This weekend Alabama passed a brutally cruel law criminalizing health care for transgender youth. Discussion of this escalation of state violence and tyranny has been muted because politicians and activists have mostly been focused on the Supreme Court’s sweeping, horrifying threat to gut abortion rights. But the attack on trans people and the attack on pregnant people are both part of the same Christian theocratic authoritarian weaponization of health care. It needs to be opposed everywhere, or reactionaries will build power and hatred to use against everyone.
The Alabama bill, signed into law by Governor Kay Ivey this week, makes it a felony for doctors to prescribe puberty blockers, hormones, or surgery to trans people under the age of 19. The law also requires school counselors and nurses to tell parents if they believe their child is trans.
There is a broad consensus among medical professionals that trans youth benefit from gender-affirming care. Trans people often experience dysphoria, or a sense of acute psychological distress, when their sex assigned at birth does not match their gender identity. Dysphoria can be accompanied by depression and anxiety. Because of dysphoria, prejudice and stigma, 82% of trans people consider killing themselves, and as many as 40% have made suicide attempts.
Gender-affirming care, such as hormones, can make a huge difference for trans youth. Studies show hormones substantially reduce depression.
As the father of a trans daughter, I’ve seen the transformative effects of hormone therapy firsthand. My 18-year-old daughter experienced intense anxiety, depression and dysphoria as she worked through her gender identity. Within a month of starting on hormone therapy, her dysphoria just about disappeared, and she was back to being the happy, creative, energetic child we knew.
Alabama, though, would prefer our daughter be miserable. State officials would imprison the doctors who helped her. They’d label us irresponsible parents. They would deny her health care if we lived there.
Alabama House Representative Wes Allen claimed that the law protects children. “Their brains are not developed to make the decisions long term about what these medications and surgeries do to their body,” he insisted. But Allen isn’t talking to the children in question or their parents. Reactionary lawmakers have rigid ideas about how gender should work. Enforcing gender norms is more important to them than the health or safety of their constituents. For Allen and his ilk, healthcare is not a means to aid those in need. It’s a mechanism of control and power.
The parallel here with the anti-abortion ideology of forced birth is clear. In the leaked draft opinion which may form the basis for striking down abortion rights, Samuel Alito launches a sweeping attack on the right to privacy. For Alito, people do not have a right to be free of government interference in fundamental personal sexual or health decisions. The state can declare certain health care immoral and punish people who try to access it. Bodily autonomy doesn’t exist. If the government decides that your body is best used as a baby factory, that’s how it will be used, and if you object, you can be thrown in prison.
The idea that the state can use your body for its own purposes is dystopian; it evokes nightmare visions like The Matrix, in which humans spend their lives as helpless thralls of a vampire state, hooked up to machines which drain their energy. But for some, absolute disempowerment is appealing as long as they are not the ones being disempowered. No one wants to be the exploited body. But some people like the idea of being the exploiters.
That’s why trans people present such a tempting target. Estimates of trans populations vary widely, but current best guesses are that around .6% of people are trans. That is a small group of people. Trans people are also widely disliked and stigmatized, and are often stereotyped as mentally ill or sexually deviant. When Republicans target trans people, cis people often don’t feel threatened. They may even feel empowered or excited. Using the power of the state to target those who are weaker can be a rush for many.
Destroying abortion rights affects many more people than transphobic legislation. But the logic of marginalization and scapegoating still functions. Wealthy people — definitely including wealthy Republicans — will have the resources to cross state lines or national lines and find abortion services when their lives are in danger or when they do not want to bear a child. The people most affected by abortion restrictions are those with fewer resources. They can be stereotyped as irresponsible and undeserving. The powerful use the power of the state to control those people over there, secure in the knowledge that they will never be targeted themselves.
If Martin Niemöller lived now, he might write, “First they came for the trans people and I did nothing, because I was not trans.” Or he might write, “First they came for the pregnant and I did nothing, because I was not pregnant.” Attacks on marginalized people are a warning that others may be targeted next.
But attacks on marginalized people also simply wrong in themselves. Whether or not the state comes for you, it’s wrong to use the power of the state to deny people health care simply because you can. It’s wrong to strip people of bodily autonomy and torture them because it amuses you, or because it makes you feel righteous. Alabama and Sam Alito are trying to create an America of tyranny for most and absolute power for some. We should resist them both.