House Republican Conference Chair Elise Stefanik,, R-N.Y., flanked by Majority Whip Tom Emmer, R-Minn., left, and Speaker of the House Rep. Mike Johnson, R-La., speaks during a news conference on Capitol Hill in Washington, Tuesday, Feb. 6, 2024. (AP Photo/Jose Luis Magana)

The national Republican party is promising to ban gender-affirming care for transgender kids if their candidate, Donald Trump, wins the White House in November.

Their proposals include a nationwide ban on the prescription of puberty blockers and a requirement that schools end trans-supportive practices like respecting students’ preferred names or pronouns. They would also federally bar public education institutions from using students’ preferred gender pronouns or preferred names or keeping information about a student’s gender identity private from their parents.

The bans would likely be driven by executive action, pushed forward by the president and his Cabinet through the federal executive bureaucracy without the need for Congressional approval.

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Trump campaign event

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On Friday, ahead of a Trump campaign event with a national advocacy group opposed to legislation protecting transgender children, Congresswoman Elise Stefanik joined with former Trump cabinet official Dr. Ben Carson, anti-LGBTQ psychiatrist Dr. Miriam Grossman and Anna Kelly, a national spokesperson for the Republican Party, to outline what steps Trump would take in the White House to ban gender-affirming care for children.

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Plans announced

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“President Trump will declare any hospital or healthcare provider that participates in medical or physical mutilation of minor youth will no longer meet federal health and safety standards for Medicaid and Medicare, and he will use all available authorities to stop transgender medical procedures and sex change surgeries on minors,” Kelly said.

“President Trump will also inform states and school districts that if any teacher or school official suggests they can be trapped in the wrong body, they will be faced with potential civil rights violations for sex discrimination and the elimination of federal funding.”

Kelly said that the Trump administration will seek to promote traditional gender roles and a nuclear family unit, and would even ask Congress to pass a formal law delineating that the only recognized genders in the U.S. are male and female, and are assigned at birth.

These steps would send a shockwave across the field of pediatric psychiatry and medicine, as well as through the wider LGBTQIA-plus community, by federally undoing many of the recent developments made on gender-affirming medical treatment and LGBTQIA-plus equality.

These moves are largely in opposition to the official medical position of the American Academy of Pediatrics and the American Psychological Association, the leading American medical trade groups for their respective focuses.

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National guidance

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Both the AAP and the APA have issued guidance supporting limited medical intervention for children suffering from gender dysphoria, the medical term for when a person feels as if they are not the gender their body presents as. Treatment for gender dysphoria in children includes the use of puberty blockers, which prevent the body from developing adult sex characteristics, trans-affirming psychotherapy and the establishment of a supportive home and social environment for the child.

Medical interventions like surgeries are very rare in children in the U.S. — most medical guidelines suggest that sexual reassignment surgeries shouldn’t be done on anyone younger than 15, and even then only in special circumstances until the person turns 18. Hormone replacement therapy, in which a person uses testosterone or estrogen supplements to alter their physical presentation and body composition, are similarly not recommended and very rarely used for patients under age 18.

And education groups like the American Federation of Teachers and the National Education Association are largely supportive of school policies focused on supporting kids who identify as transgender. That includes referring to the student by the pronouns they prefer, using the name they prefer, providing safe gendered spaces like accessible restrooms and allowing students to perform on the athletic teams they feel most comfortable on.

In some states, including New York, such protections have become the standard by law or by regulation.

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Carson, Grossman

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But GOP leaders including former Secretary of Housing and Urban Development Carson and chair of the House Republican conference Stefanik argue that these medical and educational standards are unsupported by science and suggest that implementing gender-affirming care for trans children is doing more harm than good.

Carson, who made his medical career as a neurosurgeon, argues that hormonal therapies and sex change operations are based on “no reputable medical practices.” Despite the fact that the major medical organizations do not support hormone replacement or sexual reassignment procedures for children, Carson argued that even medically-accepted trans-affirming psychotherapy and puberty blockers are harmful.

Referring to trans people as “transgenders,” Carson argued that suicide rates are higher among people, adults and children, who have transitioned than those who have not.

Experts who have studied rates of suicide and depression among trans Americans largely ascribe the higher suicide rate to the difficulty and expense of getting complete gender-affirming medical care, ongoing societal attitudes that shun transgender people, rather than the transition itself.

Dr. Grossman, who is a longtime supporter of controversial and discredited procedures like gay conversion therapy, said without evidence that children in the U.S. “as young as 12 and 13,” can undergo a double mastectomy with no medical reason, and argued that American laws “regarding gender medicine” are among the most permissive in the world.

The U.S. is not routinely ranked among the top countries for transgender rights or for trans medical care – laws vary widely by state, and there are many counties in western Europe that allow more significant medical interventions in children at younger ages than U.S. guidelines permit.

When asked why their positions stand in such stark opposition to the official positions of the major American and international medical communities, Carson and Grossman said that the major medical groups cannot be trusted and do not actually speak for the majorities in their field of practice.

“What has happened through the years is that activist doctors have pushed through this agenda through the committees of the organizations without any opportunity for debate,” Grossman said.

She said that some doctors have spun off from the major pro-trans organizations to form their own smaller trade groups, like the American College of Pediatricians, which has taken point on opposing gender-affirming care for children.

That group has only a fraction of the members the American Academy of Pediatricians has, and is not routinely referred to for medical research or practice-defining guidelines.

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“Radical ideology”

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For her part, Stefanik argued that support for transgender children is a part of a wider “anti-Western” ideology that she said is being spread through American educational institutions from public schools to elite universities.

“President Trump has vowed to protect our children and stop this radical ideology from being advanced by the federal government, doctors and teachers,” she said.

She spoke largely to the education and electoral issues — she’s introduced legislation that would bar the U.S. Department of Defense’s on-post schools from supporting trans students with preferred pronouns or keeping information on their gender identity private from parental figures, and wrote a “U.S. Parents Bill of Rights,” that would require educational institutions to provide essentially all information they have about a child, including their gender identity and relationships with schoolmates, to parents.

“I am horrified at the prospect of boys and girls being exposed to gender ideology that seeks to violate the sanctity of our nation’s children and violate our parental rights,” she said.

Stefanik said that, as opposed to a Trump presidency that would largely ban gender-affirming care for children, a Kamala Harris presidency would only enshrine more protections for transgender children and adults into law. “For every parent, the safety and health of our children is at the top of our minds, and it is very clear that the radical, far left policies of Kamala Harris and Tim Walz will put our children at risk,” she said.

While Harris has been broadly supportive of LGBTQIA-plus rights and gender-affirming care for children, she has not made that a major point in her relatively young campaign for the presidency, and has put forward no specific policies for how she would approach the issue, as the Trump team has.

The Congresswoman’s position on LGBTQIA-plus rights seems to have changed over the years — as recently as 2019, she voted in support of a federal bill to explicitly ban discrimination against people on the basis of sexual orientation and gender identity including trans identity in federal benefits programs. In 2021, she voted against the same bill with only minute changes in language.

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NY protections

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In New York, a number of bills aimed at protecting trans people and access to gender-affirming care have been introduced in recent years. In 2021, state officials passed a bill that outlaws the arrest of anyone in New York for providing gender-affirming care in or out of the state.

In June of last year, a bill to protect gender-affirming care for children specifically was passed and signed into law, banning state authorities from working to separate children from their families for providing trans-affirming care, and barred the courts from considering trans-affirming medical care to be abuse unless there is an actual abusive quality to the treatment.

New York also recognizes a non-specific gender, marked as X on official documents, for gender-nonconforming people.

This year, New Yorkers will have the chance to vote on the Equal Protection of Law amendment, that would enshrine sex, gender and gender expression, sexual orientation and pregnancy as protected classes under non-discrimination laws. Lawmakers argue the bill will not only protect access to abortion care in New York, but also protect gender-affirming and transgender medical care.

Stefanik said she and many of her constituents in northern New York are flatly opposed to that amendment, in part because it would expand gender-affirming care for children in medical and educational setting. She falsely claimed the amendment would allow for sex change operations on children without parental consent, which it does not expressly allow.

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Gonzalez-Rojas efforts

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One New Yorker has been at the forefront of many of the most trans-friendly legislation in New York — Assemblymember Jenifer Gonzalez-Rojas, D-Queens. She’s supported the Equal Protection of Law amendment, sponsored and voted for other LGBTQIA-plus friendly bills, and regularly sponsors bills to protect and defend the state’s LGBTQIA-plus population.

In a statement on Friday, Gonzalez-Rojas said the positions that Republicans have taken on this issue are out-of-touch and ill-informed.

“Like several other issues Republicans obsess about, they lack basis in evidence and science,” she said. “Gender-affirming care, including addressing students by the pronouns they identify with, medical care and LGBT-affirming psychotherapy have all had positive health outcomes for students. This is why LGBTQ voters are with Democrats.”

She said that Democrats in New York have a successful track record protecting the LGBTQIA-plus community, like banning conversion therapy, addressing school bullying and making New York a safe haven for trans medical care.

“They can sensationalize the issue, but we have real work to do to protect our families, and we won’t go back,” she said.