In early January, an Oklahoma state senator named David Bullard introduced a bill invoking the Bible to suggest that people who provide care to transgender young people should be drowned. The bill would ban gender-affirming hormones or procedures for anyone under the age of 26 and make it a crime to even refer young people for such procedures.
Bullard’s press release about the bill quotes from Matthew 18:6: “Whoever causes one of these little ones who believe in Me to sin, it is better for him that a heavy millstone be hung around his neck, and that he be drowned in the depths of the sea.”
Bullard called it the Millstone Act. And it’s a harbinger.
Since the start of 2023, state lawmakers have introduced a record 200 anti-transgender bills, reports the Equality Federation—already more than all of the anti-trans bills introduced in 2022. These measures would ban gender-affirming health care for youth and young adults, prevent families in hostile states from traveling elsewhere for care, and force teachers to out transgender students to their parents even if those parents will harm the kids as a result. What we’re seeing is not a patchwork of state initiatives to curb the rights of transgender people, troubling as that would be. Instead, fresh off its victory in the Supreme Court case that ended the right to legal abortion in June, the Christian right is following the anti-abortion playbook to eviscerate the rights of trans people across the country.
The right is deploying tactics against trans rights that are eerily similar to those mounted against abortion rights over the past five decades. Right-wing pundits are using terminology once reserved for abortion providers to denigrate providers of gender-affirming care. In a flashback to Fox News’ vilification of abortion provider George Tiller—who was murdered by an anti-abortion shooter in 2009—the network’s host Tucker Carlson has likened gender-affirming care to sexual violence and murder. During a segment last September, Carlson called doctors who provide gender-affirming care “criminals.” Displaying headshots of members of the board of Vanderbilt University Medical Center, an institution that offers such care to young people, Carlson named each of them and called upon them to stop “these crimes”—by which he meant care that affirms a young person’s gender in line with protocols issued by the nation’s leading medical groups.
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Messaging like Carlson’s has fueled violent threats against gender-affirming providers and harassment of patients outside clinics. One of the top pediatric institutions in the country, Boston Children’s Hospital, received several bomb threats after the right-wing account LibsofTikTok falsely claimed doctors there were “carving out” the reproductive systems of children. In Texas, the only clinic to serve trans youth in the state closed its doors in 2021 after weeks of harassment, threats of violence, and pressure from Governor Abbott’s office, announcing that it would shift to “a more private, insulated experience for patients.” Threats and protests of this kind were part of what pushed abortion providers into freestanding clinics, where they became easy targets for over-regulation by state legislatures.
It’s all part of a “well-worn playbook” that the Christian right has used to take acceptable practices and make them seem unacceptable, journalist Imara Jones, founder of TransLash Media, told us.
“You isolate, you stigmatize, and you demonize,” Jones said.
While far-right groups like the Proud Boys terrorize families at drag queen story hours, and right-wing media outlets fan the flames, state legislators are deploying a familiar legal strategy. First, the anti-trans bills have targeted minors, using the framework of “parental rights,” or claims about protecting children, just as anti-abortion activists did with parental consent laws for abortion beginning decades ago. Proposed legislation in Missouri would require teachers to provide parents with any material “related to sexual orientation and gender identity” so the parents could opt their kids out of the lesson if they disagree. In Iowa a bill would prevent teachers and staff from supporting trans students in school. A Virginia bill would require any school professional working with a student who is “self-identifying as a gender that is different than his biological sex” to immediately out the student to at least one parent. An Indiana bill instructs child welfare workers that they should not consider it child abuse if a parent withholds access to gender-affirming care or mental health services.
But the right to decide which health care to provide your child is only granted to some parents.
Four states—Utah, Arizona, Arkansas, and Alabama—have banned gender-affirming care for minors; only Utah’s law is currently in effect. State lawmakers have now escalated their efforts into restrictions that would impact transgender people of all ages. As of publication, three states in addition to Oklahoma have bills pending that would ban gender-affirming care entirely for young adults under 26 (in South Carolina) or under 21 (Mississippi and Kansas). Since the start of the year, state lawmakers have introduced 41 bills to ban gender-affirming care for minors and 11 that would impact adults, according to the Equality Federation. These bills range from a measure in Virginia that would ban trans people of any age from deducting their transition-related health care costs from their taxes to one in Oklahoma that would make providers who offer gender-affirming care ineligible for reimbursement (for any care they provide) through any state or federal program, including Medicaid. For abortion care, similar efforts to strip public funding from providers and restrict public insurance coverage were stepping stones toward banning care outright. In a New York Times article last week, Terry Schilling, president of the right-wing American Principles Project, acknowledged that the long-term plan is in fact to eliminate gender-affirming care, and that focusing on young people first is an attempt at “going where the consensus is.”
In Oklahoma, Bullard’s press release frames his bill to ban gender-affirming care for people under 26 as an effort to protect young people from providers who want to make a profit—a classic canard used against abortion providers. Unsurprisingly, Bullard was among the sponsors of Oklahoma’s abortion ban, which is among the strictest in the nation. A colleague of Bullard’s, Oklahoma State Representative Jim Olson, has introduced a bill making the provision of gender-affirming care to anyone under 21 (including young adults who can vote and serve in the military) a felony—punishable by a $100,000 fine or up to 10 years in prison.
Meanwhile, Florida Governor Ron DeSantis has opened a new front that draws directly from anti-abortion tactics, proposing a 24-hour waiting period for transgender people of all ages to access gender-affirming care, including hormones. The state also has a ban on Medicaid coverage of such care. Restrictions on Medicaid coverage of abortion have been a central plank of efforts to end access to the procedure since the 1970s. Waiting periods, which are in place in many states when it comes to abortion, make even less sense when you consider that trans people already wait anywhere from six months to seven years to access care.
It’s no surprise that these laws look the same, because they are driven by the same organizations—and these organizations see them as part of the same fight.
As conservative leader Phyllis Schlafly ramped up her campaign to tank the Equal Rights Amendment in the early 1970s, she warned Americans that the ERA would bring about gender-neutral bathrooms and marriage between same-sex couples. This threat struck a chord with a nascent conservative Christian faction coming into its political power. Schlafly’s Eagle Forum was part of a stable of newly energized Christian-right groups whose ultimate goal was to mold the country into a Christian nation, centered around a narrow interpretation of the Bible. Gender essentialists like Schlafly believed that God made man and woman to complement one another and that the only acceptable form of sex is the marital, procreative kind between men and women. The Equal Rights Amendment threatened those principles by “erasing sex” from US law, or so Schlafly said on her speaking tours and in her tracts and flyers.
Unsurprisingly, Schlafly and the Eagle Forum were also foundational in formulating early Christian-right messaging around abortion. As James Dobson was founding the organizations at the center of Christian-right advocacy—Focus on the Family, the Family Research Council, and the Family Policy Alliance—Schlafly was helping to shape the language they would all use to demonize and stigmatize abortion. With Schafly’s guidance, the anti-abortion movement wove a seductive tale with a villain (feminism), a victim (fetuses), and a hero (the Christian right).
Those same organizations, with the Alliance Defending Freedom (cofounded by Dobson and other pillars of the evangelical right), the Christian conservative think tank Heritage Foundation, and right-to-life groups that tended to share the Christian-right worldview but were more narrowly focused on abortion, formulated and executed a plan to overturn Roe v. Wade. And today, the very same organizations have formulated and are executing a plan to undermine the right of trans people to exist.
With Schlafly’s ghost on their shoulder and Dobson still behind the scenes, the Christian right’s strategy against trans lives has unfolded at a rapid clip according to a proven formula. The Alliance Defending Freedom drafts a ceaseless barrage of state legislation and deploys an army of lawyers to defend it in court. The Heritage Foundation, one of the most influential think tanks in the country, has the ears of media and lawmakers. The Family Policy Alliance coordinates the state family policy groups, and Family Research Council strategizes at the highest levels. Even Schlafly’s Eagle Forum is still involved, working to purge discussions of gender from public education in Texas and backing a bill to ban gender-affirming care for minors in Alabama.
Today’s Republican Party has embraced this Christian-right agenda, recognizing an opportunity to garner votes and raise money by attacking trans people. The party’s most popular rising stars, including Florida Governor Ron DeSantis, with his Medicaid ban, and Texas Governor Greg Abbott, have made demonizing trans people and those who support them a central part of their brand. DeSantis has called for doctors who provide gender-affirming care to be sued and referred to trans swimmer Lia Thomas as “that” during a tirade against trans athletes. In 2022, during his successful primary bid, Abbott ordered child welfare agencies to investigate the parents of children who were receiving gender-affirming care. The resounding reelections of Abbott and DeSantis in two of the largest states last November foreshadow a future of intensified attacks from Republicans who will see it as a winning strategy, Imara Jones told us. Meanwhile, the rise of anti-trans rhetoric is driving murderous attacks, just as happened with abortion providers. There was a marked escalation in murders and violence against trans people and drag performers in 2022, like the foiled Patriot Front attack on Pride in Coeur D’Alene, Idaho, and the massacre at the LGBTQ nightclub Club Q in Colorado Springs, Colo. In November, a donut shop in Tulsa, Okla., was firebombed after hosting a drag event. Neo-Nazis, paramilitaries, and right-wing militias disrupted over 140 drag performances in 2022, according to LGBTQ watchdog group GLAAD.
“We are in the opening minutes of the campaign of violence against trans people,” Jones said.
The people most impacted by policies like those advanced by DeSantis and Abbott are families in the South, especially low-income people of color who already faced barriers to basic health care. If the movement to save gender-affirming care can learn anything from the abortion rights movement, it’s to prioritize defense of people of color who are most impacted by Medicaid bans and other restrictions. Families in friendlier states like Massachusetts may be able to access gender-affirming care for their children—albeit while their providers are fielding bomb threats, and neo-Nazi organizations are protesting story hours at their local libraries. But that access shouldn’t give anyone a false sense of security. From the fight over legal abortion, we see clearly that the Christian right will not stop at restricting access to children or poorer people—as bad as that is. Instead, they are setting up a legal and political context in which gender-affirming care can be banned outright.
Imara Jones and her team at TransLash Media produced a video series called “Trans Bodies, Trans Choices” about transgender people who have had abortions—underscoring the fact that abortion seekers and LGBTQ people are often one and the same. In the series, Cazembe Murphy Jackson shares his story of being gang-raped by assailants who said, “God wants you to know what a real man feels like.” Jackson called his mother for comfort after the assault, and she insinuated the rape was his fault. When he became pregnant as a result of the attack, “my abortion saved my life,” he says.
We don’t know exactly how many trans and nonbinary people have abortions, because such data is scarce. One analysis found that 36 percent of transgender, nonbinary, and gender-expansive participants who had ever been pregnant had considered trying to end a pregnancy on their own and 19 percent of those ever pregnant had tried. We do know that LGBTQ people are feeling enormous stress and anxiety around abortion restrictions. Data just released by the Trevor Project found that restrictions on abortion ranked third in a list of 20 issues causing stress and anxiety for LGBTQ youth, just behind mental health and money, and ahead of bullying, racism, and anti-LGBTQ hate crimes. Transgender and nonbinary youth were significantly more worried about abortion access than cisgender survey participants.
In September, three months after the Supreme Court overturned Roe v. Wade, speakers at the country’s largest and most influential Christian-right political conference made the connection between the anti-abortion and anti-LGBTQ strategies perfectly clear.
“[F]or 50 years we did very well defending our children in the womb,” one speaker, Wendell Perez, said. “It’s time to defend our children outside of the womb, and our families.” He was referring to the lawsuit he filed, with the help of an anti-trans law firm, against his child’s school because educators there were supportive of his transgender child.
Facing a Christian right that sees these struggles as inextricable, we need to be better at understanding the connections ourselves, and at identifying what the Christian right is after. Too often, journalists and observers on the left have focused on medical debates about gender-affirming care that—as with abortion care—are best left to patients, providers, and medical associations. Any public conversation about gender-affirming care must be situated in an understanding of the wider context—the aggressive and deadly assault on bodily autonomy that affects everyone—Black, brown, low-income, and disabled people most of all.
“The freedom to decide whether or not to become or to remain pregnant, whether and with whom to have intimate relationships, whether or not to seek medical care to help our bodies align with our gender identities—all of these are about bodily autonomy,” Vivian Topping, director of advocacy and civic engagement at the Equality Federation, said. “What they’re doing is trying to take away bodily autonomy from folks across the country.”
We need to connect the dots this time, before it’s too late.