? Because this is —
Chris Hayes: Yes.
Chase Strangio: — not also Dobbs that happened over a period of 50 years. This happened over a period of three months. And we already had very poor care provision for people with waiting lists of, oftentimes, a year.
So, we have families in places that have just now stabilized their children with medication. Watching your child suffer, I mean, this is unimaginable —
Chris Hayes: Yeah.
Chase Strangio: — generally speaking. You finally get your kid treatment, they’re doing well.
Now, we have families in Tennessee where care is almost going to be gone July 1. They’re calling every single state. And now Ohio wait list, seven months, but care might be shut down in Ohio. Minnesota wait list, 18 months. You know, what if you can’t travel? What if you can’t fly?
And every state that shuts down care, that’s a whole population that’s now being sent to other states that already have way more patients than they can handle. So anyone who cares about the care itself, and not just banning it, should know that we are now making this care so much more precarious on every level, just like in the abortion context.
Chris Hayes: Yeah.
Chase Strangio: But —
Chris Hayes: Exactly.
Chase Strangio: — we have no preparation. We have no influx of resources into states that do provide the care. And so what’s happening is families are in an utter panic. And their young people, their children are terrified.
And we are just running around trying to sue where we can, trying to help people travel where we can. And some of these laws have aid and abet provisions, so people can’t even travel. And so, we’re in a situation now where we’re trying to figure out, do we have to help people physically move permanently from homes they may have lived in for generations to make sure their kids are stabilized.
And you can hate the conversations about this care. But at the end of the day, even the other side will agree, you can’t just cut off care instantaneously, at least the experts, the, quote/unquote, medical experts on the other side. But politicians are coming in and saying, you’re done.
Chris Hayes: Yeah. I mean, I’ve said this one the show before. And you know, I’ve been taking Lexapro, for 15, 16 years probably. And like, if it happens that I, and occasionally it will, that I go away or something and my prescription runs out, where I go two or three days without taking it, like, I’m messed up. You know, for folks that have had this experience or Google it, they call it, like, brain zaps. It’s like, really just a profoundly unpleasant signaling. And this is like 1/1,000 of what, like, a teenager who’s (ph) (inaudible).
Like, people should really just take a second just to emphasize the point you’re making. Like, these are human beings. These are children. These are teenagers. These are families. These are, like this is care that they’re getting, that they’re in a place and the government is coming in and saying, like, you can’t take your take your Lexapro tomorrow. You can’t. Like, you can’t access the thing that is stabilizing and regularizing your life. That’s the reality for folks in Tennessee and all these other states.
Chase Strangio: Yeah. And I mean, it’s everyone who’s facing ADHD medication shortages right now —
Chris Hayes: Yes, right now.
Chase Strangio: This is immensely destabilizing for people, and yet we’re doing it on this massive scale with adolescents.
And I think the thing that people don’t realize too is some of these interventions are also targeting adults with the justification still of being the same, that, you know, youth can’t consent to care, but, oh well, you know what, actually we’re calling into question the whole thing.
And one of the things that’s been so troubling to me is that talking to be people like me who are trans adults who have been on this medication for 20, 30 years —
Chris Hayes: Right.
Chase Strangio: — had no concept that it could ever go away like this.
But if you think about what happens if the Senate majority shifts and the presidency shifts, we’re having a federal ban on this care, just like we’re having a federal ban on abortion most likely. And what does that mean nationally? We are not prepared for that eventuality.
But once they’re moving all these bills so quickly and creating the sense that this is somehow a legitimate paradigm shift to cut people off from this treatment, that then paves the way for a huge amount of other intrusions into medical care that we’ve all come to rely on. And we should be very concerned about the precedent this sets.
Chris Hayes: We’ll be right back after we take this quick break.
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Chris Hayes: So let’s talk about the Tennessee legislation. Like, what does it actually say? Like, what’s the law say and what does it do?
Chase Strangio: So, I mean, in essence they have a series of legislative findings which, when tested, and we just went to trial in Arkansas for two weeks, I mean none of them hold up. But you know, a series of, you know, legislative findings about how the care is experimental; it is not. It has been around for over 20 years to treat adolescents with gender dysphoria.
That’s the other thing. We have a sense that this started yesterday. It did not. There have been gender clinics providing this care for 20 years or more. So it’s all about, oh, this is experimental. But even if it was, we don’t ban experimental treatment.
Chris Hayes: Right. I was about to say —
Chase Strangio: Yeah.
Chris Hayes: — there’s lots of people in America on —
Chase Strangio: Experimental treatment.
Chris Hayes: Yeah, yeah.
Chase Strangio: And they do this. I mean, also these are all the states, by the way, that explicitly ensured that people could take Ivermectin to —
Chris Hayes: Yes, exactly.
Chase Strangio: — treat COVID, despite that it is completely known to have no benefit and harms (ph) —
Chris Hayes: Literally.
Chase Strangio: Like —
Chris Hayes: Literally, the same —
Chase Strangio: — the same state.
Chris Hayes: — legislature.
Chase Strangio: Yeah.
Chris Hayes: The same people —
Chase Strangio: Yeah.
Chris Hayes: — yes. Yes, yeah.
Chase Strangio: It’s the same people. So it’s all —
Chris Hayes: Yeah.
Chase Strangio: — of course, so disingenuous.
Chris Hayes: Right.
Chase Strangio: And then, in essence —
Chris Hayes: Right.
Chase Strangio: — they say, the Tennessee bill, for example, basically said the A.G. is authorized to investigate any instance of a medical provider providing any of these types of, quote/unquote, gender transition procedures, pubertal suppression, gender-affirming hormones or surgery. And then, it also prohibits those types of interventions for purposes of gender transition being provided through telehealth or —
Chris Hayes: Wow.
Chase Strangio: — anyone from being referred for the care.
So we’re talking about an incredibly broad reaching type of prohibition.
Chris Hayes: Jesus.
Chase Strangio: Oh, and the other thing they do is they extend the liability for any, quote/unquote, injury from the care, which could include basically just the provision of the care itself to 30 years beyond the —
Chris Hayes: Wow.
Chase Strangio: — date of majority for the adolescent. So what that means is that, again, talk about hypocrisy, the same conservative groups that are, you know, obsessive about tort reform are now extending medical malpractice liability —
Chris Hayes: Right.
Chase Strangio: — like into the infinity of the future.
So, again, if you go through every single one of the legislative findings, it doesn’t actually hold up to scrutiny. But we’re not operating in a system of good faith or accountability. And so, we’re now in a situation where for years we were largely able to stop these. We come into every state legislature, and we are told, it’s a done deal. A deal has been made between made between the Senate and the House, and this bill is happening.
And now, here we are. Every day, a new disaster. Hundreds of families being affected in each one of these states. So, thousands and thousands of families now in total and complete crisis around the country.
Chris Hayes: And they’re states that have already had these on the books, right? Tennessee, Arkansas, and there’s a whole bunch of others that are coming down the pipe.
Chase Strangio: There’s a bunch of others. So prior to 2023, there was: Arkansas had passed a ban in 2021, the first one. Governor Hutchinson vetoed that ban.
Chris Hayes: Yep, he did.
Chase Strangio: It was overridden. We blocked it in court. So it never went into effect. It’s been blocked by an injunction for two years. Alabama had a ban that was passed, a felony ban, mind you, in 2022; also blocked in court.
Those were the only two statutory bans. We had Governor Abbott and Attorney General Paxton issuing their executive orders —
Chris Hayes: Right.
Chase Strangio: — in 2022, deeming the care child abuse. Families started getting investigations. Thankfully, we largely were able to block that in court as well.
So up until 2023, none of these had gone into effect.
Chris Hayes: Got you. And what are the legal theories for when a state has actually passed it and you sue to block it, what’s the legal theory that you’re articulating?
Chase Strangio: So, in Arkansas, for example, we had three claims. The first equal protection, just this is sex discrimination, this is trans status discrimination.
Chris Hayes: Yep.
Chase Strangio: It says it on the face of the law that you can’t —
Chris Hayes: Yep.
Chase Strangio: — transition gender. That’s sex discrimination. That’s trans status discrimination. Heightened scrutiny applies. The state then has the burden. I mean, they really, they did not meet their burden. Actually, our injunction in Arkansas was upheld at the Eighth Circuit, not a bastion of liberal —
Chris Hayes: No.
Chase Strangio: — progressive thinking.
And we also have a due process claim on behalf of the parents because we are operating in the realm of parental rights, which apparently exists for everyone who doesn’t want their kid to learn, or wear a mask, or get vaccinated, but doesn’t exist for the parents who want to give their kids medically indicated and recommended care.
Chris Hayes: Let’s just pause here for a second, because this is actually the thing that makes me the most furious about this. Or at least, as a cis person I can, like, as a cis parent I, like, have, like, a subjective access to in a way that is like, how dare you come in and tell me? What? What? My 12-year-old, 13-year-old isn’t going to the clinic by themselves.
Chase Strangio: Yes.
Chris Hayes: I’m taking them. We have had conversations in my household about what we are doing together as a family, with my fricking kid.
Like, how dare you tell me I can’t do that? How dare you? It is my child. Like, it is so offensive to this, even, like, almost conservative vision of parental rights and parental control. These kids are not getting the care without their parents’ consent. The parents are consenting.
Chase Strangio: They literally cannot get it without their parents’ consent. Most of these entities, too, have two part (ph), two parental consent. Like, you can’t. It is so hard to get this care.
And again, like the point about, like, I do want us to sort of, like, recalibrate to what’s actually happening and imagine, especially for parents. Like, there are parents in this equation who have cried together, who have been terrified for their child, who have sat and had many family meetings, like things we can all relate to, about —
Chris Hayes: Yeah.
Chase Strangio: — how do we get through this as a family? And it is not a fast process. It’s way too slow for a lot of young people.
And this other idea that I just really want to help people understand is totally and completely absurd is this rapid-onset gender dysphoria, this idea that young people are, you know, rapidly becoming trans, and nobody knows about it, and it’s, you know, part of this social contagion theory.
And it emerges out of this paper in which parents, who are on a website that doesn’t believe in trans people, are interviewed. Did your child appear to be trans quickly? And many of them (ph) said yes.
And anyone who’s been a child knows that we don’t tell our parents things right away, particularly things we’re afraid that they’re going to be upset about, that we’re afraid they’re going to reject in us.
And most trans people spend years struggling with their identity before telling a soul, before even saying it out loud to themselves.
And the idea that this is all happening on some sort of, they talk about it as a treadmill to surgery or something. Like the second you call someone a different pronoun then, all of a sudden, they’re having surgery. And they act like this is, like, happening in a two-year period from, like, hey, I want to go by Joe to, like all of a sudden, I’m having genital surgery.
And I just want us to sort of sit and be like, there are human beings at the center of this who are having a lot of internal struggles and conversations, and we are talking about this in a fundamentally absurd way.
Chris Hayes: Yeah, and it’s also like, I do think the parents end up getting written out of all this so much. And again, like, I don’t know that like all of these parents of the adolescents at gender clinics in Missouri are like, got (ph), like, super, like, you know, progressive values on gender. Like, I would guess a lot of them probably didn’t.
I would guess, like, there was a lot of conversations about, like, what’s wrong. Like, there was a lot of, like, working through happening among parents, I imagine.
Chase Strangio: And even people who do have super-progressive ideas —
Chris Hayes: Yeah.
Chase Strangio: — about gender still struggle.
Chris Hayes: Yeah, totally.
Chase Strangio: I mean, you know, it’s like we have to understand. I mean, I live in New York City, and parents are struggling —
Chris Hayes: Yeah.
Chase Strangio: — and they don’t know how to think it through. And so, even if you have the most progressive political people in the world, when their kid comes to them, it’s not —
Chris Hayes: Yeah.
Chase Strangio: — always a —
Chris Hayes: Totally.
Chase Strangio: — oh, let’s just jump —
Chris Hayes: Let’s do it, yeah.
Chase Strangio: — on board with whatever. And that’s really what’s so troubling is that the reality of our lives and how to best support us has been totally lost.
Chris Hayes: Well, and to go back to your gastroenterologist point, this is true for any care that you would provide (ph). Like, your kid is in distress —
Chase Strangio: Yes.
Chris Hayes: — psychological distress. My kid is reacting poorly to school. He or she’s getting bullied or whatever. There’s a whole bunch of processes you’re going to go through to problem solve. Like (ph) —
Chase Strangio: Yes.
Chris Hayes: — or my kid keeps having stomach aches. OK, let’s (ph) go to this doctor. This doctor says there’s nothing you can do (ph), well, they’re stressed. You know, something as profound as this about identity and about self, like, it just seems like it’s not going to be the subject to like faddish, willy-nilly, knee-jerk reactions by adult parents who are caring for their kids.
And if you think it is, then you’re undercutting the entire regime of parental rights —
Chase Strangio: Right, like —
Chris Hayes: — which is like —
Chase Strangio: — the centerpiece of the Republican Party right now —
Chris Hayes: Right, right.
Chase Strangio: — also. But —
Chris Hayes: Right.
Chase Strangio: — I mean, the other thing to think about is, like, especially as parents, to just think about, you know, one of the critiques of this care is that parents are not given accurate information about long-term outcomes and the uncertainty of them. And —
Chris Hayes: Yeah.
Chase Strangio: — I have gone to many doctors for my child just by virtue of being a parent. I can’t think of a time where I was advised about the long-term outcomes –
Chris Hayes: No.
Chase Strangio: — of any medication. And often, the answer we get is, we’re just not sure —
Chris Hayes: We don’t know. Yeah.
Chase Strangio: — because that’s how pediatrics works, because that is the nature. That is why, in some contexts, 80 percent of pediatric medications are prescribed off-label. That’s how it works.
So we’re coming in and saying, oh, this medication is prescribed off-label. Most of the medication that you have prescribed your child is prescribed off-label. So we just are having these (ph) selective outrage about things that are generally true about areas of medicine and then using those to fuel this sense of massive conspiracy about trans care, which is in turn creating catastrophic consequences to our communities. I just really cannot stress that enough.
Chris Hayes: Let’s just go back because you were midway through these different claims. One was an equal protection claim (ph), sex discrimination, which requires constitutionally through many years of precedent, what’s called heightened scrutiny, so there’s a higher bar to defend that, right, it’s harder for the state to do that; a parental rights claim. There was a third claim that you had?
Chase Strangio: In the cases that have these bans on referrals, we also have free speech, First Amendment claims —
Chris Hayes: Oh, right.
Chase Strangio: — that their, you know, viewpoint discrimination in that they’re restricting both the ability of doctors to speak information based on the subject of the speech and then the ability to receive the information for the patients and families.
Chris Hayes: So the political legislative state-level bans are fait accompli in many states, they’ve happened (ph) in other states. Then the question becomes what the courts will say about it.
You’ve been successful in courts in getting injunctions, but they haven’t finally been argued up to the merits, right? At some point the Supreme Court, it seems, is going to say, it’s going to land before this court whether it is constitutionally allowable to facially ban trans care in a state, right?
Chase Strangio: Yeah. I mean, it will eventually.
And right now we’re in a situation where we’ve had a few cases that have reached certain postures on a preliminary injunction up to an appellate court. We’ve gone to trial in one case.
But these are moving up through the courts, and we know that we’re existing in a landscape in this country where, A, certain circuits we know are full of judges who really, centrally and, like, as part of their identity, hate trans people. That’s very clear. So that limits the ability to go to court in some places and receive any sort of fair access to the judiciary.
Then the reality is, as we go up in the courts, I think there’s a lot riding on what’s going to happen, and it’s very difficult to be optimistic in light of what’s coming out of the courts, and the Supreme Court in particular, over the last few years.
And so, this means that it is very possible that in the next few years the Supreme Court could green light this type of discrimination, which would just leave in place the type of map that we have now, where care will likely be banned for trans adolescents in 50 percent of the country.
Chris Hayes: And that map’s going to look a lot like the abortion map.
Chase Strangio: It’s going to be the same map —
Chris Hayes: Yes.
Chase Strangio: — for the most part. And I think then the question becomes: what are the next steps?
We already see in both the abortion context and the trans context where there are efforts to restrict the ability to access the care out of state. That’s already a lot harder in the trans care context. If you’re talking about care that your child is receiving for 10 years, going out of state becomes an enormous burden, but, you know, we know that they’re going to try to restrict travel in a variety of ways.
And then, are we going to reach the point where we’re confronted with a congressional ban and then what will the courts say about that? Because that’s a different conversation and set of legal arguments, potentially going up to the court at some future time but likely in our lifetime.
Chris Hayes: So, what do you think, people who are listening this, like, what should people be doing given this context, given the assault, given the extremism of that assault, given the unbelievable human consequences for adolescents, and families, and adults all over? And you know, we haven’t even gotten into the drag aspect of this —
Chase Strangio: Yeah.
Chris Hayes: — which is sort of adjacent but obviously conceptually linked. You know, they’re trying to, like, outright criminalize drag, which to me is like obviously facially unconstitutional, but like, who knows, when it (ph) gets up to the court.
What do you want people listening to this podcast to know about what they should be doing or how they should be thinking about this?
Chase Strangio: Well, I think, and to connect it just quickly drag, if I can, is that, and as our conversation has shown, so much of what needs to happen is a disruption in the discourse. We absolutely need to change how we’re talking about it because the media conversations, the conversations we’re having in our schools, in our communities, are fueling this set of material and political consequences.
So I just would really urge people to, even if it means take a breath, Google something before you have a reflexive response to what you’re hearing. That will go a long way. Go find someone to listen to. Listen to podcasts. Like, really sit with it, because people are unsure and they’re being reflexive. And what people are being told is calculated —
Chris Hayes: Yes.
Chase Strangio: — to create a sense of outrage.
And if you think about the drag context, I just want to say this quickly, Christopher Rufo was the person, the Manhattan Institute mastermind of the so-called discourse on critical race theory, who decided to start talking about drag as sexually explicit performance to change the conversation about drag performers and, in turn, about trans people. That has been instrumental in fueling these attacks.
And we have fallen hook, line and sinker, as we always do, to the debate that’s being set by other people who have particular ideological goals.
And so, we have a responsibility, and this is more so than donating to trans-led organizations, more so than engaging politically, to change and challenge the current discourses about trans lives, trans bodies, trans medical care, and what it means to exist in the world as a gender-expansive person.
Chris Hayes: Chase Strangio is Deputy Director for Transgender Justice with ACLU’s LGBT and HIV Project, lawyer and trans activist as well.
Chase has been on WITHpod before. And it is a great, great, great pleasure to have you back. Thank you so much.
Chase Strangio: Thanks, Chris.
Chris Hayes: Once again, huge thanks to Chase for joining us. You can tweet us with the hashtag #WITHpod, e-mail withpod@gmail.com. That website I mentioned before, which is called tracktranslegislation.com, is a really useful resource for all this. And, as always, be sure to follow us on TikTok by searching for WITHpod.
“Why Is This Happening?” is presented by MSNBC and NBC News, produced by Doni Holloway and Brendan O’Melia, engineered by Bob Mallory and Cedric Wilson, and featuring music by Eddie Cooper. You can see more of our work, including links to things we mentioned here, by going to nbcnews.com/whyisthishappening.
Tweet us with the hashtag #WITHpod, email WITHpod@gmail.com. Follow us on TikTok by searching for WITHpod. “Why Is This Happening?” is presented by MSNBC and NBC News, produced by Doni Holloway and Brendan O’Melia, engineered by Bob Mallory and features music by Eddie Cooper. You can see more of our work, including links to things we mentioned here, by going to nbcnews.com/whyisthishappening.